Department of Public Health and Pediatric Sciences, University of Torino, 10100 Torino, Italy.
Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35121 Padova, Italy.
Int J Environ Res Public Health. 2021 Aug 28;18(17):9076. doi: 10.3390/ijerph18179076.
Treatment of lung cancer depends on the stage of the tumor and the histological type. In recent years, the histological confirmation of lung non-small-cell lung cancer has become crucial since the availability of selective target therapeutic approaches. The aim of the study was to develop a validated procedure to estimate the incidence and prevalence of non-small-cell and small-cell lung cancer from healthcare administrative data. A latent class model for categorical variables was applied. The following observed variables were included in the analysis: ICD-9-CM codes in the Hospital Discharge Registry, ATC codes of medications dispensed present in the Drugs Prescriptions Registry, and the procedure codes in the Outpatient Registry. The proportion of non-small-cell lung cancer diagnoses was estimated to be 85% of the total number of lung cancer on the cohort of incident cases and 89% on the cohort of prevalent cases. External validation on a cohort of 107 patients with a lung cancer diagnosis and histological confirmation showed a sensitivity of 95.6% (95%CI: 89-98.8%) and specificity of 94.1% (95%CI: 71.3-99.9%). The procedure is an easy-to-use tool to design subpopulation-based studies on lung cancer and to better plan resource allocation, which is important since the introduction of new targeted therapies in non-small-cell lung carcinoma.
肺癌的治疗取决于肿瘤的分期和组织学类型。近年来，由于选择性靶向治疗方法的出现，对肺非小细胞肺癌进行组织学确证变得至关重要。本研究旨在开发一种经过验证的程序，以便从医疗保健管理数据中估计非小细胞肺癌和小细胞肺癌的发病率和患病率。应用了用于分类变量的潜在类别模型。在分析中包括以下观察变量：住院出院登记处的 ICD-9-CM 代码、药品处方登记处中存在的药物 ATC 代码以及门诊登记处的程序代码。在新发病例队列中，非小细胞肺癌诊断占肺癌总数的 85%，在现患病例队列中占 89%。对一组 107 例经组织学证实的肺癌诊断患者进行外部验证，结果显示该方法的敏感性为 95.6%（95%CI：89-98.8%），特异性为 94.1%（95%CI：71.3-99.9%）。该程序是一种易于使用的工具，可用于设计基于人群的肺癌研究，并更好地规划资源分配，这在非小细胞肺癌引入新的靶向治疗方法后非常重要。
