Table 1.

Patient Selection Criteria for Approaches Used to Estimate Prevalence Costs of Care for Colorectal Cancer

	SEER-Medicare	5% Medicare Sample Claims Only	MEPS
CRC Patient Identification	Registry ICD-O codes 18.0, 18.2− 18.9, 19.9, 20.9, 26.0	Claims* ICD-9 codes 153–154.1, 159.0 and 230.3, 230.4	Self-report classified by ICD-9 codes 153,154,159
Year CRC Patients Diagnosed/Identified	1973 – 2002	1996–2002	1996–2004
Observation Period	1998–2002	1998–2002	1996–2004
Exclusions	Prior cancers (other than colorectal) Death certificate/ autopsy diagnosis Unusual histology Medicare managed care or Medicare fee-for-servic Part A only during observation period	Prior cancers other than colorectal (ICD-9 codes 140– 152.9, 154.2–158.9,160– 208.99) Medicare managed care or Medicare fee-for-service Part A only during observation period	Other cancers (ICD-9 codes 140–152, 155–158, 160–195, 199–208, 230)
Years Controls Identified	1998–2002	1998–2002	1996–2004
Control exclusions	Cancer per registry 1973–2002 Medicare managed care or Medicare fee-for-service Part A only during observation period	Cancer care per claims, 1998–2002 Medicare managed care or Medicare fee-for-service Part A only during observation period	Receiving care for cancer or limited by cancer per self-report
Payors	Medicare fee-for-service (Part A and Part B) only		All payors, including Medicare fee for service and managed care, Medicaid, VA, other public and private (e.g., supplemental insurance) and out of pocket
Services included	Fee-for service Part A and Part B Medicare payments from all Medicare claims files: inpatient, hospital outpatient, physician services, hospice, home health care, durable medical equipment Chemotherapy and administration for drugs administered parenterally and Prodrugs, the oral equivalent of drugs administered parenterally		All payments for hospitalizations, ambulatory visits, home health care, prescription drugs, and dental services
Services not measured	Oral prescription drugs including some chemotherapies, long-term care, services where Medicare is secondary payor, out-of- pocket (i.e., co-pays, deductibles)		Chemotherapy not identified separately, but included in outpatient care

CRC = colorectal cancer SEER = Surveillance Epidemiology and End Results; MEPS = Medical Expenditure Panel Survey; ICD-O = International Classification of Diseases for Oncology; ICD-9= International Classification of Diseases-9^th Revision;

^*Colorectal cancer cases were identified as patients with any hospital claims with diagnosis codes for colorectal cancer or 2 physician or outpatient claims with claims for colorectal cancer 60 days apart, but within 1 year.