Demographic and claim characteristics of fee-for-service Medicare beneficiaries with prevalent mesothelioma by case definition, 2016–2019
| Characteristics* | Fee-for-service beneficiaries | Mesothelioma prevalence | |||||
| Broad case definition‡ | Intermediate case definition¶ | Narrow case definition** | |||||
| N (%) | N (%)§ | Rate per 100 000 beneficiaries | N (%) | Rate per 100 000 beneficiaries | N (%) | Rate per 100 000 beneficiaries | |
| Total | 42 529 117 | 19 036 | 44.8 | 13 642 | 32.1 | 8213 | 19.3 |
| Age group (years) | |||||||
| 18–44 | 1 762 943 (4.2) | 178 (1.0) | 10.1 | 109 (0.8) | 6.2 | 68 (0.9) | 3.9 |
| 45–64 | 5 475 168 (12.9) | 1362 (7.4) | 24.9 | 860 (6.6) | 15.7 | 453 (5.7) | 8.3 |
| 65–74 | 21 476 428 (50.5) | 6289 (34.4) | 29.3 | 4360 (33.3) | 20.3 | 2833 (35.5) | 13.2 |
| 75–84 | 9 154 419 (21.5) | 6885 (37.6) | 75.2 | 5134 (39.2) | 56.1 | 3341 (41.9) | 36.5 |
| 85+ | 4 657 743 (11.0) | 3596 (19.6) | 77.2 | 2641 (20.2) | 56.7 | 1289 (16.1) | 27.7 |
| Sex | |||||||
| Male | 19 404 996 (45.6) | 12 364 (67.5) | 63.7 | 9522 (72.7) | 49.1 | 5932 (74.3) | 30.6 |
| Female | 23 124 112 (54.4) | 5946 (32.5) | 25.7 | 3582 (27.3) | 15.5 | 2052 (25.7) | 8.9 |
| Race† | |||||||
| White | 34 749 963 (81.7) | 16 198 (88.5) | 46.6 | 11 736 (89.6) | 33.8 | 7236 (90.6) | 20.8 |
| Black | 4 212 833 (9.9) | 1193 (6.5) | 28.3 | 739 (5.6) | 17.5 | 357 (4.5) | 8.5 |
| Hispanic | 966 292 (2.3) | 254 (1.4) | 26.3 | 166 (1.3) | 17.2 | 101 (1.3) | 10.5 |
| Other | 1 799 594 (4.2) | 461 (2.5) | 25.6 | 317 (2.4) | 17.6 | 190 (2.4) | 10.6 |
| Unknown | 800 435 (1.9) | 204 (1.1) | 25.5 | 146 (1.1) | 18.2 | 100 (1.3) | 12.5 |
| Five states of residence with highest broad prevalence rate | |||||||
| New Jersey | 1 357 217 (3.2) | 883 (4.8) | 65.1 | 567 (4.3) | 41.8 | 345 (4.3) | 25.4 |
| Delaware | 194 590 (0.5) | 118 (0.6) | 60.6 | 90 (0.7) | 46.3 | 62 (0.8) | 31.9 |
| New York | 2 256 557 (5.3) | 1169 (6.4) | 51.8 | 814 (6.2) | 36.1 | 462 (5.8) | 20.5 |
| Louisiana | 635 495 (1.5) | 336 (1.8) | 51.3 | 240 (1.8) | 37.8 | 139 (1.7) | 21.9 |
| Florida | 2 764 916 (6.5) | 1407 (7.7) | 50.9 | 957 (7.3) | 34.6 | 554 (6.9) | 20.0 |
| Original entitlement reason | |||||||
| Aged ≥65 years | 32 122 273 (75.5) | 14 647 (80.0) | 45.6 | 10 691 (81.6) | 33.3 | 6735 (84.4) | 21.0 |
| Disability | 10 050 392 (23.6) | 3555 (19.4) | 35.4 | 2356 (18.0) | 23.4 | 1221 (15.3) | 12.1 |
| End-stage renal disease | 356 452 (0.8) | 108 (0.6) | 30.3 | 57 (0.4) | 16.0 | 28 (0.4) | 7.9 |
| Therapy | 7965 (41.8) | 7638 (56.0) | 6693 (81.5) | ||||
| Chemotherapy only | 1444 (7.6) | 1243 (9.1) | 931 (11.3) | ||||
| Radiation only | 242 (1.3) | 209 (1.5) | 113 (1.4) | ||||
| Surgery only | 2716 (14.3) | 2631 (19.3) | 2217 (27.0) | ||||
| Chemotherapy+radiation only | 356 (1.9) | 348 (2.6) | 297 (3.6) | ||||
| Chemotherapy+surgery only | 2144 (11.3) | 2144 (15.7) | 2095 (25.5) | ||||
