scholarly journals Incidence of First-Line and Second-Line Myelodysplastic Syndrome in a US Commercial Claims Database

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 6008-6008
Author(s):  
Christopher R. Cogle ◽  
Sandra E. Kurtin ◽  
Tanya GK Bentley ◽  
Michael S Broder ◽  
Eunice Chang ◽  
...  

Abstract Background: The myelodysplastic syndromes (MDS) include a group of malignancies characterized by myeloid stem cell origin and increasing incidence with age. Although treatment is available with hypomethylating agents (HMAs), 80% of patients fail to achieve remission and nearly all patients eventually develop chemoresistant disease. The incidence of MDS 1st-line HMA treatment failures has not been previously reported. Methods: We examined US commercial health insurance claims data to estimate the annual incidence of MDS and the number of MDS patients potentially eligible for 2nd-line therapy. We conducted a retrospective cohort study of patients with an MDS-associated medical claim (ICD-9-CM diagnosis code 238.7x) in the identification (ID) period (calendar year 2009). The subgroup of newly diagnosed patients had no prior MDS diagnosis in the pre-ID period (calendar year 2008); patients newly treated with HMA had a claim for HMA in the ID but not pre-ID periods. Using expert input, we defined MDS patients as potential candidates for 2nd-line therapy if they used an HMA in the ID period and stopped for ≥2 months, switched to another HMA, or remained on the first HMA for >7 months. MDS incidence rates were stratified by age (≤49, 50-64, 65-74, and ≥75 years) and sex. Results: We identified 9,209 patients with an MDS-associated claim. There were 4,151 patients newly diagnosed with MDS, yielding an overall MDS incidence of 69.9/100,000 enrollees (Table). Incidence was slightly higher among women (75.7/100,000) than men (63.1/100,000). Women between the ages of 50 and 64 years had the highest incidence (111.5/100,000) among all newly diagnosed patients stratified by age and sex. The incidence of newly treated MDS patients was 2.8/100,000 enrollees. Among this group, incidence was higher among men (3.6/100,000) than women (2.1/100,000), and when stratified by age and sex the incidence was highest among men aged 75 years or older (10.5/100,000). For each 100,000 enrollees, there were 3 new 2nd-line therapy candidates. Conclusions: The estimated incidence of MDS in the United States was 69.9 per 100,000 insured enrollees in 2009, similar to results found in other epidemiological databases (Cogle et al, Blood 2011; Goldberg et al, J Clin Oncol 2010). The incidence of MDS patients identified as eligible for 2nd-line therapy was 3/100,000. In this commercially insured patient population we estimate that approximately 9,500 people per year in the United States may be candidates for 2nd-line therapy for MDS. These data can be used to inform population-based estimates that would include Medicare patients in addition to those commercially insured of the medical and economic burden of disease faced by MDS patients. Table: Incidence of MDS Stratified by Age and Gender Gender Age Group, years Newly Diagnosed Patients Newly Treated Patients Potential 2nd Line Treatment Candidates Female All ages 75.7 2.1 2.0 ≤49 56.6 0.1 0.0 50-64 111.5 2.1 1.1 65-74 101.2 4.0 5.3 ≥75 68.5 4.4 4.4 Male All ages 63.1 3.6 4.1 ≤49 29.6 0.2 0.1 50-64 86.5 2.5 3.8 65-74 106.1 8.5 8.5 ≥75 97.1 10.5 11.7 All All ages 69.9 2.8 3.0 Note: Results are expressed as number of cases per 100,000 enrollees. Disclosures Cogle: Partnership for Health Analytic Research (PHAR): Consultancy, I was paid as a consultant for my expert opinion while developing the analyses Other. Kurtin:Celgene, Millenium, Onyx, TEVA, Onconova, Incyte: Consultancy. Bentley:Partnership for Health Analytic Research (PHAR): Employment, I am an employee of PHAR, LLC, which was paid by Onconova Therapeutics to conduct the analyses described in this abstract. Other. Broder:Partnership for Health Analytic Research (PHAR): Employment, I am an employee of PHAR, LLC, which was paid by Onconova Therapeutics to conduct the analyses described in this abstract. Other. Chang:Partnership for Health Analytic Research (PHAR): Employment, I am an employee of PHAR, LLC, which was paid by Onconova Therapeutics to conduct the analyses described in this abstract. Other. Lawrence:Onconova Therapeutics, Inc. : Employment. McKearn:Onconova Therapeutics, Inc. : Employment. Megaffin:Onconova Therapeutics, Inc. : Employment. Percy:Onconova Therapeutics, Inc. : Employment. Petrone:Onconova Therapeutics, Inc. : Employment, Stock Options Other. Sun:Partnership for Health Analytic Research (PHAR): Employment, I am an employee of PHAR, LLC, which was paid by Onconova Therapeutics to conduct the analyses described in this abstract. Other.

