CMET-41. LIFETIME LUNG, BREAST, AND SKIN CANCER BRAIN METASTASES INCIDENCE: A REPRODUCIBLE SEER-MEDICARE STUDY. (5th November 2018)

• Record Type: Journal Article
• Authors: Ascha, Mustafa; Ostrom, Quinn; Bordeaux, Jeremy; Sloan, Andrew; Schumacher, Frederick; Kruchko, Carol; Barnholtz-Sloan, Jill
• Is Part Of: Neuro-oncology. Volume 20(2018)Supplement 6
• Page Start: vi62
• Page End: vi62
• Publication Date: 2018-11-05
• Subjects: Brain Neoplasms -- Periodicals; Brain -- Tumors -- Periodicals; Brain -- Cancer -- Periodicals; Nervous system -- Cancer -- Periodicals; 616.99481
• DOI: 10.1093/neuonc/noy148.251
• Languages: English
• ISSNs: 1522-8517

Abstract

Abstract: INTRODUCTION: With improvements in cancer detection and primary cancer control, brain metastases (BM) become a greater concern. The Surveillance, Epidemiology, and End-Results (SEER) program recently released data on BM diagnosed at the same time as primary cancer, referred to as synchronous BM (SBM). Tentative evidence of lifetime BM (LBM) is present in Medicare claims, expanding the utility of these new SBM data. PURPOSE: This is a reproducible SEER-Medicare study estimating synchronous versus lifetime frequencies of BM for primary lung, breast, and skin cancers. MATERIALS AND METHODS: SEER data were linked to Medicare claims from 2007–2014 to identify incidence proportions (IP) and average annual age-adjusted incidence rates of SBM and LBM. SEER SBM data were linked to Medicare claims and used as a gold standard to evaluate Medicare BM algorithms, the classification performance of which informed similar estimates of LBM incidence. RESULTS: The IP of SEER SBM in lung, breast, and skin cancers was 9.6%, 0.3%, and 1.1%, respectively. The greatest SBM IP among lung cancer patients was 13.4% for non-small cell lung cancer, and among breast cancer patients was 0.7% for triple-negative breast cancer. The greatest LBM IP among lung cancers was 21.7% in small-cell lung cancer, 4.0% in triple negative cases for breast cancer, and 1.7% in nevi and melanomas. Concordance between Medicare claims and SEER regarding SBM was 0.61 (95% CI: 0.60 - 0.62) for lung cancer, 0.45 (95% CI: 0.39 - 0.51) for breast cancers, and 0.65 (95% CI: 0.59 - 0.70) for melanoma. Fewer SBM cases were found in Medicare claims than in SEER. CONCLUSIONS: These analyses provide a population-level glimpse into the natural history of BM, estimating both synchronous and lifetime incidence in lung, breast, and skin cancers using a large dataset that is representative of the US.