Gallaway Michael Shayne, Huang Bin, Chen Quan, Tucker Tom, McDowell Jaclyn, Durbin Eric, Siegel David, Tai Eric
Centers for Disease Control and Prevention, Atlanta, GA.
University of Kentucky, Lexington, KY.
JCO Clin Cancer Inform. 2019 May;3:1-8. doi: 10.1200/CCI.19.00011.
Linkage of cancer registry data with complementary data sources can be an informative way to expand what is known about patients and their treatment and improve delivery of care. The purpose of this study was to explore whether patient smoking status and smoking-cessation modalities data in the Kentucky Cancer Registry (KCR) could be augmented by linkage with health claims data.
The KCR conducted a data linkage with health claims data from Medicare, Medicaid, state employee insurance, Humana, and Anthem. Smoking status was defined as documentation of personal history of tobacco use (International Classification of Diseases, Ninth Revision [ICD-9] code V15.82) or tobacco use disorder (ICD-9 305.1) before and after a cancer diagnosis. Use of smoking-cessation treatments before and after the cancer diagnosis was defined as documentation of smoking-cessation counseling (Healthcare Common Procedure Coding System codes 99406, 99407, G0375, and G0376) or pharmacotherapy (eg, nicotine replacement therapy, bupropion, varenicline).
From 2007 to 2011, among 23,703 patients in the KCR, we discerned a valid prediagnosis smoking status for 78%. KCR data only (72%), claims data only (6%), and a combination of both data sources (22%) were used to determine valid smoking status. Approximately 4% of patients with cancer identified as smokers (n = 11,968) and were provided smoking-cessation counseling, and 3% were prescribed pharmacotherapy for smoking cessation.
Augmenting KCR data with medical claims data increased capture of smoking status and use of smoking-cessation modalities. Cancer registries interested in exploring smoking status to influence treatment and research activities could consider a similar approach, particularly if their registry does not capture smoking status for a majority of patients.
将癌症登记数据与补充数据源相链接，可能是一种扩充对患者及其治疗情况的了解并改善医疗服务提供的有效方式。本研究的目的是探讨肯塔基癌症登记处（KCR）中患者的吸烟状况及戒烟方式数据能否通过与健康保险理赔数据相链接得到扩充。
KCR将数据与来自医疗保险、医疗补助、州政府雇员保险、Humana和Anthem的健康保险理赔数据进行了链接。吸烟状况定义为癌症诊断前后记录的个人烟草使用史（国际疾病分类第九版[ICD-9]编码V15.82）或烟草使用障碍（ICD-9 305.1）。癌症诊断前后使用戒烟治疗定义为记录有戒烟咨询（医疗保健通用程序编码系统编码99406、99407、G0375和G0376）或药物治疗（如尼古丁替代疗法、安非他酮、伐尼克兰）。
2007年至2011年期间，在KCR的23703名患者中，我们识别出78%的患者在诊断前有有效的吸烟状况。仅使用KCR数据（72%）、仅使用理赔数据（6%）以及同时使用这两种数据源（22%）来确定有效的吸烟状况。约4%被确定为吸烟者的癌症患者（n = 11968）接受了戒烟咨询，3%被开了戒烟药物治疗。
用医疗理赔数据扩充KCR数据可增加对吸烟状况的获取以及戒烟方式的使用。对探索吸烟状况以影响治疗和研究活动感兴趣的癌症登记处可考虑类似方法，特别是如果其登记处未获取大多数患者的吸烟状况。
