Non-melanoma skin cancer ascertainment in the HMO

More than one million nonmelanoma skin cancers (NMSC), including squamous cell carcinoma (SCC) and basal cell carcinoma (BCC), will be diagnosed in the United States (US) in 2008. Despite the large population affected and personal, societal and economic burdens, the epidemiology of NMSC is understudied. This may be because large cancer registries often exclude NMSC, including the SEER program. Secondary data analysis has been limited because SCC and BCC do not have unique International Classification of Disease (ICD-9) identifiers. The CRN could serve as a resource in which to study NMSC etiology, health services and economic resource utilization, and behavioral interventions. We submit a proposal to develop the CRN’s capacity to serve as a “virtual registry” to study NMSC. We plan to compare algorithms for identifying NMSC in the claims data of HFHS using the Virtual Data Warehouse (VDW) which will be validated again pathology information. The sensitivity, specificity, positive and negative predictive values will be calculated. This pilot project will further the development of the infrastructure of the CRN to allow for identification of NMSC. We will also identify the resources and additional artnerships necessary for the generation of future NIH proposals with the aim of eventually developing technology capable of distinguishing the NMSC subtypes.

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