Cancer diagnoses after living kidney donation: Linking U.S. Registry data and administrative claims

Krista L. Lentine, Anitha Vijayan, Huiling Xiao, Mark A. Schnitzler, Connie L. Davis, Amit X. Garg, David Axelrod, Kevin C. Abbott, Daniel Brennan

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Mortality records identify cancer as the leading cause of death among living kidney donors, but information on the burden of cancer outside death records is limited in this population. METHODS: We examined a database wherein U.S. Organ Procurement and Transplantation Network identifiers for 4,650 living kidney donors in 1987 to 2007 were linked to administrative data of a U.S. private health insurer (2000-2007 claims) to identify postdonation cancer diagnoses. Skin cancer and non-skin cancer diagnoses were ascertained from International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes on billing claims. Donors were also matched one-to-one with general insurance beneficiaries by sex and age when benefits began. Diagnosis rates within observation windows were compared as rate ratios. RESULTS: The median time from donation to the end of plan insurance enrollment was 7.7 years, with a median observation period of 2.1 years. Skin cancer rates were similar among prior living donors in the observation period and nondonor controls (rate ratio, 0.91; 95% confidence interval [CI], 0.59-1.40). In contrast, the rate of total non-skin cancers was significantly less common among donors than among controls (rate ratio, 0.74; 95% CI, 0.55-0.99), although reduced relative risk was limited to donors captured earlier in relation to donation. Several cases of cancer diagnosis (uterine, melanoma, "other") were identified within the first year after donation. Prostate cancer diagnosis was significantly more common among living donors compared with controls (rate ratio, 3.80; 95% CI, 1.42-10.2). CONCLUSIONS: Continued study of cancer after kidney donation is warranted to ensure that evaluation, selection, and long-term follow-up support overall good health of the donor.

Original languageEnglish (US)
Pages (from-to)139-144
Number of pages6
JournalTransplantation
Volume94
Issue number2
DOIs
StatePublished - Jul 27 2012
Externally publishedYes

Fingerprint

Registries
Living Donors
Kidney
Skin Neoplasms
Tissue Donors
Neoplasms
Observation
Confidence Intervals
Insurance Carriers
Uterine Neoplasms
Death Certificates
Tissue and Organ Procurement
Kidney Neoplasms
Health
Organ Transplantation
International Classification of Diseases
Insurance Benefits
Insurance
Cause of Death
Melanoma

Keywords

  • Administrative claims
  • Cancer
  • Kidney transplantation
  • Living donors
  • Registries

ASJC Scopus subject areas

  • Transplantation

Cite this

Cancer diagnoses after living kidney donation : Linking U.S. Registry data and administrative claims. / Lentine, Krista L.; Vijayan, Anitha; Xiao, Huiling; Schnitzler, Mark A.; Davis, Connie L.; Garg, Amit X.; Axelrod, David; Abbott, Kevin C.; Brennan, Daniel.

In: Transplantation, Vol. 94, No. 2, 27.07.2012, p. 139-144.

Research output: Contribution to journalArticle

Lentine, KL, Vijayan, A, Xiao, H, Schnitzler, MA, Davis, CL, Garg, AX, Axelrod, D, Abbott, KC & Brennan, D 2012, 'Cancer diagnoses after living kidney donation: Linking U.S. Registry data and administrative claims', Transplantation, vol. 94, no. 2, pp. 139-144. https://doi.org/10.1097/TP.0b013e318254757d
Lentine, Krista L. ; Vijayan, Anitha ; Xiao, Huiling ; Schnitzler, Mark A. ; Davis, Connie L. ; Garg, Amit X. ; Axelrod, David ; Abbott, Kevin C. ; Brennan, Daniel. / Cancer diagnoses after living kidney donation : Linking U.S. Registry data and administrative claims. In: Transplantation. 2012 ; Vol. 94, No. 2. pp. 139-144.
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abstract = "BACKGROUND: Mortality records identify cancer as the leading cause of death among living kidney donors, but information on the burden of cancer outside death records is limited in this population. METHODS: We examined a database wherein U.S. Organ Procurement and Transplantation Network identifiers for 4,650 living kidney donors in 1987 to 2007 were linked to administrative data of a U.S. private health insurer (2000-2007 claims) to identify postdonation cancer diagnoses. Skin cancer and non-skin cancer diagnoses were ascertained from International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes on billing claims. Donors were also matched one-to-one with general insurance beneficiaries by sex and age when benefits began. Diagnosis rates within observation windows were compared as rate ratios. RESULTS: The median time from donation to the end of plan insurance enrollment was 7.7 years, with a median observation period of 2.1 years. Skin cancer rates were similar among prior living donors in the observation period and nondonor controls (rate ratio, 0.91; 95{\%} confidence interval [CI], 0.59-1.40). In contrast, the rate of total non-skin cancers was significantly less common among donors than among controls (rate ratio, 0.74; 95{\%} CI, 0.55-0.99), although reduced relative risk was limited to donors captured earlier in relation to donation. Several cases of cancer diagnosis (uterine, melanoma, {"}other{"}) were identified within the first year after donation. Prostate cancer diagnosis was significantly more common among living donors compared with controls (rate ratio, 3.80; 95{\%} CI, 1.42-10.2). CONCLUSIONS: Continued study of cancer after kidney donation is warranted to ensure that evaluation, selection, and long-term follow-up support overall good health of the donor.",
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T1 - Cancer diagnoses after living kidney donation

