Burden of illness for osteoporotic fractures compared with other serious diseases among postmenopausal women in the United States.

Objectives: To provide a national estimate of the incidence of hospitalizations due to osteoporotic fractures (OFs) in women; compare this with the incidence of myocardial infarction (MI), stroke, and breast cancer; and assess temporal trends in the incidence and length of hospitalizations.

Patients And Methods: The study included all women 55 years and older at the time of admission, admitted to a hospital participating in the US Nationwide Inpatient Sample for an outcome of interest. We performed a retrospective analysis of hospitalizations for OFs (hip, forearm, spine, pelvis, distal femur, wrist, and humerus), MI, stroke, or breast cancer, using the US Nationwide Inpatient Sample, 2000-2011.

Declining rates of osteoporosis management following fragility fractures in the U.S., 2000 through 2009.

Background: Clinical practice recommendations state that patients with fragility fractures should be evaluated for osteoporosis and treated for the disease if it is present. The purpose of this study was to assess osteoporosis evaluation and treatment patterns for patients with fragility fractures and assess whether anti-osteoporosis pharmacotherapy initiated immediately following a fragility fracture is associated with improved adherence to the treatment protocol.

Methods: This retrospective cohort study involved data from a large commercially insured population seen in the period from 2001 through 2009.

Validation of the Osteoporosis-Specific Morisky Medication Adherence Scale in long-term users of bisphosphonates.

Purpose: To examine the psychometric properties and validity of the 8-item Osteoporosis-Specific Morisky Medication Adherence Scale (OS-MMAS-8) in postmenopausal women prescribed bisphosphonates (BPs) for at least 15 months.

Methods: A random sample of women aged ≥55 years with osteoporosis prescribed daily or weekly BPs was identified. Pharmacy fill data were extracted to calculate the medication possession ratio (MPR).

Changing patterns of use of osteoporosis medications in the years after launch: implications for comparative effectiveness research.

Purpose: Newly marketed medications may be used selectively in patients with more severe disease. Changes in patterns of use following a drug's introduction to the market can greatly influence results from non-experimental comparative effectiveness research. We sought to explore this issue by characterizing trends in oral and injectable prescription drug claims for the prevention and treatment of osteoporosis.

Completeness of prescription information in US commercial claims databases.

Purpose: Pharmacy commercial claims databases are widely used for pharmacoepidemiologic research. However, concerns have been raised that these databases may not fully capture claims for generic medications as a result of patients filling outside the context of their insurance. This has implications for many research activities and quality improvement programs.

An international assessment of ovarian cancer incidence and mortality.

Objective: To assess and characterize the temporal variation in ovarian cancer incidence and mortality by age within countries in the Americas, Europe, Asia, and Oceania.

Methods/materials: Data from the National Cancer Institute's Surveillance, Epidemiology, and End Results Program in the United States (U.S.

Misclassification of incident conditions using claims data: impact of varying the period used to exclude pre-existing disease.

Background: Estimating the incidence of medical conditions using claims data often requires constructing a prevalence period that predates an event of interest, for instance the diagnosis of cancer, to exclude those with pre-existing conditions from the incidence risk set. Those conditions missed during the prevalence period may be misclassified as incident conditions (false positives) after the event of interest.Using Medicare claims, we examined the impact of selecting shorter versus longer prevalence periods on the incidence and misclassification of 12 relatively common conditions in older persons.

The implications of age and comorbidity on survival following epithelial ovarian cancer: summary and results from a Centers for Disease Control and Prevention study.

Background: Advances in treatment have improved ovarian cancer survival for most women, although less for the elderly. We report on this disparity and add further evidence about the relationship among age, comorbidity, and survival after ovarian cancer.

Methods: To examine age and comorbidity, Centers for Disease Control and Prevention (CDC)-funded cancer registries examined 2367 women residing in New York and Northern California diagnosed with epithelial ovarian cancer (1998-2000).

Psychometric properties of the Osteoporosis-specific Morisky Medication Adherence Scale in postmenopausal women with osteoporosis newly treated with bisphosphonates.

Background: Poor adherence to oral osteoporosis medications is common. Strategies for improving adherence begin with identification of the problem. The 8-item Morisky Medication Adherence Scale for self-reported adherence to antihypertensive medications was modified for assessing adherence to oral osteoporosis medications.

Trends in dual-energy X-ray absorptiometry in the United States, 2000-2009.

After a decade of policies encouraging dual-energy X-ray absorptiometry (DXA) use, Medicare incrementally decreased reimbursement for non-facility-based DXAs, effective 2007. This study quantifies trends in central DXA use before and after the reimbursement change. Using 2000-2009 claims data, we selected subjects aged 50+yr with Medicare supplemental or commercial insurance.

Survival by histologic subtype in stage IV nonsmall cell lung cancer based on data from the Surveillance, Epidemiology and End Results Program.

Background: The role of histology in the targeted management of nonsmall cell lung cancer (NSCLC) has garnered renewed attention in recent years. We provide contemporary population-based estimates of survival and an assessment of important prognostic factors in stage IV NSCLC by major histologic subtype.

Methods: Using data from the Surveillance, Epidemiology and End Results (SEER) Program, we stratified 51,749 incident stage IV NSCLC patients (1988-2003 with follow-up through 2006) by major histologic subtype.

Surgical staging of early stage epithelial ovarian cancer: results from the CDC-NPCR ovarian patterns of care study.

