Validity of cancer diagnosis in the National Health Insurance database compared with the linked National Cancer Registry in Taiwan

Kao, Wei-Chun; Hong, Ji-Hong; See, Lai‐Chu; Yu, Huang-Ping; Hsu, Jun‐Te; Chou, I-Jun; Chou, Wen‐Chi; Chiou, Meng-Jiun; Wang, Chun‐Chieh; Kuo, Chang‐Fu

doi:10.1002/pds.4267

Cited by 90 publications

(81 citation statements)

References 23 publications

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“…Fifth, the index date of HNC in the RCIPD is actually the date of application instead of date of cancer diagnosis. Previous study reported a delay of median of 15 days after cancer diagnosis was noted in the date of application in the NHIRD 28 . Nevertheless, in this study, we focused on the long-term outcome (more than 10 years).…”

Section: Discussionmentioning

confidence: 97%

A nationwide population-based study to access the risk of metachronous esophageal cancers in head and neck cancer survivors

Tseng

Wang

Lee

et al. 2020

Sci Rep

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How long esophageal screening should be performed for, and on which subgroups of head and neck cancer (HNC) survivors, remains uncertain. This retrospective study analyzed data from the Taiwan National Health Insurance Research Database from 1999 to 2013. A total of 68,131 newly-diagnosed HNC patients were enrolled. Subjects who received esophageal endoscopic screening within 6 months after their diagnosis date of index HNC were identified. The incidence trends of secondary primary EC were analyzed using a Cochran-Armitage trend test. Among the 9,707 patients who received index esophageal endoscopy screening, 101 (1.0%) cases of synchronous EC were diagnosed. The 5-and 10-year cumulative incidence rates of metachronous ECs were 1.4% and 2.7%, respectively in those with an initial negative index endoscopic finding. Patients with oropharynx or hypopharynx cancers were at significantly higher risk of developing metachronous ECs compared with those with oral or larynx cancers (10-year incidence rate: 3.3% vs. 0.9%, respectively; hazard ratio: 2.15; 95% confidence intervals: 1.57-2.96). Metachronous EC continues to develop in patients with HNC even at 10-years after treatment for primary HNC. HNC patients, especially those with oropharynx or hypopharynx cancer, may require long-term endoscopic surveillance.

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Section: Discussionmentioning

confidence: 97%

A nationwide population-based study to access the risk of metachronous esophageal cancers in head and neck cancer survivors

Tseng

Wang

Lee

et al. 2020

Sci Rep

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“…The HWDS claim data, which are managed by the Taiwan MOHW, consist of all medical records of more than 99% Taiwanese residents 22 . The diagnostic accuracy of the major diseases such as stroke, cardiovascular, and cancers was confirmed in other studies 22‐24 . The database is linked to the cancer patient data from the TCR and patient mortality from the TDR 25 .…”

Section: Methodsmentioning

confidence: 99%

Statins use and its impact in EGFR‐TKIs resistance to prolong the survival of lung cancer patients: A Cancer registry cohort study in Taiwan

et al. 2020

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Statins have been shown to be a beneficial treatment as chemotherapy and target therapy for lung cancer. This study aimed to investigate the effectiveness of statins in combination with epidermal growth factor receptor‐tyrosine kinase inhibitor therapy for the resistance and mortality of lung cancer patients. A population‐based cohort study was conducted using the Taiwan Cancer Registry database. From January 1, 2007, to December 31, 2012, in total 792 non‐statins and 41 statins users who had undergone EGFR‐TKIs treatment were included in this study. All patients were monitored until the event of death or when changed to another therapy. Kaplan‐Meier estimators and Cox proportional hazards regression models were used to calculate overall survival. We found that the mortality was significantly lower in patients in the statins group compared with patients in the non‐statins group (4‐y cumulative mortality, 77.3%; 95% confidence interval (CI), 36.6%‐81.4% vs. 85.5%; 95% CI, 78.5%‐98%; P = .004). Statin use was associated with a reduced risk of death in patients the group who had tumor sizes <3 cm (hazard ratio [HR], 0.51, 95% CI, 0.29‐0.89) and for patients in the group who had CCI scores <3 (HR, 0.6; 95% CI, 0.41‐0.88; P = .009). In our study, statins were found to be associated with prolonged survival time in patients with lung cancer who were treated with EGFR‐TKIs and played a synergistic anticancer role.

