Challenges and opportunities in measuring cancer recurrence in the United States

Cancer recurrence and disease-free survival are key outcomes for measuring the burden of illness, assessing the quality of cancer care, and informing decisions about increasingly costly cancer therapies. Yet information about recurrence is not collected in cancer registries or other population-based...

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Bibliographic Details
Published in:JNCI : Journal of the National Cancer Institute 2015-08, Vol.107 (8), p.djv134-djv134
Main Authors: Warren, Joan L, Yabroff, K Robin
Format: Article
Language:English
Subjects:
Algorithms
Disease-Free Survival
Electronic Health Records - statistics & numerical data
Humans
Insurance Claim Review - statistics & numerical data
Insurance, Health
Neoplasm Recurrence, Local - epidemiology
Neoplasms - epidemiology
Neoplasms - mortality
Neoplasms - pathology
Population Surveillance - methods
Recurrence
Registries
Software
United States
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Summary:Cancer recurrence and disease-free survival are key outcomes for measuring the burden of illness, assessing the quality of cancer care, and informing decisions about increasingly costly cancer therapies. Yet information about recurrence is not collected in cancer registries or other population-based data sources. To address the lack of population-based recurrence information, researchers are increasingly using algorithms applied to health claims to infer recurrence. However, the validity of these approaches has not been comprehensively evaluated. In this commentary, we review existing studies and discuss options for improving the availability of recurrence data. We found that the validity of claims-based approaches appears promising in small, single institution studies, but larger population-based studies have identified substantial limitations with using claims to identify recurrence. With the increasing availability of health data, there are potential options that can be implemented to enhance information about recurrence. These options include design of software for the electronic medical record that enables rapid and standardized reporting of recurrence, use of electronic pathology reports to facilitate streamlined collection of recurrence by cancer registries, and mandates by insurers to require reporting of recurrence on health claims submitted by physicians. All of these options will require that governmental agencies, health insurers, professional societies, and other groups recognize the importance of population-based recurrence data and determine that this information is a priority for assessing cancer outcomes and costs.
ISSN:0027-8874
1460-2105
DOI:10.1093/jnci/djv134