||4UH3CA218909-03 Interpret this number
||Fred Hutchinson Cancer Research Center
||RECAPSE: Recurrence From Claims and Pros for Seer Enhancement
The Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute
serves as a national dashboard for cancer surveillance and is an authoritative resource for cancer
incidence and mortality rates. However, the registry lacks information on cancer recurrence, which is
a major outcome impacting decisions and policies around management of disease at both the
individual and the population levels. The goal of the proposed study is to develop a scalable approach
for population-based ascertainment of cancer recurrence with a specific focus on breast cancer. The
first (UG3) phase of the study will develop an innovative algorithm for detecting a first recurrence by
combining medical claims with patient reported outcomes (PROs). This phase will be conducted in
collaboration with the Seattle-Puget Sound SEER registry and will leverage ongoing research
agreements with Puget Sound payers. Different algorithms will be developed to allow for flexibility in
maximizing sensitivity or specificity. The algorithms will be validated against gold-standard recurrence
information based on electronic medical records from two major local providers. Study participants
will consistent of stage I-III breast cancer patients diagnosed in 2013–2016 on whom “gold standard”
information on recurrence is available. A retrospective case-control design will be employed in which
an equal number of recurrent cases and non-recurrent controls at each validation site will be solicited
for PROs regarding their recurrence histories. All validation activities will explicitly adjust for missing
data resulting from participant non-response to the PRO solicitation. The second (UH3) phase will be
conducted in collaboration with the Kentucky Cancer Registry. The algorithms developed in the UG3
phase will be deployed on all Kentucky stage I-III breast cancer diagnoses in 2015–2017 on whom
claims data are available. This phase will include a validation against medical records from patients
diagnosed at the University of Kentucky Markey Cancer Center over a concurrent period. In this
phase, the study team will develop a visual interface for summarizing recurrence risks overall and
within specified prognostic subgroups. The interface will allow users to examine representativeness of
the patient cohort used to estimate recurrence risks and will also provide estimates that are adjusted
for participant non-response. The proposed work will represent a pioneering effort that establish
whether medical claims data combined with patient self-report constitute a promising avenue towards
determining whether the critical endpoint of cancer recurrence can be added to population-based
Incorporating Breast Cancer Recurrence Events Into Population-Based Cancer Registries Using Medical Claims: Cohort Study.
, Beatty J.D.
, Fedorenko C.
, Markowitz D.
, Corey T.
, Lange J.
, Schwartz S.M.
, Huang B.
, Chubak J.
, Etzioni R.
JMIR cancer, 2020-08-17; 6(2), p. e18143.