Cancer incidence estimation at a district level without a national registry: A validation study for 24 cancer sites using French health insurance and registry data

Cancer incidence estimation at a district level without a national registry: A validation study for 24 cancer sites using French health insurance and registry data

Abstract Background : District-level cancer incidence estimation is an important issue in countries without a national cancer registry. This study aims to both evaluate the validity of district-level estimations in France for 24 cancer sites, using health insurance data (ALD demands – Affection de L...

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Bibliographic Details
Published in:Cancer epidemiology Vol. 37; no. 2; pp. 99 - 114
Main Authors: Uhry, Zoé, Remontet, Laurent, Colonna, Marc, Belot, Aurélien, Grosclaude, Pascale, Mitton, Nicolas, Delacour-Billon, Solenne, Gentil, Julie, Boussac-Zarebska, Marjorie, Bossard, Nadine, Danzon, Arlette, Altana, Michelle, Frete, François, Weill, Alain, Rogel, Agnès
Format: Journal Article
Language:English
Published: Amsterdam Elsevier Ltd 01-04-2013
Elsevier
Elsevier Limited
Subjects:
Age
Biological and medical sciences
Cancer
Confidence intervals
Epidemiology
Female
France - epidemiology
Health insurance
Health insurance data
Health risk assessment
Hematology, Oncology and Palliative Medicine
Humans
Incidence
Insurance, Health
Internal Medicine
Life Sciences
Male
Medical sciences
Methods
Models, Theoretical
Mortality
Multiple tumors. Solid tumors. Tumors in childhood (general aspects)
Neoplasms - epidemiology
Population
Registries
Statistical modelling
Tumors
Validity
France
Registries
Health insurance data
Statistical modelling
Cancer
Incidence
Medical data
Health insurance
Estimation
Malignant tumor
Epidemiology
Modeling
Statistics
Test validation
French
Specific registry
Welfare aids
Sanitary surveillance
Public health
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Summary:Abstract Background : District-level cancer incidence estimation is an important issue in countries without a national cancer registry. This study aims to both evaluate the validity of district-level estimations in France for 24 cancer sites, using health insurance data (ALD demands – Affection de Longue Durée ) and to provide estimations when considered valid. Incidence is estimated at a district-level by applying the ratio between the number of first ALD demands and incident cases (ALD/I ratio), observed in those districts with cancer registries, to the number of first ALD demands available in all districts. These district-level estimations are valid if the ratio does not vary greatly across the districts or if variations remain moderate compared with variations in incidence rates. Methods : Validation was performed in the districts covered by cancer registries over the period 2000–2005. The district variability of the ALD/I ratio was studied, adjusted for age (mixed-effects Poisson model), and compared with the district variability in incidence rate. The epidemiological context is also considered in addition to statistical analyses. Results : District-level estimation using the ALD/I ratio was considered valid for eight cancer sites out of the 24 studied (lip–oral cavity–pharynx, oesophagus, stomach, colon–rectum, lung, breast, ovary and testis) and incidence maps were provided for these cancer sites. Conclusion : Estimating cancer incidence at a sub-national level remains a difficult task without a national registry and there are few studies on this topic. Our validation approach may be applied in other countries, using health insurance or hospital discharge data as correlate of incidence.
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ISSN:1877-7821
1877-783X
DOI:10.1016/j.canep.2012.10.010