Grant Number:	5R01CA229551-04 Interpret this number
Primary Investigator:	Bradley, Cathy
Organization:	University Of Colorado Denver
Project Title:	Addressing Urban Rural Disparities in Cancer: the Case for Registry Expansion
Fiscal Year:	2022

Geographic disparities among U.S. counties are considerable. Health care disparities between rural and urban Americans, in particular, is worsening. Cancer outcomes are no exception. Progress toward ameliorating disparities has been hindered by a lack of data on the actionable items that lead to improved outcomes. We propose to link the Colorado Central Cancer Registry (CCR) with the statewide All Payer Claims Database (APCD). We supplement these data with the Area Resource File and other public use data to enhance the existing infrastructure. The resulting dataset will contain information at the person, treatment, county, and policy and health care delivery levels for the years 2009-2018. We focus on common adult cancers: breast, cervical, prostate, colorectal, melanoma, and lung. Our aims are: Aim 1: Evaluate the completeness of the linked CCR and APCD in terms of rural/urban residency, race/ethnicity, age, gender, and insurance type (Medicare, Medicaid, private, uninsured). This aim is critical for dissemination and implementation efforts in other states. It serves two purposes: 1) informs the registry about the utility of the APCD in case ascertainment and treatment data and 2) informs the research community about the benefits and pitfalls of using linked registry-APCD data. Aim 2. Measure the relationship between rural residence and the following outcomes: stage, treatment (time to treatment, guideline concordant care, use of newly approved agents), spending, and mortality. H1: Rural residence will be positively associated with adverse outcomes. H2: Hispanics and American Indians residing in rural areas will disproportionately experience poor outcomes relative to their white counterparts in rural areas and their Hispanic counterparts in urban areas. Aim 3: Evaluate the impact of Medicaid's Accountable Care Collaborative (ACC) on cancer outcomes. H1: Enrollment in ACCs improved cancer outcomes for rural residents through enhanced care coordination and prevention. The proposed study will generate new data to inform whether linkages between central cancer registries and All Payer Claims Databases yield valuable data for understanding and addressing disparities, particularly in rural populations. We test hypotheses regarding distance to health care resources and the type of resources available (primary and specialty care) and the policies that govern them. These assessments will inform policy debates about the type of health care investments needed to close the gap between cancer treatment and mortality in rural and urban areas.




Building Data Infrastructure for Disease-Focused Health Economics Research.
Authors: Bradley C.J. , Liang R. , Lindrooth R.C. , Sabik L.M. , Perraillon M.C. .
Source: Medical care, 2023-12-01; 61(12 Suppl 2), p. S147-S152.
EPub date: 2023-11-09.
PMID: 37963034
Related Citations

Post-Acute Care Outcomes of Cancer Patients <65 Reveal Disparities in Care Near the End of Life.
Authors: Singh S. , Molina E. , Perraillon M. , Fischer S.M. .
Source: Journal of palliative medicine, 2023 Aug; 26(8), p. 1081-1089.
EPub date: 2023-02-28.
PMID: 36856522
Related Citations

Treatment Disparities in Radiation and Hormone Therapy Among Women Covered by Medicaid vs Private Insurance in Cancer Registry and Claims Data.
Authors: Bradley C.J. , Sabik L.M. , Liang R. , Lindrooth R.C. , Perraillon M.C. .
Source: JAMA health forum, 2023-05-05; 4(5), p. e230673.
EPub date: 2023-05-05.
PMID: 37145688
Related Citations

The role of all-payer claims databases to expand central cancer registries: Experience from Colorado.
Authors: Perraillon M.C. , Liang R. , Sabik L.M. , Lindrooth R.C. , Bradley C.J. .
Source: Health services research, 2022 Jun; 57(3), p. 703-711.
EPub date: 2021-11-15.
PMID: 34743320
Related Citations

Capitalizing on Central Registries for Expanded Cancer Surveillance and Research.
Authors: Bradley C.J. , Entwistle J. , Sabik L.M. , Lindrooth R.C. , Perraillon M. .
Source: Medical care, 2022-02-01; 60(2), p. 187-191.
PMID: 35030567
Related Citations

Cancer Treatment Data in Central Cancer Registries: When Are Supplemental Data Needed?
Authors: Bradley C.J. , Liang R. , Jasem J. , Lindrooth R.C. , Sabik L.M. , Perraillon M.C. .
Source: Cancer informatics, 2022; 21, p. 11769351221112457.
EPub date: 2022-07-30.
PMID: 35923286
Related Citations

Factors Associated With Use of High-Cost Agents for the Treatment of Metastatic Non-Small Cell Lung Cancer.
Authors: Bradley C.J. , Eguchi M. , Perraillon M.C. .
Source: Journal of the National Cancer Institute, 2020-08-01; 112(8), p. 802-809.
PMID: 31710664
Related Citations