Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Jul;56(4):312-318.
doi: 10.3961/jpmph.23.033. Epub 2023 May 31.

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

Hyeree Park  1   2   3 , Yu Rim Kim  4 , Yerin Pyun  5 , Hyundeok Joo  1 , Aesun Shin  1   2   3
Affiliations
Review

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

Hyeree Park et al. J Prev Med Public Health. 2023 Jul.

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: Colorectal neoplasms; Incidence; National Health Programs; Rectal neoplasms.

PubMed Disclaimer

Conflict of interest statement

CONFLICT OF INTEREST

The authors have no conflicts of interest associated with the material presented in this paper.

Figures

Figure 1
Figure 1
Flow chart of study selection for the review.
Figure 2
Figure 2
Age-standardized incidence rate of colorectal can­cer according to four operational definitions and Korea Cen­tral Cancer Registry (KCCR) data. (A) Male. (B) Female.
See this image and copyright information in PMC

References

    1. Korea Central Cancer Registry . Annual report of cancer statistics in Korea in 2019. Sejong: Ministry of Health and Welfare; 2021. (Korean)
    1. Vital Statistics Division . Annual report on the causes of death statistics in 2021. Daejeon: Statistics Korea; 2022. (Korean)
    1. 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. - PMC - PubMed
    1. 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. - PMC - PubMed
    1. 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. - PMC - PubMed