2009 ◽  
Vol 36 (1) ◽  
pp. 63-67 ◽  
Author(s):  
MICHAEL M. WARD

ObjectiveTo determine if the incidence of endstage renal disease (ESRD) due to lupus nephritis has decreased from 1996 to 2004.MethodsPatients age 15 years or older with incident ESRD due to lupus nephritis in 1996–2004 and living in one of the 50 United States or the District of Columbia were identified using the US Renal Data System, a national population-based registry of all patients receiving renal replacement therapy for ESRD. Incidence rates were computed for each calendar year, using population estimates of the US census as denominators.ResultsOver the 9-year study period, 9199 new cases of ESRD due to lupus nephritis were observed. Incidence rates, adjusted to the age, sex, and race composition of the US population in 2000, were 4.4 per million in 1996 and 4.9 per million in 2004. Compared to the pooled incidence rate in 1996–1998, the relative risk of ESRD due to lupus nephritis in 1999–2000 was 0.99 (95% CI 0.93–1.06), in 2001–2002 was 0.99 (95% CI 0.92–1.06), and in 2003–2004 was 0.96 (95% CI 0.89–1.02). Findings were similar in analyses stratified by sex, age group, race, and socioeconomic status.ConclusionThere was no decrease in the incidence of ESRD due to lupus nephritis between 1996 and 2004. This may reflect the limits of effectiveness of current treatments, or limitations in access, use, or adherence to treatment.


Blood ◽  
2009 ◽  
Vol 113 (21) ◽  
pp. 5064-5073 ◽  
Author(s):  
Porcia T. Bradford ◽  
Susan S. Devesa ◽  
William F. Anderson ◽  
Jorge R. Toro

Abstract There have been no prior large population-based studies focusing on cutaneous lymphomas (CL) in the United States. Using the Surveillance, Epidemiology and End Results (SEER) program data, we analyzed age-adjusted CL incidence rates (IRs) and survival rates by sex and race/ethnicity. There were 3884 CLs diagnosed during 2001-2005. Cutaneous T-cell lymphomas (CTCLs) accounted for 71% (age-adjusted incidence rate [IR] = 7.7/1 000 000 person-years), whereas cutaneous B-cell lymphomas(CBCLs) accounted for 29% (IR = 3.1/1 000 000 person-years). Males had a statistically significant higher IR of CL than females (14.0 vs 8.2/1 000 000 person-years, respectively; male-female IR ratio [M/F IRR] = 1.72; P < .001). CL IRs were highest among blacks and non-Hispanic whites (both 11.5/1 000 000 person-years), followed by Hispanic whites (7.9) and Asian/Pacific Islanders (7.1). The CTCL IR was highest among blacks (10.0/1 000 000 person-years), whereas the CBCL IR was highest among non-Hispanic whites (3.5). Over the past 25 years, the CL IR increased from 5.0/1 000 000 person-years during 1980-1982 to 14.3 during 2001-2003. During 2004-2005, the CL IR was 12.7. This recent apparent change could be incomplete case ascertainment or potential leveling off of IRs. CLs rates vary markedly by race and sex, supporting the notion that they represent distinct disease entities.


