Estimating Chemotherapy Use Among Patients With a Prior Primary Cancer Diagnosis Using SEER-Medicare Data
Estimating Chemotherapy Use Among Patients With a Prior Primary Cancer Diagnosis Using SEER-Medicare Data
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DOI：
10.1093/jncimonographs/lgaa005
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发表时间：
2020-05-01
期刊：
影响因子：
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通讯作者：
Mariotto, Angela B.
中科院分区：
文献类型：
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作者：
Lam, Clara J. K.;Enewold, Lindsey;Mariotto, Angela B.
癌症治疗研究通常排除了先前患有原发性癌症的患者，因为难以确定治疗的部位。监测，流行病学和最终结果-纳入了2004年至2013年期间被诊断患有结肠癌或直肠癌（CRC）或女性乳腺癌（BC）的65岁及以上的医疗保险患者。化疗，定义为“任何化疗”，更严格地说是“确诊的化疗”，根据既往癌症史在索引癌症诊断后6个月内的索赔数据确定。既往患有癌症的患者中任何化疗的使用率略低（CRC：既往无= 17.4%，既往= 16.1%; BC：既往无= 12.9%，既往= 12.0%）。由于需要确诊，估计值较低，尤其是在既往患有癌症的患者中（CRC：既往无= 16.8%，既往= 13.6%; BC：既往无= 12.6%，既往= 11.0%）。这些发现表明，既往患有癌症的患者可以纳入化疗使用研究;需要确证性诊断可以增加治疗分配的信心。
Cancer treatment studies commonly exclude patients with prior primary cancers due to difficulties in ascertaining for which site treatment is intended. Surveillance, Epidemiology, and End Results-Medicare patients 65 years and older diagnosed with an index colon or rectal cancer (CRC) or female breast cancer (BC) between 2004 and 2013 were included. Chemotherapy, defined as "any chemotherapy" and more restrictively as "chemotherapy with confirmatory diagnoses," was ascertained based on claims data within 6 months of index cancer diagnosis by prior cancer history. Any chemotherapy use was slightly lower among patients with a prior cancer (CRC: no prior = 17.4%, prior = 16.1%; BC: no prior = 12.9%, prior = 12.0%). With confirmatory diagnoses required, estimates were lower, especially among patients with a prior cancer (CRC: no prior = 16.8%, prior = 13.6%; BC: no prior = 12.6%, prior = 11.0%). These findings suggest that patients with prior cancers can be included in studies of chemotherapy use; requiring confirmatory diagnoses can increase treatment assignment confidence.