Journal of Preventive Medicine and Public Health

The Korean Society for Preventive Medicine (대한예방의학회)
권호 표지
DOI QR코드

DOI QR Code

Operational Definitions of Colorectal Cancer in the Korean National Health Insurance Database

  • Hyeree Park (Department of Preventive Medicine, Seoul National University College of Medicine) ;
  • Yu Rim Kim (College of Medicine, Ewha Womans University) ;
  • Yerin Pyun (College of Nursing, Seoul National University) ;
  • Hyundeok Joo (Department of Preventive Medicine, Seoul National University College of Medicine) ;
  • Aesun Shin (Department of Preventive Medicine, Seoul National University College of Medicine)
  • Received : 2023.01.20
  • Accepted : 2023.05.10
  • Published : 2023.07.31
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives: We reviewed the operational definitions of colorectal cancer (CRC) from studies using the Korean National Health Insurance Service (NHIS) and compared CRC incidence derived from the commonly used operational definitions in the literature with the statistics reported by the Korea Central Cancer Registry (KCCR). Methods: We searched the MEDLINE and KoreaMed databases to identify studies containing operational definitions of CRC, published until January 15, 2021. All pertinent data concerning the study period, the utilized database, and the outcome variable were extracted. Within the NHIS-National Sample Cohort, age-standardized incidence rates (ASRs) of CRC were calculated for each operational definition found in the literature between 2005 and 2019. These rates were then compared with ASRs from the KCCR. Results: From the 62 eligible studies, 9 operational definitions for CRC were identified. The most commonly used operational definition was "C18-C20" (n=20), followed by "C18-C20 with claim code for treatment" (n=3) and "C18-C20 with V193 (code for registered cancer patients' payment deduction)" (n=3). The ASRs reported using these operational definitions were lower than the ASRs from KCCR, except for "C18-C20 used as the main diagnosis." The smallest difference in ASRs was observed for "C18-C20," followed by "C18-C20 with V193," and "C18-C20 with claim code for hospitalization or code for treatment." Conclusions: In defining CRC patients utilizing the NHIS database, the ASR derived through the operational definition of "C18-C20 as the main diagnosis" was comparable to the ASR from the KCCR. Depending on the study hypothesis, operational definitions using treatment codes may be utilized.

Keywords

Acknowledgement

This research was supported by a grant of the MD-PhD/Medical Scientist Training Program through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea. This research was also supported by a National Research Foundation of Korea (NRF) grant funded by the Korean government (MSIT) (No. 2022R1A2C1004608).

References

  1. Korea Central Cancer Registry. Annual report of cancer statistics in Korea in 2019. Sejong: Ministry of Health and Welfare; 2021 (Korean).
  2. Vital Statistics Division. Annual report on the causes of death statistics in 2021. Daejeon: Statistics Korea; 2022 (Korean).
  3. Kang MJ, Won YJ, Lee JJ, Jung KW, Kim HJ, Kong HJ, et al. Cancer statistics in Korea: incidence, mortality, survival, and prevalence in 2019. Cancer Res Treat 2022;54(2):330-344. https://doi.org/10.4143/crt.2022.128
  4. Seong SC, Kim YY, Khang YH, Park JH, Kang HJ, Lee H, et al. Data resource profile: the National Health Information Database of the National Health Insurance Service in South Korea. Int J Epidemiol 2017;46(3):799-800.
  5. Yang MS, Park M, Back JH, Lee GH, Shin JH, Kim K, et al. Validation of cancer diagnosis based on the National Health Insurance Service Database versus the National Cancer Registry Database in Korea. Cancer Res Treat 2022;54(2):352-361. https://doi.org/10.4143/crt.2021.044
  6. Kim DW, Lee SM, Lim HS, Choi JK, Park HY, Yuk TM, et al. A study on the manipulative definition of disease based on National Healthcare Insurance claims. Goyang: National Healthcare Insurance Service Ilsan Hospital; 2017 (Korean).
  7. Lee J, Lee JS, Park SH, Shin SA, Kim K. Cohort profile: the National Health Insurance Service-National Sample Cohort (NHISNSC), South Korea. Int J Epidemiol 2017;46(2):e15.
  8. Statistics Korea. Cancer incident cases and incidence rates by 61 sites, sex and 5-year age group [cited 2022 Aug 6] Available from: https://kosis.kr/statHtml/statHtml.do?orgId=117&tblId=DT_117N_A0024&conn_path=I3 (Korean).
  9. Lee S. Healthcare accreditation in Korea: the current status and challenges ahead. Health Policy Manag 2018;28(3):251-256 (Korean).
  10. Choe S, Lee J, Park JW, Jeong SY, Cho YM, Park BJ, et al. Prognosis of patients with colorectal cancer with diabetes according to medication adherence: a population-based cohort study. Cancer Epidemiol Biomarkers Prev 2020;29(6):1120-1127. https://doi.org/10.1158/1055-9965.EPI-19-1455
  11. Lee J, Choe S, Park JW, Jeong SY, Shin A. The risk of colorectal cancer after cholecystectomy or appendectomy: a population-based cohort study in Korea. J Prev Med Public Health 2018;51(6):281-288. https://doi.org/10.3961/jpmph.18.105
  12. Jang D, Choe S, Park JW, Jeong SY, Shin A. Smoking status before and after colorectal cancer diagnosis and mortality in Korean men: a population-based cohort study. Cancer Med 2020;9(24):9641-9648. https://doi.org/10.1002/cam4.3609
  13. Kang JK, Kim MS, Jang WI, Seo YS, Kim HJ, Cho CK, et al. The clinical utilization of radiation therapy in Korea between 2009 and 2013. Radiat Oncol J 2016;34(2):88-95. https://doi.org/10.3857/roj.2016.01753
  14. Kim E, Jang WI, Kim MS, Paik EK, Kim HJ, Yoo HJ, et al. Clinical utilization of radiation therapy in Korea, 2016. J Radiat Res 2020;61(2):249-256. https://doi.org/10.1093/jrr/rrz095
  15. Rim CH, Kim CY, Yang DS, Yoon WS. Clinical significance of gender and body mass index in Asian patients with colorectal cancer. J Cancer 2019;10(3):682-688. https://doi.org/10.7150/jca.28495
  16. Song N, Huang D, Jang D, Kim MJ, Jeong SY, Shin A, et al. Optimal body mass index cut-off point for predicting colorectal cancer survival in an Asian population: a national health information database analysis. Cancers (Basel) 2020;12(4):830.
  17. Kim YA, Lee YR, Park J, Oh IH, Kim H, Yoon SJ, et al. Socioeconomic burden of cancer in Korea from 2011 to 2015. Cancer Res Treat 2020;52(3):896-906. https://doi.org/10.4143/crt.2019.398
  18. Hwang IC, Chang J, Park SM. Emerging hazard effects of proton pump inhibitor on the risk of colorectal cancer in low-risk populations: a Korean nationwide prospective cohort study. PLoS One 2017;12(12):e0189114.