title: Validating the use of Medicare Australia billing data to examine trends in skin cancer.
abstract: BACKGROUND
  Epidemiological data surrounding non-melanomatous skin cancer (NMSC) is highly variable, in part due to the lack of government cancer registries. Several studies employ the use of Medical Australia (MA) rebate data in assessing such trends, the validity of which has not been studied in the past. Conversely, melanoma skin cancer is a notifiable disease, and thus, MA and cancer registry data is readily available. The aim of the current study is to assess the use of MA for epidemiological measures for skin cancers, by using melanoma as a disease sample.
  
  
  METHODS
  Following ethics approval, data from MA and Victorian Cancer Registry (VCR) from 2004-2008 were extracted. Incidence of MA and VCR unique melanoma cases were compared and stratified by age and local government area (LGA). Regression and a paired-samples t-test were performed.
  
  
  RESULTS
  During the study period; 15,150 and 13,886 unique melanoma patients were identified through VCR and MA data sources respectively. An outlier in the >80- year age group was noted between MA and VCR data. When stratified by age, significant correlation between MA and VCR was observed for all patients (gradient 0.91, R²= 0.936) and following exclusion of >80 patients (gradient 0.96, R²= 0.995). When stratified by LGA, a high degree of observation was observed for all patients (gradient 0.94, R²= 0.977) and following exclusion of >80 patients (gradient 0.996, R²= 0.975).
  
  
  CONCLUSIONS
  Despite the inclusion of outlier data groups, acceptable correlation between MA and VCR melanoma data was observed, suggesting that MA may be suitable for assessing epidemiological trends. Such principals may be used to validate the use of MA data for similar calculations assessing NMSC trends.
authors.affiliation: Cancer Council Victoria, Melbourne, Australia; Faculty of Medicine, Dentistry and Health Science, University of Melbourne, Parkville, Australia; Sinclair Dermatology, Melbourne, Australia.
authors.forename: Eshini
authors.initials: E
authors.lastname: Perera
authors.affiliation: Plastic Surgery, Royal Brisbane Hospital, Brisbane, Australia.
authors.forename: Neiraja
authors.initials: N
authors.lastname: Gnaneswaran
authors.affiliation: School of Medicine, University of Queensland, Brisbane, Australia.
authors.forename: Marlon
authors.initials: M
authors.lastname: Perera
authors.affiliation: Faculty of Medicine, Dentistry and Health Science, University of Melbourne, Parkville, Australia; Sinclair Dermatology, Melbourne, Australia.
authors.forename: Rodney
authors.initials: R
authors.lastname: Sinclair
keywords: Dermatology incidence; Nonmelanoma skin cancer; epidemiology; medicare; melanoma