scholarly journals 807Association between diabetes and adjuvant chemotherapy implementation among patients with stage III colorectal cancer

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Rieko Kanehara ◽  
Atsushi Goto ◽  
Tomone Watanabe ◽  
Kosuke Inoue ◽  
Masataka Taguri ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Adjuvant Chemotherapy ◽  
Postoperative Complications ◽  
Mediation Analysis ◽  
Claims Data ◽  
Health Claims ◽  
Stage Iii ◽  
Implementation Rate ◽  
Health Claims Data ◽  
To Receive

Abstract Background Preexisting diabetes may contribute to the indication for adjuvant chemotherapy among patients with colorectal cancer (CRC); however, the association between diabetes and its implementation is largely unknown. Methods We analyzed the hospital-based cancer registry and health claims data of patients with stage III CRC who received curative surgery in 2013 in Japan (n = 6,344). Chemotherapy and diabetes was identified based on procedure, prescription, and diabetes codes in claims data. We examined the association between diabetes and implementation rate of adjuvant chemotherapy using the generalized linear model adjusted for age, sex, and updated Charlson Comorbidity Index, hospital type, and prefecture. We further applied a mediation analysis to examine the extent to which postoperative complications mediated the association. Results Of these, 1,236 (19.5%) had diabetes. Compared with those without diabetes, patients with diabetes were less likely to receive adjuvant chemotherapy (crude rate: 58.9% and 49.8%; adjusted percentage point difference: 4.7% [95% confidence limits: 1.7, 7.5]). Mediation analysis indicated that postoperative complications explained 9.4% of the association between diabetes and adjuvant chemotherapy implementation. Conclusions Our findings suggest that patients with stage III CRC and diabetes are less likely to receive adjuvant chemotherapy than those without diabetes, and postoperative complications may partially account for the association. Key messages Concomitant diabetes might negatively impact the implementation rate of adjuvant chemotherapy in patients with stage III CRC.

The influence of employer-based health insurance and job support on receipt of adjuvant chemotherapy in stage III colorectal cancer.

2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 278-278
Author(s):  
Christine Marie Veenstra ◽  
Scott E. Regenbogen ◽  
Sarah T. Hawley ◽  
Mousumi Banerjee ◽  
Ikuko Kato ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Health Insurance ◽  
Adjuvant Chemotherapy ◽  
Insurance Coverage ◽  
Stage Iii ◽  
Medical Illness ◽  
Recommended Care ◽  
Job Support ◽  
Catchment Areas ◽  
To Receive

278 Background: Approximately 15% of the U.S. population lacks health insurance. Adjuvant chemotherapy confers significant survival benefit in stage III colorectal cancer (CRC), yet many patients fail to receive recommended care. We hypothesized that access to employer-based health insurance (EBHI) and other job-related support programs influences receipt of chemotherapy. Methods: We performed a population-based survey of patients diagnosed with stage III CRC in the state of Georgia and Metropolitan Detroit SEER catchment areas. The primary outcome was receipt of adjuvant chemotherapy. Patients were queried regarding clinical, sociodemographic, and employment characteristics (EBHI and job support - e.g., sick leave, disability, flexible schedule, unpaid time off). We used χ2 analyses to examine associations between health insurance coverage, job support availability and receipt of chemotherapy, adjusting for other characteristics. Results: To date, 630 patients have responded (preliminary response rate=56%). 257 (41%) were working for pay at diagnosis, of whom 46% had EBHI and 9% had no insurance at all. Rates of chemotherapy receipt were higher among those with EBHI than those without (97% vs. 90%, P=0.001). 26% with EBHI reported that they kept their job mainly to keep insurance. 79% of those working for pay reported some form of available job support. Rates of chemotherapy receipt were higher among employed respondents with job support compared to those without (97% vs. 85%, P<0.001). Availability of job support was significantly associated with ability to retain employment; 48% of those without support stopped working altogether because of CRC vs. only 11% of those with support (P<0.001). Conclusions: Patients with EBHI and job support were significantly more likely to receive recommended adjuvant chemotherapy after surgery for stage III CRC. Further, lack of job-related support for medical illness was significantly associated with loss of employment for patients undergoing treatment for CRC. These findings suggest that employer-based health insurance and job support are important contributors to receipt of recommended cancer care.

