||7R01CA090626-04 Interpret this number
||University Of Texas Hlth Sci Ctr Houston
||Evaluation of Chemotherapy Claims for Breast Cancer
DESCRIPTION (provided by applicant): Over the past several decades, numerous
clinical trials have consistently demonstrated that chemotherapy is efficacious
in both premenopausal and postmenopausal women with breast cancer. However,
little is known about the use of chemotherapy and its effectiveness in the
community because of a lack of large population-based data. While the
Surveillance, Epidemiology and End Results (SEER) tumor registries provide data
on radiation therapy and surgical treatment for breast cancer, they do not
provide information on chemotherapy. They are not required to collect this
information, and the medical records in oncologists' offices, where
chemotherapy is likely to be administered, may not be routinely reviewed for
data on the primary course of cancer-directed therapy.
Medicare claims are a potential source of national data on chemotherapy use for
breast cancer cases aged 65 and older. However, no study has examined the
validity of this information. If Medicare claims provide accurate and complete
data on chemotherapy, their utility for breast cancer research would be
considerably enhanced, allowing for population-based analyses of the current
uses of chemotherapy as well as effectiveness studies in the community.
Therefore, we propose to examine the utility of information on chemotherapy
from Medicare claims data for women aged 65 and older who have been diagnosed
with breast cancer.
Our approach is to identify women aged 65 years or older who have been
diagnosed with breast cancer in the New Mexico Tumor Registry (a SEER
registry), that can be linked with Medicare claims data by unique identifiers.
We will contract with the registry to abstract the medical records on
chemotherapy administration for eligible patients in all facilities including
medical oncologists' offices where patients may have received chemotherapy. We
will then compare information on the use of chemotherapy from medical chart
review with information obtained from Medicare claims data. Our aims are 1) to
determine whether Medicare data can identify women who received chemotherapy
for breast cancer; 2) to determine whether Medicare data can differentiate
among the specific regimens of chemotherapy; and 3) to determine whether the
number of claims can be used to estimate the number of cycles of chemotherapy.
Based on this information, we will characterize the nature and extent of error
in using Medicare claims for chemotherapy effectiveness research among older
women diagnosed with breast cancer. We will then use the Medicare-SEER linked
data for all SEER areas to examine patterns and outcomes of chemotherapy among
older women with breast cancer. Information generated from the medical chart
reviews will also allow us to examine patterns of chemotherapy care independent
of the Medicare claims data or independent of those parts of the claims that we
find generate invalid estimates.
The influence of marital status on the stage at diagnosis, treatment, and survival of older women with breast cancer.
Osborne C, Ostir GV, Du X, Peek MK, Goodwin JS
Breast Cancer Res Treat, 2005 Sep;93(1), p. 41-7.
Effectiveness of adjuvant chemotherapy for node-positive operable breast cancer in older women.
Du XL, Jones DV, Zhang D
J Gerontol A Biol Sci Med Sci, 2005 Sep;60(9), p. 1137-44.
Community-based assessment of adjuvant hormone therapy in women with breast cancer, 1991-1997.
Du XL, Key CR, Osborne C
Breast J, 2004 Sep-Oct;10(5), p. 433-9.
Discrepancy between consensus recommendations and actual community use of adjuvant chemotherapy in women with breast cancer.
Du XL, Key CR, Osborne C, Mahnken JD, Goodwin JS
Ann Intern Med, 2003 Jan 21;138(2), p. 90-7.
Population-based assessment of hospitalizations for toxicity from chemotherapy in older women with breast cancer.
Du XL, Osborne C, Goodwin JS
J Clin Oncol, 2002 Dec 15;20(24), p. 4636-42.