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“…Individual information contained in the NHI database during 2002-2014 was encrypted utilizing the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code. e NHIRD is a large representative health care database, and its validity and clinical consistency in cancer research have been proved [16].…”

Section: Source Data and Study Populationmentioning

confidence: 99%

“…Using a unique personal encrypted identification number for each beneficiary in Taiwan, we are able to crosslink efficiently among different subsets of the NHI database. e internal linkage between each dataset is robust, and the data quality was accepted with validity in previous publications [16,17]. is population-based cohort study comprised ethnic Taiwanese patients with the main diagnosis of lung cancer (ICD-9-CM code 162.xx) identified via the NHIRD from 2002 to 2014. e histological subtypes of lung cancer were retrieved from the TCRD, while the survival rates were extracted from the NDR database.…”

Section: Source Data and Study Populationmentioning

confidence: 99%

Epidemiology and Survival Outcomes of Lung Cancer: A Population-Based Study

Lin

Liu

et al. 2019

BioMed Research International

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Purpose. Lung cancer has been the top-ranking cause of cancer deaths in Taiwan for decades. Limited data were available in global cancer surveillance regarding lung cancer epidemiology in Taiwan, and previous reports are outdated. Patients and Methods. This population-based cohort study extracted data of patients with lung cancer from the Taiwan National Health Insurance database and determined the lung cancer incidence and prevalence during 2002–2014. Histological subtypes were retrieved from the Taiwan Cancer Registry database; survival rates were gathered from the National Death Registry. Average annual percentage changes (APCs) of prevalence, incidence, and overall survival were estimated by joinpoint regression analysis. Results. Age-standardized incidence of lung cancer increased from 45.04 per 100,000 person-years in 2002 to 49.86 per 100,000 person-years in 2014, with an average APC of 0.7 (95% CI = 0.3–1.1; 0.2 in males, 2.0 in females). Lung cancer was more prevalent in male patients, but this increase gradually slowed down. Socioeconomic analysis showed that lung cancer has higher prevalence in patients with higher income level and urban residency. Adenocarcinoma was the most abundant histological subtype in Taiwan (adenocarcinoma-to-squamous cell carcinoma ratio = 4.16 in 2014), with a 2.4-fold increase of incident cases during 2002–2014 (from 43.47% to 64.89% of all lung cancer cases). The 5-year survival rate of lung cancer patients in 2010 was 17.34% (12.60% in male, 25.40% in female), with an average APC of 9.3 (6.3 in male, 11.8 in female) during 2002–2010. Conclusion. Average APCs of prevalence and incidence of lung cancer were 3.1 and 0.7, respectively, during 2002–2014 in Taiwan. The number of female patients and number of patients with adenocarcinoma have increased the most, with incident cases doubling in these years. Facing this fatal malignancy, it is imperative to improve risk stratification, encourage early surveillance, and develop effective therapeutics for lung cancer patients in Taiwan.

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Validity of cancer diagnosis in the National Health Insurance database compared with the linked National Cancer Registry in Taiwan

Abstract: Recording of cancer diagnoses and survival estimates based on these diagnosis codes in the NHI database are generally consistent with the NCR. Studies using NHI database data must pay careful attention to eligibility and record linkage; use of both sources is recommended.

Cited by 90 publications

References 23 publications

A nationwide population-based study to access the risk of metachronous esophageal cancers in head and neck cancer survivors

A nationwide population-based study to access the risk of metachronous esophageal cancers in head and neck cancer survivors

Statins use and its impact in EGFR‐TKIs resistance to prolong the survival of lung cancer patients: A Cancer registry cohort study in Taiwan

Epidemiology and Survival Outcomes of Lung Cancer: A Population-Based Study

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