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Identification of ovarian cancer symptoms in health insurance claims data.
J Womens Health (Larchmt) 2010; 19(3):381-9JW

Abstract

BACKGROUND

Women with ovarian cancer have reported abdominal/pelvic pain, bloating, difficulty eating or feeling full quickly, and urinary frequency/urgency prior to diagnosis. We explored these findings in a general population using a dataset of insured women aged 40-64 and investigated the potential effectiveness of a routine review of claims data as a prescreen to identify women at high risk for ovarian cancer.

METHODS

Data from a large Washington State health insurer were merged with the Seattle-Puget Sound Surveillance, Epidemiology and End Results (SEER) cancer registry for 2000-2004. We estimated the prevalence of symptoms in the 36 months prior to diagnosis for early and late-stage ovarian cancer cases and for two comparison groups. The potential performance of a passive screener that would flag women with two or more visits for any of the symptoms in the previous 2-month period was examined.

RESULTS

Of the 223,903 insured women, 161 had incident cases of ovarian cancer. Both early and late-stage patients had a higher prevalence of abdominal/pelvic pain and bloating than the comparison groups, primarily in the 3 months before diagnosis. The passive screener had a sensitivity of 0.31 and specificity of 0.83 and usually identified women right before diagnosis. Assuming an average cost of $500 per false positive, the screener would be considered cost-effective if the true positives had an average increase of 8.5 years of life expectancy.

CONCLUSIONS

These results support previous findings that ovarian cancer symptoms were reported in health insurance claims and were more prevalent before diagnosis, but the symptoms may occur too close to the diagnosis date to provide useful diagnostic information. The passive screening approach should be reevaluated in the future using electronic medical records; if found to be effective, the method may be potentially useful for other incident diseases.

Authors+Show Affiliations

Department of Biostatistics, School of Public Health, University of Washington, Seattle, Washington 98195-9455, USA. devlin@u.washington.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

20156131

Citation

Devlin, Sean M., et al. "Identification of Ovarian Cancer Symptoms in Health Insurance Claims Data." Journal of Women's Health (2002), vol. 19, no. 3, 2010, pp. 381-9.
Devlin SM, Diehr PH, Andersen MR, et al. Identification of ovarian cancer symptoms in health insurance claims data. J Womens Health (Larchmt). 2010;19(3):381-9.
Devlin, S. M., Diehr, P. H., Andersen, M. R., Goff, B. A., Tyree, P. T., & Lafferty, W. E. (2010). Identification of ovarian cancer symptoms in health insurance claims data. Journal of Women's Health (2002), 19(3), pp. 381-9. doi:10.1089/jwh.2009.1550.
Devlin SM, et al. Identification of Ovarian Cancer Symptoms in Health Insurance Claims Data. J Womens Health (Larchmt). 2010;19(3):381-9. PubMed PMID: 20156131.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Identification of ovarian cancer symptoms in health insurance claims data. AU - Devlin,Sean M, AU - Diehr,Paula H, AU - Andersen,M Robyn, AU - Goff,Barbara A, AU - Tyree,Patrick T, AU - Lafferty,William E, PY - 2010/2/17/entrez PY - 2010/2/17/pubmed PY - 2013/2/13/medline SP - 381 EP - 9 JF - Journal of women's health (2002) JO - J Womens Health (Larchmt) VL - 19 IS - 3 N2 - BACKGROUND: Women with ovarian cancer have reported abdominal/pelvic pain, bloating, difficulty eating or feeling full quickly, and urinary frequency/urgency prior to diagnosis. We explored these findings in a general population using a dataset of insured women aged 40-64 and investigated the potential effectiveness of a routine review of claims data as a prescreen to identify women at high risk for ovarian cancer. METHODS: Data from a large Washington State health insurer were merged with the Seattle-Puget Sound Surveillance, Epidemiology and End Results (SEER) cancer registry for 2000-2004. We estimated the prevalence of symptoms in the 36 months prior to diagnosis for early and late-stage ovarian cancer cases and for two comparison groups. The potential performance of a passive screener that would flag women with two or more visits for any of the symptoms in the previous 2-month period was examined. RESULTS: Of the 223,903 insured women, 161 had incident cases of ovarian cancer. Both early and late-stage patients had a higher prevalence of abdominal/pelvic pain and bloating than the comparison groups, primarily in the 3 months before diagnosis. The passive screener had a sensitivity of 0.31 and specificity of 0.83 and usually identified women right before diagnosis. Assuming an average cost of $500 per false positive, the screener would be considered cost-effective if the true positives had an average increase of 8.5 years of life expectancy. CONCLUSIONS: These results support previous findings that ovarian cancer symptoms were reported in health insurance claims and were more prevalent before diagnosis, but the symptoms may occur too close to the diagnosis date to provide useful diagnostic information. The passive screening approach should be reevaluated in the future using electronic medical records; if found to be effective, the method may be potentially useful for other incident diseases. SN - 1931-843X UR - https://www.unboundmedicine.com/medline/citation/20156131/Identification_of_ovarian_cancer_symptoms_in_health_insurance_claims_data_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/20156131/ DB - PRIME DP - Unbound Medicine ER -