Cancer incidence in HIV-infected versus uninfected veterans: Comparison of cancer registry and ICD-9 code diagnoses

Authors

Lesley S. Park, Yale University
Janet P. Tate, Yale University
Maria Rodriguez-Barradas, Michael E. DeBakey Veterans Affairs (VA), Medical Cente
David Rimland, Emory University
Matthew B. Goetz, University of California, Los Angeles
Cynthia L. Gibert, George Washington UniversityFollow
Sheldon T. Brown, Mount Sinai School of Medicine
Michael J. Kelley, Department of Veterans Affairs, Washington, DC
Amy C. Justice, Yale University
Robert Dubrow, Yale University

Document Type

Journal Article

Publication Date

2014

Journal

Journal of AIDS and Clinical Research

Volume

Volume 5

Inclusive Pages

Article number 318

Abstract

Background: Given the growing interest in the cancer burden in persons living with HIV/AIDS, we examined the validity of data sources for cancer diagnoses (cancer registry versus International Classification of Diseases, Ninth Revision [ICD-9 codes]) and compared the association between HIV status and cancer risk using each data source in the Veterans Aging Cohort Study (VACS), a prospective cohort of HIV-infected and uninfected veterans from 1996 to 2008.

Methods: We reviewed charts to confirm potential incident cancers at four VACS sites. In the entire cohort, we calculated cancer-type-specific age-, sex-, race/ethnicity-, and calendar-period-standardized incidence rates and incidence rate ratios (IRR) (HIV-infected versus uninfected). We calculated standardized incidence ratios (SIR) to compare VACS and Surveillance, Epidemiology, and End Results rates.

Results: Compared to chart review, both Veterans Affairs Central Cancer Registry (VACCR) and ICD-9 diagnoses had approximately 90% sensitivity; however, VACCR had higher positive predictive value (96% versus 63%). There were 6,010 VACCR and 13,386 ICD-9 incident cancers among 116,072 veterans. Although ICD-9 rates tended to be double VACCR rates, most IRRs were in the same direction and of similar magnitude, regardless of data source. Using source, all cancers combined, most viral-infection-related cancers, lung cancer, melanoma, and leukemia had significantly elevated IRRs. Using ICD-9, eight additional IRRs were significantly elevated, most likely due to false positive diagnoses. Most ICD-9 SIRs were significantly elevated and all were higher than the corresponding VACCR SIR.

Conclusions: ICD-9 may be used with caution for estimating IRRs, but should be avoided when estimating incidence or SIRs. Elevated cancer risk based on VACCR diagnoses among HIV-infected veterans was consistent with other studies.

Comments

Reproduced with permission of OMICS, Journal of AIDS and Clinical Research.

Creative Commons License

This work is licensed under a Creative Commons Attribution 3.0 License.

APA Citation

Park, L.S., Tate, J.P., Rodriguez-Barradas, M.C., Rimland, D., Goetz, M.B. et al. (2014). Cancer incidence in HIV-infected versus uninfected veterans: Comparison of Cancer Registry and ICD-9 code diagnoses. Journal of AIDS and Clinical Research, 5:318.

Open Access

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