德国先进结直肠癌的发病率：比较索赔数据和癌症登记数据。
Incidence of advanced colorectal cancer in Germany: comparing claims data and cancer registry data.
机构信息
Department of Clinical Epidemiology, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, 28359, Bremen, Germany.
Bremen Cancer Registry, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
出版信息
BMC Med Res Methodol. 2019 Jul 8;19(1):142. doi: 10.1186/s12874-019-0784-y.
BACKGROUND
Incidence rates of advanced cancer stages are important, e.g., for monitoring cancer screening programs. However, information from cancer registries on tumor stage is often incomplete. Exemplified by colorectal cancer (CRC), we explored the potential of German claims data to estimate incidence rates of advanced cancer stages.
METHODS
We used claims data of the German Pharmacoepidemiological Research Database (GePaRD; information on > 20 million persons) to identify incident patients with advanced CRC based on ICD-10 codes for CRC and secondary malignant neoplasms. We calculated annual age-standardized incidence rates (ASIRs) of advanced CRC per 100,000 for the years 2008-2015 stratified by the presence of affected lymph nodes only (C77) vs. distant metastases (C78-C79) and compared them to ASIRs determined using data (2008-2014) from the German Centre for Cancer Registry Data (ZfKD).
RESULTS
In GePaRD, the ASIRs of advanced CRC per 100,000 in 2014 were 21.5 among men and 14.9 among women. Compared to ZfKD data the ASIR in GePaRD was 2.58 lower in men and 0.27 higher in women (per 100,000) in 2014. Stratification by presence of distant metastases showed divergent patterns: the ASIRs regarding distant metastases were ~ 50% (women) and ~ 30% (men) higher, and the ASIRs regarding affected lymph nodes only were ~ 40% lower in GePaRD as compared to ZfKD.
CONCLUSION
While ASIRs of advanced CRCs overall agreed well between claims and cancer registry data in 2014, the analyses stratified by presence of distant metastases showed differences. Cancer registries might underestimate ASIRs of CRCs with distant metastases.
背景
晚期癌症阶段的发病率很重要，例如，用于监测癌症筛查计划。然而，癌症登记处关于肿瘤分期的信息往往不完整。以结直肠癌（CRC）为例，我们探讨了德国索赔数据估算晚期癌症阶段发病率的潜力。
方法
我们使用德国药物流行病学研究数据库（GePaRD；超过 2000 万人的信息）的索赔数据，根据 CRC 和继发性恶性肿瘤的 ICD-10 代码识别出晚期 CRC 的新发病例。我们计算了 2008-2015 年每年每 10 万人中晚期 CRC 的年龄标准化发病率（ASIR），按仅受影响的淋巴结（C77）与远处转移（C78-C79）的存在情况进行分层，并将其与德国癌症登记数据中心（ZfKD）的数据（2008-2014 年）确定的 ASIR 进行了比较。
结果
在 GePaRD 中，2014 年男性每 10 万人中晚期 CRC 的 ASIR 为 21.5，女性为 14.9。与 ZfKD 数据相比，2014 年 GePaRD 男性的 ASIR 低 2.58，女性高 0.27（每 10 万人）。按远处转移的存在情况进行分层显示出不同的模式：关于远处转移的 ASIR 高约 50%（女性）和 30%（男性），关于仅受影响的淋巴结的 ASIR 低约 40%。
结论
尽管 2014 年索赔和癌症登记数据之间的晚期 CRC 总体 ASIR 一致，但按远处转移存在情况进行分层的分析显示出差异。癌症登记处可能低估了具有远处转移的 CRC 的 ASIR。
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