Common data determinants of recurrent cancer are broken, mislead researchers

January 2, 2013 by Garth Sundem
Current algorithms used to pull the needle of patients with recurrent cancer from the haystack of patient databases are broken. Image: Flickr/jromero

In order to study the effectiveness or cost effectiveness of treatments for recurrent cancer, you first have to discover the patients in medical databases who have recurrent cancer. Generally studies do this with billing or treatment codes – certain codes should identify who does and does not have recurrent cancer. A recent study published in the journal Medical Care shows that the commonly used data determinants of recurrent cancer may be misidentifying patients and potentially leading researchers astray.

"For example, a study might look in a database for all patients who had chemotherapy and then another round of chemotherapy more than six months after the first, imagining that a second round defines recurrent disease. Or a study might look in a database for all patients with a newly discovered secondary tumor, imagining that all patients with a secondary tumor have recurrent disease. Our study shows that both methods are leave substantial room for improvement," says Debra Ritzwoller, PhD, at the Kaiser Permanente Colorado Institute for Health Research and investigator at the University of Colorado Cancer Center.

The study used two unique datasets derived from HMO/Cancer Research Network and CanCORS/Medicare to check if the widely used algorithms in fact discovered the patients with recurrent disease that the algorithms were designed to detect. They did not. For example, a newly diagnosed may not mark a recurrence but may instead be a new cancer entirely; a second, later round of chemotherapy may be needed for continuing control of the de novo cancer, and not to treat recurrence.

"Basically, these algorithms don't work for all cancer sites in many commonly used for ," says Ritzwoller.

For example, to discover recurrent , no combination of billing codes used in this large data set pointed with sensitivity and specificity to patients whom notes in the data showed had recurrent disease. The highest success of the widely used algorithms was predicting patients with recurrent lung, colorectal and breast cancer, with success rates only between 75 and 85 percent.

"We need to know who in these data sets has . Then we can do things like look at which treatments lead to which outcomes," Ritzwoller says. Matching patients to outcomes can help to decide who gets what treatment, and can help optimize costs in health care systems.

In a forthcoming paper, Ritzwoller and colleagues will suggest algorithms to replace these that have now proved inadequate.

Explore further: Certain head and neck cancer patients benefit from second round of treatment

More information: journals.lww.com/lww-medicalca … ndicators.99357.aspx

Related Stories

Certain head and neck cancer patients benefit from second round of treatment

June 13, 2011
A new study has determined predictors that can better identify patients who will benefit from a potentially toxic second course of treatment, which offers a small but real chance of cure in select patients with head and neck ...

Chemo may extend survival after breast cancer's return

December 6, 2012
(HealthDay)—In women with breast cancer that has recurred but remains confined to in or near the breast, post-surgical chemotherapy appears to boost survival, new research shows.

New drug combination slows tumor growth for recurrent ovarian cancer

June 6, 2011
Bevacizumab (Avastin) in combination with chemotherapy resulted in a clinical benefit for patients with recurrent ovarian cancer, according to a new study. Results from the phase III "OCEANS" trial were presented today by ...

Recommended for you

Stem cell therapy attacks cancer by targeting unique tissue stiffness

July 26, 2017
A stem cell-based method created by University of California, Irvine scientists can selectively target and kill cancerous tissue while preventing some of the toxic side effects of chemotherapy by treating the disease in a ...

Understanding cell segregation mechanisms that help prevent cancer spread

July 26, 2017
Scientists have uncovered how cells are kept in the right place as the body develops, which may shed light on what causes invasive cancer cells to migrate.

Study uncovers potential 'silver bullet' for preventing and treating colon cancer

July 26, 2017
In preclinical experiments, researchers at VCU Massey Cancer Center have uncovered a new way in which colon cancer develops, as well as a potential "silver bullet" for preventing and treating it. The findings may extend to ...

Compound shows promise in treating melanoma

July 26, 2017
While past attempts to treat melanoma failed to meet expectations, an international team of researchers are hopeful that a compound they tested on both mice and on human cells in a petri dish takes a positive step toward ...

Study may explain failure of retinoic acid trials against breast cancer

July 25, 2017
Estrogen-positive breast cancers are often treated with anti-estrogen therapies. But about half of these cancers contain a subpopulation of cells marked by the protein cytokeratin 5 (CK5), which resists treatment—and breast ...

Breaking the genetic resistance of lung cancer and melanoma

July 25, 2017
Researchers from Monash University and the Memorial Sloan Kettering Cancer Center (MSKCC, New York) have discovered why some cancers – particularly lung cancer and melanoma – are able to quickly develop deadly resistance ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.