Objectives: The objectives of this study were to determine the adequacy of surgical staging performed on surgically treated epithelial ovarian cancer (EOC) patients with apparent early stage disease and to determine if receipt of surgical staging had an influence on survival.

Methods: Detailed surgical staging information was collected from medical records for 721 patients diagnosed between 1998 and 2000 with EOC. Patients resided in California or New York and were identified through population-based cancer registries.

Factors affecting receipt of chemotherapy in women with breast cancer.

Aims: To review literature describing factors associated with receipt of chemotherapy for breast cancer, to better understand what factors are most relevant to women's health and whether health disparities are apparent, and to assess how these factors might affect observational studies and outcomes research. Patterns of care for metastatic breast cancer, for which no standard-of-care exists, were of particular interest.

Methods: Relevant studies written in English, Italian, French, or Spanish, published in 2000 or later, were identified through MEDLINE and reviewed.

Use of electronic medical records in oncology outcomes research.

Oncology outcomes research could benefit from the use of an oncology-specific electronic medical record (EMR) network. The benefits and challenges of using EMR in general health research have been investigated; however, the utility of EMR for oncology outcomes research has not been explored. Compared to current available oncology databases and registries, an oncology-specific EMR could provide comprehensive and accurate information on clinical diagnoses, personal and medical histories, planned and actual treatment regimens, and post-treatment outcomes, to address research questions from patients, policy makers, the pharmaceutical industry, and clinicians/researchers.

Factors associated with the suboptimal treatment of women less than 55 years of age with early-stage ovarian cancer.

Objectives: A significant number of young patients with early-stage ovarian cancer did not receive chemotherapy based on standard practice guidelines. We investigated factors associated with the suboptimal treatment in these women.

Materials And Methods: Data were obtained from California Cancer Registry from 1994 to 1996.

Longitudinal, population-based study of racial/ethnic differences in colorectal cancer survival: impact of neighborhood socioeconomic status, treatment and comorbidity.

Background: Colorectal cancer, if detected early, has greater than 90% 5-year survival. However, survival has been shown to vary across racial/ethnic groups in the United States, despite the availability of early detection methods.

Methods: This study evaluated the joint effects of sociodemographic factors, tumor characteristics, census-based socioeconomic status (SES), treatment, and comorbidities on survival after colorectal cancer among and within racial/ethnic groups, using the SEER-Medicare database for patients diagnosed in 1992-1996, and followed through 1999.

Influence of the gynecologic oncologist on the survival of ovarian cancer patients.

Objective: To estimate the influence of gynecologic oncologists on the treatment and outcome of patients with ovarian cancer.

Methods: Data were obtained from California Cancer Registry from 1994 to 1996. Kaplan-Meier and Cox proportional hazard methods were used for analyses.

Medicaid status and stage at diagnosis of cervical cancer.

Objectives: We examined whether Medicaid beneficiaries are more likely to be diagnosed with late-stage cervical cancer than women not enrolled in Medicaid.

Methods: Using the California Cancer Registry-Medicaid linked file, we identified 4682 women diagnosed during 1996-1999 with invasive cervical cancer. Multivariate logistic regression was used to evaluate the association between late-stage diagnosis and prediagnosis Medicaid status.

Validity of cancer registry medicaid status against enrollment files: implications for population-based studies of cancer outcomes.

Background: Poor access to or inadequate health insurance contributes to disparities in cancer incidence and mortality. Cancer registry "payer source" data is collected by many cancer registries in the United States and has been used to compare cancer outcomes across insurance types.

Objectives: We evaluated the validity of cancer registry data on patient Medicaid status against enrollment data from Medi-Cal, California's Medicaid program.

Incidence of male breast cancer in california, 1988-2000: racial/ethnic variation in 1759 men.

Breast cancer among males is rare, accounting for less than 1% of all breast cancers in the United States. Although it is rare, it can cause significant morbidity and mortality. We analyzed data from 1759 California males whose diagnosis of breast cancer was made between 1988 and 2000 and reported to the population-based California Cancer Registry.

Cancer surveillance research: a vital subdiscipline of cancer epidemiology.

Public health surveillance systems relevant to cancer, centered around population-based cancer registration, have produced extensive, high-quality data for evaluating the cancer burden. However, these resources are underutilized by the epidemiology community due, we postulate, to under-appreciation of their scope and of the methods and software for using them. To remedy these misperceptions, this paper defines cancer surveillance research, reviews selected prior contributions, describes current resources, and presents challenges to and recommendations for advancing the field.

Breast implants following mastectomy in women with early-stage breast cancer: prevalence and impact on survival.

Background: Few studies have examined the effect of breast implants after mastectomy on long-term survival in breast cancer patients, despite growing public health concern over potential long-term adverse health effects.

Methods: We analyzed data from the Surveillance, Epidemiology and End Results Breast Implant Surveillance Study conducted in San Francisco-Oakland, in Seattle-Puget Sound, and in Iowa. This population-based, retrospective cohort included women younger than 65 years when diagnosed with early or unstaged first primary breast cancer between 1983 and 1989, treated with mastectomy.

Survival of Californian women with epithelial ovarian cancer, 1994-1996: a population-based study.

Objective: The objective was to identify demographic, clinical, and provider characteristics that might influence cancer survival in a cohort of Northern California women using a population-based cancer registry.

Methods: We used California Cancer Registry data to evaluate survival in 1051 Northern California women who were diagnosed with epithelial ovarian cancer between 1994 and 1996 and underwent a surgical procedure for their cancer. Chemotherapy data from the cancer registry were supplemented with a physician survey and medical record review.