/
Early- and late-age onset colorectal cancer in Kentucky: using health administrative claims-linked Early- and late-age onset colorectal cancer in Kentucky: using health administrative claims-linked

Early- and late-age onset colorectal cancer in Kentucky: using health administrative claims-linked - PowerPoint Presentation

mrsimon
mrsimon . @mrsimon
Follow
346 views
Uploaded On 2020-06-15

Early- and late-age onset colorectal cancer in Kentucky: using health administrative claims-linked - PPT Presentation

Julie S Townsend MS Epidemiologist Division of Cancer Prevention and Control NAACCRIARC Conference June 13 2019 CRC in Kentucky Collaborative and strategic efforts to expand CRC screening across the state ID: 777468

onset crc patients early crc onset early patients data cancer kentucky screening risk claims factors diagnosis late years history

Share:

Link:

Embed:

Download Presentation from below link

Download The PPT/PDF document "Early- and late-age onset colorectal can..." is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.


Presentation Transcript

Slide1

Early- and late-age onset colorectal cancer in Kentucky: using health administrative claims-linked cancer registry data to better understand risk factors and comorbidities

Julie S. Townsend, MS

Epidemiologist, Division of Cancer Prevention and Control

NAACCR/IARC Conference

June 13, 2019

Slide2

CRC in Kentucky

Collaborative and strategic efforts to expand CRC screening across the state

Incidence rates peaked in 2001 at 64.0 per 100,000

Lowest incidence rates in 2015 at 48.4 per 100,000

Considerable progress in reducing overall CRC incidence rates

Slide3

Background

Early-onset Colorectal Cancer (CRC): diagnosed before age 50 years

In the United States,

incidence and

death

rates for colorectal cancer (CRC) have been increasing in persons aged <50

years

Relatively rare among persons aged < 50 years: 7.6 cases per 100,000 in the US from 2011 – 2015

Highest incidence rates

over past 5 years

in Kentucky (9.6 per 100,000) among persons < 50 years

Slide4

CRC Risk Factors

Slide5

Purpose

Study Question

To better understand these trends, we sought to examine risk factors, comorbidities, and screening test use among Kentucky CRC patients

Slide6

Methods

Years: 2007 – 2011Registry data probabilistically linked to claims data from a set of public

(including Medicare and Medicaid),

state employee database, and private Kentucky insurers

Inclusion criteria:

First primary CRC cases

Continuously enrolled for one year prior to their cancer diagnosis

Had at least 1 claim

ICD 9 and CPT codes from claims data captured chronic conditions, screening test use, and risk factors

Captured within

1 year prior

diagnosisDescriptive analysis in SAS comparing early-onset to late-onset CRC patients

Demographic and tumor characteristics

Comorbidities, CRC risk factors, family history of CRC

Screening test use

Average time from screening to diagnosis confirmation, to initial treatment

Data linkages between Kentucky Cancer Registry and health administrative claims data

Slide7

Results

Kentucky, 2007 - 2011

Slide8

Early-onset CRC patients were more frequently male, had rectal cancer, and no other comorbidities

Slide9

However, these differences among early- and late-onset patients were not drastically different

Regional and distant

stage tumors were more

common among early-onset CRC patients

Slide10

There was considerable variation in mean time to diagnosis in both age groups

Mean time to diagnosis and treatment did not differ among early- and late-onset CRC patients in Kentucky

Early-onset

Late-onset

Mean time from diagnostic colonoscopy to CRC diagnosis

18.95±58.79

22.62±61.40

Mean time from CRC diagnosis to treatment initiation

13.04±18.85

14.43±23.41

Slide11

Late-onset CRC patients had higher prevalence of diabetes, hypertension, and poor lipid profiles

Family history of CRC, IBD, obesity, and use of smoking cessation medications were more common among early-onset CRC patients

Slide12

Early-onset CRC patients more frequently had colonoscopy

Slide13

LimitationsObesity prevalence based on claims data

was severely underestimatedExamined risk factors in the year prior to diagnosis, so long term history was not collectedMay affect obesity prevalence, because weight loss associated with advanced CRC

Difficult to discern screening colonoscopy vs. diagnostic colonoscopy Excluded the uninsured

The primary purpose of claims data is for billing, so it can’t always address every research question

Slide14

Summary

Claims data useful to identify comorbidities and screening test useThe linkage included Medicaid and privately insured

patientsIn Kentucky, early-onset CRC patients more frequently had obesity, family history of CRC, and IBD than older counterpartsDiabetes and tobacco-use history both relatively common in early- and late-onset CRC patients

These findings indicate that many early-onset CRC patients may be at risk for a second cancer given their history of obesity, diabetes, and tobacco useImproved recognition of these risk factors in people under age 50 may allow for healthcare discussions about starting screening earlier, if appropriate

Supplementing cancer registry data with claims data has many benefits

Slide15

Acknowledgements:

Kentucky Cancer RegistryBin Huang,

DrPHQuan Chen, DrPH

Eric Tai, MD, MS

Slide16