2020 ◽  
Vol 163 (6) ◽  
pp. 1070-1072
Author(s):  
Douglas J. Totten ◽  
John P. Marinelli ◽  
Samuel A. Spear ◽  
Sarah N. Bowe ◽  
Matthew L. Carlson

Stapedectomy remains a joint key-indicator case with ossiculoplasty for otolaryngology residents in the United States. Yet, residents consistently report feeling inadequately prepared to perform stapes surgery following graduation. Applying recently described age- and sex-standardized incidence rates of surgically confirmed cases of otosclerosis to the US populace, upper and lower estimates of residents’ case exposure to stapedectomy can be approximated. With this, uppermost projections estimate 6484 new cases of stapes surgery are performed annually nationwide. With approximately 1424 otolaryngology residents nationally, the average case exposure is 7.8 stapedectomies throughout their training, with upper and lower estimates of 17.1 and 4.2 cases, respectively. As such, proficiency in stapedectomy is no longer a realistic expectation for US graduating residents. This reality supports the removal of “stapedectomy” from the list of 14 key-indicator case requirements, leaving ossiculoplasty as its own key-indicator case, thereby reinforcing true competence in this fundamental procedure for the graduating otolaryngologist.


2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 448-448
Author(s):  
Kabir Mody ◽  
Samuel O Antwi ◽  
David O Hodge ◽  
Zahara Meghji ◽  
Sikander Ailawadhi ◽  
...  

448 Background: Cholangiocarcinoma (CCA) is a rare, lethal cancer with five-year survival of less than 10%. Although incidence rates have been increasing in the United States, ethnic variations in survival have not been investigated. We examined multi-ethnic variation in overall survival (OS) and CCA-specific survival (CSS) using data from the population-based Surveillance Epidemiology and End Results (SEER) program in the four year periods before and after introduction of gemcitabine/cisplatin as treatment for CCA. Methods: The study included data from 9,975 CCA cases reported in SEER between 2006 and 2013. Multivariable-adjusted hazard ratios (HR) and 95% confidence intervals (CIs) were calculated to examine overall and cholangiocarcinoma-specific survival by ethnicity, age, gender and in the pre- and post- gemcitabine/cisplatin era (2006-2009 vs. 2010-2013). Results: Compared to non-Hispanic Whites, Hispanics had poorer 3-year OS (HR = 1.18, 95% CI = 1.10-1.26) and 3-year CCA-specific survival (HR = 1.25, 95% CI = 1.16-1.35). Similarly, non-Hispanic Blacks had 3-year OS (HR = 1.22, 95% CI = 1.12-1.30) and 3-year CCA-specific survival (HR = 1.24, 95% CI = 1.13-1.37). Males and older patients also were found to have shorter survival compared to females and younger patients. Also noted was an increase in CCA incidence rate over time (2006-2013) of 5.93%. Among those < 50 versus ≥50 years old, a 23% higher rate of incidence in those < 50 was noted. Overall survival and CSS were both significantly improved for patients post-advent of Gemcitabine/Cisplatin. Statistically significant improvement in CSS pre- and post-advent of Gemcitabine/Cisplatin was noted in non-hispanic whites (p < 0.001) and Hispanics (p = 0.02). Conclusions: Hispanics and non-Hispanic Blacks have worse survival after diagnosis with CCA. Further studies are needed to determine the determinants of poor survival among these groups toward targeted intervention. Significant improvements in OS and CSS have been seen after the advent of Gemcitabine/Cisplatin. The incidence of CCA is rising faster in young persons, under the age of 50, compared with older patients.


Blood ◽  
2008 ◽  
Vol 112 (1) ◽  
pp. 45-52 ◽  
Author(s):  
Dana E. Rollison ◽  
Nadia Howlader ◽  
Martyn T. Smith ◽  
Sara S. Strom ◽  
William D. Merritt ◽  
...  

Abstract Reporting of myelodysplastic syndromes (MDSs) and chronic myeloproliferative disorders (CMDs) to population-based cancer registries in the United States was initiated in 2001. In this first analysis of data from the North American Association of Central Cancer Registries (NAACCR), encompassing 82% of the US population, we evaluated trends in MDS and CMD incidence, estimated case numbers for the entire United States, and assessed trends in diagnostic recognition and reporting. Based on more than 40 000 observations, average annual age-adjusted incidence rates of MDS and CMD for 2001 through 2003 were 3.3 and 2.1 per 100 000, respectively. Incidence rates increased with age for both MDS and CMD (P < .05) and were highest among whites and non-Hispanics. Based on follow-up data through 2004 from the Surveillance, Epidemiology, and End Results (SEER) Program, overall relative 3-year survival rates for MDS and CMD were 45% and 80%, respectively, with males experiencing poorer survival than females. Applying the observed age-specific incidence rates to US Census population estimates, approximately 9700 patients with MDS and 6300 patients with CMD were estimated for the entire United States in 2004. MDS incidence rates significantly increased with calendar year in 2001 through 2004, and only 4% of patients were reported to registries by physicians' offices. Thus, MDS disease burden in the United States may be underestimated.