The efficacy of adjuvant chemotherapy for resected high-risk stage II and stage III colorectal cancer in frail patients

2021 ◽  
Author(s):  
Kosuke Mima ◽  
Nobutomo Miyanari ◽  
Keisuke Kosumi ◽  
Takuya Tajiri ◽  
Kosuke Kanemitsu ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
High Risk ◽  
Adjuvant Chemotherapy ◽  
Stage Ii ◽  
Stage Iii ◽  
Frail Patients

scholarly journals Predictive modeling of nontuberculous mycobacterial pulmonary disease epidemiology using German health claims data

2021 ◽  
Vol 104 ◽  
pp. 398-406
Author(s):  
Felix C. Ringshausen ◽  
Raphael Ewen ◽  
Jan Multmeier ◽  
Bondo Monga ◽  
Marko Obradovic ◽  
...  
Keyword(s):  
Pulmonary Disease ◽  
Predictive Modeling ◽  
Claims Data ◽  
Health Claims ◽  
Disease Epidemiology ◽  
German Health ◽  
Health Claims Data

scholarly journals Actual survival after resection of primary colorectal cancer: results from a prospective multicenter study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Inge van den Berg ◽  
Robert R. J. Coebergh van den Braak ◽  
Jeroen L. A. van Vugt ◽  
Jan N. M. Ijzermans ◽  
Stefan Buettner
Keyword(s):  
Colorectal Cancer ◽  
Postoperative Complications ◽  
Multicenter Study ◽  
Survival Data ◽  
Standard Therapy ◽  
Tumor Grade ◽  
National Registry ◽  
Stage I ◽  
Stage Iii ◽  
Curative Intent

Abstract Background Colorectal cancer is the third most common type of cancer in the world. We characterize a cohort of patients who survived up to 5 years without recurrence and identify factors predicting the probability of cure. Methods We analyzed data of patients who underwent curative intent surgery for stage I–III CRC between 2007 and 2012 and who had had been included in a large multicenter study in the Netherlands. Cure was defined as 5-year survival without recurrence. Survival data were retrieved from a national registry. Results Analysis of data of 754 patients revealed a cure rate of 65% (n = 490). Patients with stage I disease and T1- and N0-tumor had the highest probability of cure (94%, 95% and 90%, respectively). Those with a T4-tumor or N2-tumor had the lowest probability of cure (62% and 50%, respectively). A peak in the mortality rate for older patients early in follow-up suggests early excess mortality as an explanation. A similar trend was observed for stage III disease, poor tumor grade, postoperative complications, sarcopenia, and R1 resections. Patients with stage III disease, poor tumor grade, postoperative complications, sarcopenia, and R1 resections show a similar trend for decrease in CSS deaths over time. Conclusion In the studied cohort, the probability of cure for patients with stage I–III CRC ranged from 50 to 95%. Even though most patients will be cured from CRC with standard therapy, standard therapy is insufficient for those with poor prognostic factors, such as high T- and N-stage and poor differentiation grade.

scholarly journals JADE: A tool for medical researchers to explore adverse drug events using health claims data

2014 ◽  
Vol 05 (03) ◽  
pp. 621-629 ◽  
Author(s):  
S.K. Sauter ◽  
C. Rinner ◽  
L.M. Neuhofer ◽  
M. Wolzt ◽  
W. Grossmann ◽  
...  
Keyword(s):  
Adverse Drug Events ◽  
Claims Data ◽  
Age Groups ◽  
Rule Learning ◽  
Health Claims ◽  
Drug Event ◽  
Study Cohort ◽  
Defined Daily Doses ◽  
Health Claims Data ◽  
Medical Researchers

SummaryObjective: The objective of our project was to create a tool for physicians to explore health claims data with regard to adverse drug reactions. The Java Adverse Drug Event (JADE) tool should enable the analysis of prescribed drugs in connection with diagnoses from hospital stays.Methods: We calculated the number of days drugs were taken by using the defined daily doses and estimated possible interactions between dispensed drugs using the Austria Codex, a database including drug-drug interactions. The JADE tool was implemented using Java, R and a PostgreSQL database.Results: Beside an overview of the study cohort which includes selection of gender and age groups, selected statistical methods like association rule learning, logistic regression model and the number needed to harm have been implemented.Conclusion: The JADE tool can support physicians during their planning of clinical trials by showing the occurrences of adverse drug events with population based information.Citation: Edlinger D, Sauter SK, Rinner C, Neuhofer LM, Wolzt M, Grossmann W, Endel G, Gall W. JADE: A tool for medical researchers to explore adverse drug events using health claims data. Appl Clin Inf 2014; 5: 621–629http://dx.doi.org/10.4338/ACI-2014-04-RA-0036

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