Racial Disparities in Delay of Diagnosis and Treatment Among Cancer Patients: Data Management Challenges for the SEER-Medicare Linked Database

• Activity Number: 518
• Type: Contributed
• Date/Time: Wednesday, August 1, 2012 : 10:30 AM to 12:20 PM
• Sponsor: Section on Government Statistics
• Author(s): Ji-Hyun Lee*+ and Kate Fisher and Richard Roetzheim
• Companies: Moffitt Cancer Center and Moffitt Cancer Center and University of South Florida
• Keywords: Racial disparity ; SEER-Medicare linked data ; Algorithm ; Medical claims

Abstract

Minority populations bear a heavier burden of cancer mortality than the non-minority group in the United States. Such disparity has been attempted to be understood with several factors, including delay in diagnosis and treatment. There are three dates of importance when examining diagnostic/treatment delays: date of the clinical/screening abnormality associated with the cancer diagnosis, date of definitive diagnosis, and date of first treatment. However, there is no agreed upon methodology for identifying these dates either from the medical records/medical claims data. This causes difficulties, errors, and inconsistencies between studies. A generalizable strategy to identify reliable dates is imperative before assessing any delays. This study has two aims:(1) Develop an algorithm to estimate reliable dates of diagnosis and treatment from Medicare claims data; 2) Measure disparity in the timeliness and its impact in clinic outcome. Our study population will come from the Surveillance, Epidemiology, and End Results (SEER) cancer registries. The study will utilize data from the SEER-Medicare linked datasets from 1992 to the most recent year for cancer survival status, 2009.