Stroke ◽  
2001 ◽  
Vol 32 (suppl_1) ◽  
pp. 363-363
Author(s):  
Megan C Leary ◽  
Jeffrey L Saver

P134 Background: Recent estimates of stroke incidence in the US range from 715,000–750,000 annually. These estimates, however, do not reflect silent infarcts and hemorrhages. Since population-based studies have found that prevalence of silent stroke is 10–20 times that of symptomatic, estimates of stroke incidence based solely on symptomatic events may substantially underestimate the annual burden of stroke. Silent strokes contribute to vascular dementia, gait impairment, and other major adverse patient outcomes. Methods: Incidence of silent infarcts for different age strata were derived from two US population-based studies of the prevalence of silent infarct-like lesions on MRI, Atherosclerosis Risk In Communities and Cardiovascular Health Study. Prevalence observations in these studies and age-specific death rates from the US Census Bureau were inputted to calculate silent infarct incidence (method of Leske et al). Similarly, incidence rates of silent hemorrhage at differing ages were extrapolated from population-based prevalence observations employing MR GRE imaging in the Austrian Stroke Prevention Study. Age-specific incidence rates were projected onto age cohorts in the 1998 US population to calculate annual burden of silent stroke. Results: Derived incidence rates per 100,000 of silent infarct ranged from 6400 in the age 50–59 strata to 16400 at ages 75–79. Extrapolated incidence rates of silent hemorrhage ranged from 230 in the age 30–39 strata to 7360 at ages > 80. Incidence rates of both subclinical infarcts and hemorrhage increased exponentially with age. Overall estimated annual US occurrence of silent infarct was 9,039,000, and of silent hemorrhage 2,130,000. Conclusion: In 1998, nearly 12 million strokes occurred in the United States, of which ∼750,000 were symptomatic and over 11 million were subclinical. Among the silent strokes, ∼81% were infarcts and ∼19% hemorrhages. These findings demonstrate that the annual burden of stroke is substantially higher than suggested by estimates based solely on clinically manifest events, and suggest that greater research and clinical resources should be allocated to stroke prevention and treatment.


2021 ◽  
pp. 019459982110420
Author(s):  
John P. Marinelli ◽  
Cynthia J. Beeler ◽  
Matthew L. Carlson ◽  
Per Caye-Thomasen ◽  
Samuel A. Spear ◽  
...  

Objective Ubiquitous throughout the literature and during patient counseling, vestibular schwannoma is often quoted to affect about 1 per 100,000 people. Yet, reports from distinct international populations suggest that the incidence is likely much higher. The objective of the current work was to systematically characterize the global incidence of sporadic vestibular schwannoma. Data Sources Scopus, Embase, and PubMed. Review Methods Population-based studies reporting incidence rates of sporadic vestibular schwannoma between January 2010 and August 2020 were searched with language restrictions requiring reports to be published in Chinese, English, German, Italian, or Spanish. The protocol was registered with PROSPERO (CRD42021228208) prior to commencement of data collection. PRISMA guidelines for transparent reporting of systematic reviews were followed. Results Among 424 citations, 6 publications covering 4 distinct populations from Denmark, the Netherlands, Taiwan, and the United States met inclusion criteria. Most recent incidence rates of among all ages ranged between 3.0 and 5.2 per 100,000 person-years. Highest incidence rates were reported among patients aged ≥70 years, peaking at 20.6 per 100,000 person-years. One study from the United States reported the incidence of asymptomatic, incidentally diagnosed tumors at a rate of 1.3 per 100,000 person-years from 2012 to 2016. Conclusions Recent international incidence rates of sporadic vestibular schwannoma exceed the commonly quoted “1 per 100,000” figure by up to 5-fold among all ages and by up to 20-fold among age groups at highest risk. Based on modern incidence rates, the lifetime prevalence of developing sporadic vestibular schwannoma likely exceeds 1 per 500 persons.


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