Prevalence of hypercalcemia among cancer patients in the United States
Prevalence of hypercalcemia among cancer patients in the United States
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DOI：
10.1002/cam4.749
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发表时间：
2016-08-01
期刊：
影响因子：
4
通讯作者：
Liede, Alexander
中科院分区：
文献类型：
--
作者：
Gastanaga, Victor M.;Schwartzberg, Lee S.;Liede, Alexander
恶性肿瘤高钙血症（HCM）是一种严重的代谢并发症，其基于人群的患病率尚未量化。HCM的发病率因肿瘤类型而异，多发性骨髓瘤患者的发病率最高，结直肠癌和前列腺癌患者的发病率最低。该分析估计了HCM在美国的患病率。这项回顾性研究使用肿瘤服务综合电子记录（OSCER）电子健康记录（EHR）仓库，包括565个肿瘤门诊站点治疗的569000名患者的实验室值。通过将电子病历与索赔数据联系起来，将oser数据预测到国家层面。纳入的癌症患者年龄为18岁，有血清钙（Ca）和白蛋白（校正后的血清钙[CSC]）记录。根据HCM CTCAE分级、肿瘤类型和年份（2009-2013年）估算期患病率。根据可与办公室和医院数据相关联的患者子集，对估计进行了调整，以捕获肿瘤实践之外诊断为HCM的患者。该分析包括68023例（2009年）至121482例（2013年）癌症患者。2013年，HCM患者中位数为6次Ca检测，69.7%接受化疗，34%接受骨修饰剂。多发性骨髓瘤患者HCM发生率最高（7.5%[2012]-10.2%[2010]），前列腺癌最低（1.4%[2012]-2.1%[2011]）。2009 - 2013年调整后HCM年患病率分别为95441、96281、89797、70158和71744。HCM占所有癌症患者的2.0-2.8%。来自肿瘤诊所的电子病历数据对本研究至关重要，因为这些数据包含实验室研究的结果（即血清钙值），这是在该环境中常规要求的。我们估计2013年HCM在美国的患病率为71744，影响了大约2%的癌症患者。这一比例因肿瘤类型而异，在5年的研究期间似乎有所下降。
Hypercalcemia of malignancy (HCM) is a serious metabolic complication whose population-based prevalence has not been quantified. Rates of HCM differ by tumor type, with highest rates reported in multiple myeloma and lowest among colorectal and prostate cancer patients. This analysis estimates HCM prevalence in the US. This retrospective study used the Oncology Services Comprehensive Electronic Records (OSCER) warehouse of electronic health records (EHR) including laboratory values from 569000 patients treated at 565 oncology outpatient sites. OSCER data were projected to the national level by linking EHR to claims data. Cancer patients included were 18years, and had serum calcium (Ca) and albumin (for corrected serum Ca [CSC]) records. Period prevalence was estimated by HCM CTCAE grade, tumor type, and year (2009-2013). Estimates were adjusted to capture patients diagnosed with HCM outside oncology practices based on a subset of patients linkable to office and hospital data. The analysis included 68023 (2009) to 121482 (2013) cancer patients. In 2013, patients with HCM had a median of six Ca tests, 69.7% had chemotherapy, and 34% received bone modifying agents. HCM rates were highest for multiple myeloma patients (7.5% [2012]-10.2% [2010]), lowest for prostate cancer (1.4% [2012]-2.1% [2011]).The estimated adjusted annual prevalence of HCM from 2009 to 2013 was 95441, 96281, 89797, 70158, and 71744, respectively. HCM affected 2.0-2.8% of all cancer patients. EHR data from oncology clinics were critical for this study because these data contain results from laboratory studies (i.e., serum calcium values) that are routinely ordered in that setting. We estimated that the prevalence of HCM in the US in 2013 is 71744, affecting approximately 2% of cancer patients overall. This percentage differs by tumor type and appears to have decreased over the five-year study period.