Grant Number:	1R01CA090626-01 Interpret this number
Primary Investigator:	Du, Xianglin
Organization:	University Of Texas Medical Br Galveston
Project Title:	Evaluation of Chemotherapy Claims for Breast Cancer
Fiscal Year:	2001

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.




Competing causes of death for women with breast cancer and change over time from 1975 to 2003.
Authors: Du X.L. , Fox E.E. , Lai D. .
Source: American Journal Of Clinical Oncology, 2008 Apr; 31(2), p. 105-16.
PMID: 18391593
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Racial disparities and trends in radiation therapy after breast-conserving surgery for early-stage breast cancer in women, 1992 to 2002.
Authors: Du Xianglin L. , Gor B.J. .
Source: Ethnicity & Disease, 2007 Winter; 17(1), p. 122-8.
PMID: 17274221
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External validation of medicare claims for breast cancer chemotherapy compared with medical chart reviews.
Authors: Du X.L. , Key C.R. , Dickie L. , Darling R. , Geraci J.M. , Zhang D. .
Source: Medical Care, 2006 Feb; 44(2), p. 124-31.
PMID: 16434911
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Information on chemotherapy and hormone therapy from tumor registry had moderate agreement with chart reviews.
Authors: Du X.L. , Key C.R. , Dickie L. , Darling R. , Delclos G.L. , Waller K. , Zhang D. .
Source: Journal Of Clinical Epidemiology, 2006 Jan; 59(1), p. 53-60.
PMID: 16360561
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Temporal and geographic variation in the use of hematopoietic growth factors in older women receiving breast cancer chemotherapy: findings from a large population-based cohort.
Authors: Du X.L. , Lairson D.R. , Begley C.E. , Fang S. .
Source: Journal Of Clinical Oncology : Official Journal Of The American Society Of Clinical Oncology, 2005-12-01 00:00:00.0; 23(34), p. 8620-8.
PMID: 16314624
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Variation in modes of chemotherapy administration for breast carcinoma and association with hospitalization for chemotherapy-related toxicity.
Authors: Du X.L. , Chan W. , Giordano S. , Geraci J.M. , Delclos G.L. , Burau K. , Fang S. .
Source: Cancer, 2005-09-01 00:00:00.0; 104(5), p. 913-24.
PMID: 15991239
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Effectiveness of adjuvant chemotherapy for node-positive operable breast cancer in older women.
Authors: Du X.L. , Jones D.V. , Zhang D. .
Source: The Journals Of Gerontology. Series A, Biological Sciences And Medical Sciences, 2005 Sep; 60(9), p. 1137-44.
PMID: 16183952
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The influence of marital status on the stage at diagnosis, treatment, and survival of older women with breast cancer.
Authors: Osborne C. , Ostir G.V. , Du X. , Peek M.K. , Goodwin J.S. .
Source: Breast Cancer Research And Treatment, 2005 Sep; 93(1), p. 41-7.
PMID: 16184457
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Community-based assessment of adjuvant hormone therapy in women with breast cancer, 1991-1997.
Authors: Du X.L. , Key C.R. , Osborne C. .
Source: The Breast Journal, 2004 Sep-Oct; 10(5), p. 433-9.
PMID: 15327498
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Discrepancy between consensus recommendations and actual community use of adjuvant chemotherapy in women with breast cancer.
Authors: Du X.L. , Key C.R. , Osborne C. , Mahnken J.D. , Goodwin J.S. .
Source: Annals Of Internal Medicine, 2003-01-21 00:00:00.0; 138(2), p. 90-7.
PMID: 12529090
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Population-based assessment of hospitalizations for toxicity from chemotherapy in older women with breast cancer.
Authors: Du X.L. , Osborne C. , Goodwin J.S. .
Source: Journal Of Clinical Oncology : Official Journal Of The American Society Of Clinical Oncology, 2002-12-15 00:00:00.0; 20(24), p. 4636-42.
PMID: 12488407
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Increase of chemotherapy use in older women with breast carcinoma from 1991 to 1996.
Authors: Du X. , Goodwin J.S. .
Source: Cancer, 2001-08-15 00:00:00.0; 92(4), p. 730-7.
PMID: 11550141
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