| Radiation+surgery only | 191 (1.0) | 191 (1.4) | 178 (2.2.) | ||||
| Chemotherapy+radiation+surgery | 872 (4.6) | 872 (6.4) | 862 (10.5) | ||||
| Total claims | n=4 78 335 (%) | n=4 72 580 (%) | 53 782 (%) | ||||
| Claim type | |||||||
| Carrier | 327 691 (68.5) | 323 929 (68.5) | 28 280 (52.6) | ||||
| Outpatient | 114 446 (23.9) | 112 971 (23.9) | 20 689 (38.5) | ||||
| Inpatient | 14 369 (3.0) | 14 369 (3.0) | 4767 (8.9) | ||||
| Hospice | 13 973 (2.9) | 13 691 (2.9) | 46 (0.1) | ||||
| Home health agency | 5542 (1.2) | 5360 (1.1) | 0 (0) | ||||
| Skilled nursing facility | 2314 (0.5) | 2260 (0.5) | 0 (0) | ||||
| ICD-10-CM principal diagnosis | |||||||
| Mesothelioma of pleura (C45.0) | 163 924 (34.3) | 163 444 (34.6) | 17 900 (33.3) | ||||
| Mesothelioma of peritoneum (C45.1) | 35 239 (7.4) | 34 796 (7.4) | 4277 (8.0) | ||||
| Mesothelioma of pericardium (C45.2) | 907 (0.2) | 732 (0.2) | 87 (0.2) | ||||
| Mesothelioma of other sites (C45.7) | 27 653 (5.8) | 27 496 (5.8) | 3250 (6.0) | ||||
| Mesothelioma, unspecified (C45.9) | 87 754 (18.4) | 86 429 (18.3) | 12 339 (22.9) | ||||
| Encounter for antineoplastic chemotherapy and immunotherapy (Z51.1) | 23 594 (4.9) | 23 534 (5.0) | 797 (1.5) | ||||
| Pleural effusion (J90) | 7383 (1.5) | 7298 (1.5) | 2649 (4.9) | ||||
| Other principal diagnoses | 131 881 (27.6) | 128 851 (27.3) | 12 483 (23.2) | ||||
Significant differences (p<0.05) were found within demographic categories (age, sex, race and original entitlement reason) between all three case definitions and between total fee-for-service beneficiaries and all three case definitions.
*Demographic information was determined from the year of a beneficiary’s first broad, intermediate or narrow mesothelioma claim for the corresponding case definition of interest.
†Other race includes Asian, North American Native and other.
‡The broad mesothelioma case definition identified any fee-for-service beneficiary with a claim including the ICD-10-CM code C45 (mesothelioma).
§Demographic information was available for the year of the first mesothelioma claim for 18 310 beneficiaries (broad case definition), 13 104 beneficiaries (intermediate case definition) and 7984 beneficiaries (narrow case definition).
¶The intermediate mesothelioma case definition identified any fee-for-service beneficiary with at least one inpatient claim or ≥2 other claims (outpatient, hospice, home health agency, skilled nursing facility or carrier) including the ICD-10-CM code C45.
**The narrow mesothelioma case definition identified any fee-for-service beneficiary with at least one inpatient claim or ≥2 other claims (outpatient, hospice, home health agency, skilled nursing facility or carrier) including the ICD-10-CM code C45 and a Healthcare Common Procedure Coding System code or an ICD-CM procedure code for a mesothelioma diagnostic procedure.
ICD-10-CM, 10th Revision International Classification of Diseases, Clinical Modification .