Details
Routinely collected electronic health data about cancer screening and follow-up would be helpful adjuncts for assessing guideline adherence in real-world populations. We compared the use of insurance claims data to other sources to describe (1) abnormal colorectal cancer, breast cancer, and cervical cancer screening results and (2) follow-up after abnormal cancer screening results. We evaluated over 100 million person-years of curated claims data from one large national and two smaller regional insurers participating in the National Institutes of Health (NIH) Health Care Systems Research Collaboratory Distributed Research Network (DRN). We assessed rates of new colorectal, breast, and cervical cancer screenings and abnormal cancer screening results from January 1, 2007 to December 31, 2014, and in 2013, we assessed selected follow-up events (cancer diagnosis, imaging, or biopsy) within 90 days following a new abnormal colorectal, breast, or cervical cancer screening result. We used US Preventative Services Task Force recommendations to establish lower boundaries for age at screening. Individuals aged at least 50, 40, and 21 years for colon, breast, or cervical cancer, respectively, were required to have continuous medical and pharmacy coverage for > 9 months (270 days) before their index cancer screening or abnormal cancer screening result, allowing gaps in coverage ≤ 45 days.