T2 - Linking U.S. Registry data and administrative claims

AU - Lentine, Krista L.

AU - Vijayan, Anitha

AU - Xiao, Huiling

AU - Schnitzler, Mark A.

AU - Davis, Connie L.

AU - Garg, Amit X.

AU - Axelrod, David

AU - Abbott, Kevin C.

AU - Brennan, Daniel

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N2 - BACKGROUND: Mortality records identify cancer as the leading cause of death among living kidney donors, but information on the burden of cancer outside death records is limited in this population. METHODS: We examined a database wherein U.S. Organ Procurement and Transplantation Network identifiers for 4,650 living kidney donors in 1987 to 2007 were linked to administrative data of a U.S. private health insurer (2000-2007 claims) to identify postdonation cancer diagnoses. Skin cancer and non-skin cancer diagnoses were ascertained from International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes on billing claims. Donors were also matched one-to-one with general insurance beneficiaries by sex and age when benefits began. Diagnosis rates within observation windows were compared as rate ratios. RESULTS: The median time from donation to the end of plan insurance enrollment was 7.7 years, with a median observation period of 2.1 years. Skin cancer rates were similar among prior living donors in the observation period and nondonor controls (rate ratio, 0.91; 95% confidence interval [CI], 0.59-1.40). In contrast, the rate of total non-skin cancers was significantly less common among donors than among controls (rate ratio, 0.74; 95% CI, 0.55-0.99), although reduced relative risk was limited to donors captured earlier in relation to donation. Several cases of cancer diagnosis (uterine, melanoma, "other") were identified within the first year after donation. Prostate cancer diagnosis was significantly more common among living donors compared with controls (rate ratio, 3.80; 95% CI, 1.42-10.2). CONCLUSIONS: Continued study of cancer after kidney donation is warranted to ensure that evaluation, selection, and long-term follow-up support overall good health of the donor.

AB - BACKGROUND: Mortality records identify cancer as the leading cause of death among living kidney donors, but information on the burden of cancer outside death records is limited in this population. METHODS: We examined a database wherein U.S. Organ Procurement and Transplantation Network identifiers for 4,650 living kidney donors in 1987 to 2007 were linked to administrative data of a U.S. private health insurer (2000-2007 claims) to identify postdonation cancer diagnoses. Skin cancer and non-skin cancer diagnoses were ascertained from International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes on billing claims. Donors were also matched one-to-one with general insurance beneficiaries by sex and age when benefits began. Diagnosis rates within observation windows were compared as rate ratios. RESULTS: The median time from donation to the end of plan insurance enrollment was 7.7 years, with a median observation period of 2.1 years. Skin cancer rates were similar among prior living donors in the observation period and nondonor controls (rate ratio, 0.91; 95% confidence interval [CI], 0.59-1.40). In contrast, the rate of total non-skin cancers was significantly less common among donors than among controls (rate ratio, 0.74; 95% CI, 0.55-0.99), although reduced relative risk was limited to donors captured earlier in relation to donation. Several cases of cancer diagnosis (uterine, melanoma, "other") were identified within the first year after donation. Prostate cancer diagnosis was significantly more common among living donors compared with controls (rate ratio, 3.80; 95% CI, 1.42-10.2). CONCLUSIONS: Continued study of cancer after kidney donation is warranted to ensure that evaluation, selection, and long-term follow-up support overall good health of the donor.

KW - Administrative claims

KW - Cancer

KW - Kidney transplantation

KW - Living donors

KW - Registries

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