(132) Integrating Healthcare Databases to Establish Screening Cohort for Asian Nomadic Descendants in China Inner Mongolia Autonomous Region: Cohort Profile of Scan-China

Publication Number: 1177

Background: Considerable cancer burdens are reported among Mongolian, the largest ethnic minority in East Asia (over 10 million population globally with 63% Chinese), who mainly reside in the inner Mongolia autonomous region (IM), China. However, few epidemiological studies or health interventions has been initiated to rectify the cancer health disparity.

Objectives: To establish an ethnic-oriented dynamic cancer screening cohort, via integrating primarily collected data (risk assessments & screening tests) with electronic healthcare databases (EHD).

Methods: Since Jan 2017, citizens aged 40-75 in 5 districts of 2 most populated cities in IM are conveniently sampled via free-of-charge attendance, social medium and recommendations. Information on sociodemographic and risk factors associated with targeted cancers (lung, breast, liver, upper gastrointestinal including esophageal and gastric, colorectal cancer [1]) was collected by paper-based risk assessment questionnaire. With an established risk score system, participants considered at high risk will undergo screening tests. Participants screened as negative will be followed actively by five-year annual screening and phone/in-house visits. All participants in the cohort will be passively followed using EHD (claims, cancer registry, first page of medical records and death registry) to update their information on diagnosis, medications, cause of death, tumor onset, comorbidities, etc. Data linkage and integration is realized by personal identify number, which is de-identified during data analysis for privacy protection.

Results: This project is ongoing with 70,010 valid baseline questionnaires. After de-duplication and verification, 69,590 eligible participants remain for data analysis (mean age = 55.7 years, 53.7% female, 11.3% Mongolian and 86.2% general population interacting with Mongolian due to geographic subjection). 22.5%, 21.0%, 15.9%, 16.8%, 19.0%, 19.3% participants were considered at high risk in targeted cancer types [1]. By 2019, 365 new cases of all cancer types were captured in claims and cancer registry, and 59,57,18,22,19,57 were diagnosed as targeted cancer types [1]. 414,752 prescriptions were captured in the claims, among the top 5 prevalent being solvents, Niuhuang Chinese medicine, aspirin, adrenal corticosteroids and proton pump inhibitors.

Conclusions: Scan-China is a unique multi-source EHD platform to generalize epidemiological knowledge and popularize screening interventions on the Mongolian population. Though at the preliminary statistical stage, risk factors will be explored and validated using prediction models, as well as cancer-related comorbidities, complication, treatment patterns, drug efficacy and safety, etc will be studied in the future.