Kuliszewski Margaret Gates, Qiao Baozhen, Zhang Xiuling, Anger Holly, Schymura Maria J, Insaf Tabassum
New York State Cancer Registry, New York State Department of Health, Albany, New York.
College of Integrated Health Sciences, University at Albany, Rensselaer, New York.
J Registry Manag. 2024 Winter;51(4):146-157.
Chronic infection with hepatitis B or C substantially increases risk of hepatocellular carcinoma. However, central cancer registries do not routinely collect information on hepatitis diagnoses. We evaluated the extent to which information on hepatitis B or C diagnosis could be ascertained from linked external data sources for cancers reported to the New York State Cancer Registry.
We linked data for 14,747 New York City (NYC) residents diagnosed with liver or intrahepatic bile duct cancer during 2004-2018 to 2 data sources: (1) the NYC Viral Hepatitis Surveillance Registry, which collects information on reported probable and confirmed cases of hepatitis B and C from New York laboratories and health care providers, and (2) the New York Statewide Planning and Research Cooperative System (SPARCS), which captures hepatitis diagnosis codes from hospital inpatient stays and outpatient encounters. We determined whether documentation of hepatitis B or C was present in 1 or both data sources, assessed concordance between the data sources, and used multivariable-adjusted logistic regression to examine factors associated with discordance in hepatitis positivity.
Of the 14,747 cancer cases included, 3,972 had documentation in either data source of hepatitis B (26.9%), 7,599 had documentation of hepatitis C (51.5%), and 9,753 had either diagnosis (66.1%). There was moderate to substantial agreement between the 2 data sources. The percent of NYC patients with any unrecorded hepatitis infection was 12.7% for the hepatitis registry and 7.8% for SPARCS, and discordance in hepatitis positivity was more common in certain individuals, including those aged ≥70 years at cancer diagnosis and those with intrahepatic bile duct cancer, Hispanic ethnicity (hepatitis registry only), and Black or Asian race (SPARCS only).
These results indicate that hospital discharge and public health surveillance data can be used to assess individual-level hepatitis B and C infection status in people diagnosed with liver cancer. Possible reasons for discrepancies between the data sources include incomplete reporting in the hepatitis registry, especially for earlier diagnosis years, differing case inclusion criteria, and differences in the linkage methods for the 2 data sources. This information can be used to enrich cancer registry data for epidemiologic analyses of hepatocellular carcinoma and other cancers.
慢性乙型或丙型肝炎感染会大幅增加肝细胞癌的风险。然而，中央癌症登记机构通常不会常规收集肝炎诊断信息。我们评估了从与纽约州癌症登记处报告的癌症相关的外部数据源中获取乙型或丙型肝炎诊断信息的程度。
我们将2004年至2018年期间被诊断为肝癌或肝内胆管癌的14747名纽约市居民的数据与两个数据源进行了关联：（1）纽约市病毒性肝炎监测登记处，该登记处收集来自纽约实验室和医疗服务提供者报告的可能和确诊的乙型和丙型肝炎病例信息；（2）纽约州全州规划和研究合作系统（SPARCS），该系统从医院住院和门诊就诊记录中获取肝炎诊断代码。我们确定了乙型或丙型肝炎的记录是否存在于一个或两个数据源中，评估了数据源之间的一致性，并使用多变量调整逻辑回归来检查与肝炎阳性不一致相关的因素。
在纳入的14747例癌症病例中，3972例在任一数据源中有乙型肝炎记录（26.9%），7599例有丙型肝炎记录（51.5%），9753例有任一诊断（66.1%）。两个数据源之间存在中度到高度的一致性。纽约市任何未记录的肝炎感染患者在肝炎登记处的比例为12.7%，在SPARCS中的比例为7.8%，肝炎阳性不一致在某些个体中更为常见，包括癌症诊断时年龄≥70岁的人、肝内胆管癌患者、西班牙裔（仅肝炎登记处）以及黑人或亚洲种族（仅SPARCS）。
这些结果表明，医院出院数据和公共卫生监测数据可用于评估肝癌患者个体层面的乙型和丙型肝炎感染状况。数据源之间差异的可能原因包括肝炎登记处报告不完整，尤其是早期诊断年份，病例纳入标准不同，以及两个数据源的关联方法不同。这些信息可用于丰富癌症登记数据，以进行肝细胞癌和其他癌症的流行病学分析。
