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Detection of incident breast and colorectal cancer cases from an administrative healthcare database in Catalonia, Spain

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Abstract

Objective

To validate the Catalan minimum basic data set (MBDS) of hospital discharges as an information source for detecting incident breast (BC) and colorectal cancer (CRC), against the Hospital del Mar Cancer Registry (RTHMar) in Barcelona (Spain) as the gold standard.

Methods

Using ASEDAT software (Analysis, Selection and Extraction of Tumour Data), we identified Catalan public hospital discharge abstracts in patients with a first-time diagnosis of BC and CRC in the years 2005, 2008, and 2011, aggregated by unique patient identifiers and sorted by date. Once merged with the RTHMar database and anonymized, tumour-specific algorithms were validated to extract data on incident cases, tumour stage, surgical treatment, and date of incidence.

Results

MBDS had a respective sensitivity and positive predictive value (PPV) of 78.0% (564/723) and 90.5% (564/623) for BC case detection; and 83.9% (387/461) and 94.9% (387/408) for CRC case detection. The staging algorithms overestimated the proportion of local-stage cases and underestimated the regional-stage cases in both cancers. When loco-regional stage and surgery were combined, sensitivity and PPV reached 98.3% and 99.8%, respectively, for BC and 96.4% and 98.4% for CRC. The differences between dates of incidence between RTHMar and MBDS were greater for BC cases without initial surgery, whereas they were generally smaller and homogeneous for CRC cases.

Conclusions

The MBDS is a valid and efficient instrument to improve the completeness of a hospital-based cancer registry (HBCR), particularly in BC and CRC, which require hospitalization and are predominantly surgical.

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Abbreviations

MBDS:

Catalan minimum basic data set of hospital discharge

BC:

Breast cancer

CRC:

Colorectal cancer

RTHMar:

Hospital del Mar Cancer Registry

ASEDAT:

Analysis, Selection and Extraction of Tumour data

PPV:

Positive predictive value

HBCR:

Hospital-based cancer registry

ICD-9-CM:

International Classification of Diseases, 9th revision, Clinical Modification

ICD-10-CM/PCS:

International Statistical Classification of Disease and Related Health Problems, 10th revision

HMar:

Hospital Parc de Salut MAR

ICD-O-1:

International Classification of Diseases for Oncology, 1st edition

CI:

Confidence interval

FP:

False positive

FN:

False negative

PBCR:

Population-based cancer registry

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Acknowledgements

We thank A. Melià, L. Roca, and P. Rodríguez from the Catalan Cancer Planning Directorate, and C. Hernández from the RTHMar, for reviewing the information of cases included in this study. We would also like to thank M. Bustins from the Evaluation Unit of the Health Department of the Government of Catalonia for providing the Catalan minimum basic data set of hospital discharge. This study was partially funded by the Agency for Management of University and Research Grants (AGAUR), Government of Catalonia, Grant Number 2017SGR00450 (http://agaur.gencat.cat), under the authority of the Secretariat of Universities and Research, Ministry of Enterprise and Knowledge of the Government of Catalonia. Meggan Harris for editing and improving this manuscript.

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Authors and Affiliations

  1. Catalan Cancer Registry, Cancer Planning Directorate, Department of Health, Generalitat de Catalunya, Av. Gran Via 199-203, 1st floor, 08908, L’ Hospitalet de Llobregat, Spain

    J. M. Escribà, J. Gálvez, L. Esteban, L. Pareja, R. Clèries, X. Sanz, J. M. Borrás & J. Ribes

  2. Department of Clinical Sciences, University of Barcelona, Campus de Bellvitge, Feixa Llarga s/n, 08907, L’ Hospitalet de Llobregat, Barcelona, Spain

    J. M. Escribà, R. Clèries, J. M. Borrás & J. Ribes

  3. Unit of Prevention and Cancer Registry, Service of Epidemiology and Evaluation, Parc de Salut Mar, Barcelona, Passeig Marítim 25-29, 08003, Barcelona, Spain

    M. Banqué, F. Macià & X. Castells

  4. Anoia Health Consortium, Av. Catalunya 11, 08700, Igualada, Barcelona, Spain

    M. Banqué

  5. Faculty of Medicine, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, 08193, Bellaterra, Spain

    X. Castells

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Contributions

JME conceived and designed the study, collected and analysed data, and wrote the article. MB designed the study, collected and analysed data, and reviewed and approved the final version. FM designed the study, interpreted data and reviewed and approved the final version. JG and XS collected and prepared the data. RC, LE, and LP performed the statistical data analyses. JR designed the study, analysed the data, wrote the article, and approved the final version. XC and JMB critically reviewed and approved the final version. All authors approved the final version.The number of authors is justified as it is a collaborative project in which different health professionals have participated, including medical epidemiologists, technical computer engineers, biostatisticians, and trained documentation specialists for the review of cases between two institutions.

Corresponding author

Correspondence to J. M. Escribà.

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Conflict of interest

All authors declare that they have no conflicts of interest for the present study. All the authors have carefully read the manuscript and fully approved it. The manuscript is original, and it has not been submitted to other journals.

Ethical approval

The current study has been performed in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments.

Informed consent

Informed consent was not required, because we used administrative databases with anonymized information to the researchers.

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Escribà, J.M., Banqué, M., Macià, F. et al. Detection of incident breast and colorectal cancer cases from an administrative healthcare database in Catalonia, Spain. Clin Transl Oncol 22, 943–952 (2020). https://doi.org/10.1007/s12094-019-02219-3

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