TY - JOUR
T1 - Using health insurance claims data to assess long-term disease progression in a prostate cancer cohort
AU - Khan, Saira
AU - Vohra, Sanah
AU - Farnan, Laura
AU - Elmore, Shekinah N.C.
AU - Toumbou, Khadijah
AU - Madhav, K. C.
AU - Fontham, Elizabeth T.H.
AU - Peters, Edward S.
AU - Mohler, James L.
AU - Bensen, Jeannette T.
N1 - Funding Information:
The North Carolina−Louisiana Prostate Cancer Project (PCaP) and the Health Care Access and Prostate Cancer Treatment in North Carolina (HCaP‐NC) study were carried out as collaborative studies supported by the Department of Defense contract DAMD 17‐03‐2‐0052 and the American Cancer Society award RSGT‐08‐008‐01‐CPHPS, respectively. Racial Differences in Financial Impact of Prostate Cancer Treatment and Outcome (10‐year follow‐up survey) was carried out as a collaborative study supported by the Department of Defense contract DAMD W81XWH‐17‐1‐0119. In addition, work on this study was supported by the Cancer Information and Population Health Resource, UNC Lineberger Comprehensive Cancer Center, with funding provided by the University Cancer Research Fund via the state of North Carolina. S. V. was supported by the UNC Cancer Control Education Program (T32CA057726). The authors thank the staff, advisory committees, and research subjects participating in the PCaP study for their important contributions.
Publisher Copyright:
© 2022 Wiley Periodicals LLC.
PY - 2022/11/1
Y1 - 2022/11/1
N2 - Background: Long-term population-based cohort studies of men diagnosed with prostate cancer are limited. However, adverse outcomes can occur many years after treatment. Herein, we aim to assess the utility of using claims data to identify prostate cancer progression 10−15 years after diagnosis. Methods: The study population was derived from the North Carolina−Louisiana Prostate Cancer Project (PCaP). PCaP-North Carolina (NC) included 1031 men diagnosed with prostate cancer from 2004 to 2009. An initial follow-up with a survey and manual medical record abstraction occurred from 2008 to 2011 (Follow-up 1). Herein, we extended this follow-up with linkage to healthcare claims data from North Carolina (2011−2017) and a second, supplementary 10-year follow-up survey (2018−2020) (Follow-up 2). Vital statistics data also were utilized. Long-term oncological progression was determined using these data sources in combination with expert clinical input. Results: Among the 1031 baseline PCaP-NC participants, 652 were linked to medical claims. Forty-two percent of the men had insurance coverage for the entire 72 months of follow-up. In addition, 275 baseline participants completed the supplementary 10-year follow-up survey. Using all sources of follow-up data, we identified a progression event in 259 of 1031 (25%) men with more than 10 years of follow-up data after diagnosis. Conclusions: Understanding long-term clinical outcomes is essential for improving the lives of prostate cancer survivors. However, access and utility of long-term clinical outcomes with claims alone remain a challenge due to individualized agreements required with each insurer for data access, lack of detailed clinical information, and gaps in insurance coverage. We were able to utilize claims data to determine long-term progression due to several unique advantages that included the availability of detailed baseline clinical characteristics and treatments, detailed manually abstracted clinical data at 5 years of follow-up, vital statistics data, and a supplementary 10-year follow-up survey.
AB - Background: Long-term population-based cohort studies of men diagnosed with prostate cancer are limited. However, adverse outcomes can occur many years after treatment. Herein, we aim to assess the utility of using claims data to identify prostate cancer progression 10−15 years after diagnosis. Methods: The study population was derived from the North Carolina−Louisiana Prostate Cancer Project (PCaP). PCaP-North Carolina (NC) included 1031 men diagnosed with prostate cancer from 2004 to 2009. An initial follow-up with a survey and manual medical record abstraction occurred from 2008 to 2011 (Follow-up 1). Herein, we extended this follow-up with linkage to healthcare claims data from North Carolina (2011−2017) and a second, supplementary 10-year follow-up survey (2018−2020) (Follow-up 2). Vital statistics data also were utilized. Long-term oncological progression was determined using these data sources in combination with expert clinical input. Results: Among the 1031 baseline PCaP-NC participants, 652 were linked to medical claims. Forty-two percent of the men had insurance coverage for the entire 72 months of follow-up. In addition, 275 baseline participants completed the supplementary 10-year follow-up survey. Using all sources of follow-up data, we identified a progression event in 259 of 1031 (25%) men with more than 10 years of follow-up data after diagnosis. Conclusions: Understanding long-term clinical outcomes is essential for improving the lives of prostate cancer survivors. However, access and utility of long-term clinical outcomes with claims alone remain a challenge due to individualized agreements required with each insurer for data access, lack of detailed clinical information, and gaps in insurance coverage. We were able to utilize claims data to determine long-term progression due to several unique advantages that included the availability of detailed baseline clinical characteristics and treatments, detailed manually abstracted clinical data at 5 years of follow-up, vital statistics data, and a supplementary 10-year follow-up survey.
KW - insurance claims
KW - long-term follow-up
KW - PCaP-NC
KW - progression
KW - prostate cancer
UR - http://www.scopus.com/inward/record.url?scp=85134769093&partnerID=8YFLogxK
U2 - 10.1002/pros.24418
DO - 10.1002/pros.24418
M3 - Article
C2 - 35880605
AN - SCOPUS:85134769093
VL - 82
SP - 1447
EP - 1455
JO - Prostate
JF - Prostate
SN - 0270-4137
IS - 15
ER -