{"doi":"10.1093/jamia/ocaf172","title":"A novel analysis methodology for assessment of re-identification risks for the National Cancer Institute cancer registry privacy preserving record linkage technique","abstract":"OBJECTIVE: The National Cancer Institute (NCI), part of the National Institutes of Health (NIH) supports efforts to address critical challenges in advancing cancer research. As part of this effort, NCI sponsored the development of a privacy-preserving record linkage (PPRL) software that transforms identifying patient information into multiple tokens through a set of cryptographically secure keyed hash functions. This project aims to evaluate the PPRL software in the perspective of re-identification risks and propose effective strategies to sufficiently mitigate these risks. MATERIALS AND METHODS: To achieve the goals, we developed a novel re-identification risk assessment framework, based on token frequency analysis, to estimate the privacy impact of hashed tokens shared for record linkage. We assessed privacy risk through empirical analysis on a state-level voter registration database, a public dataset commonly used for re-identification, under various scenarios. These scenarios are defined based on several factors, including the size of the dataset used for linkage and a group size parameter that determines when an adversary can claim that a record has been re-identified. RESULTS: We found that the re-identification risk based on frequency analysis attack is approximately 0.0002 (ie, 2 patients out of 10 000 are potentially identifiable) under reasonable adversarial settings, with a group size parameter of k = 12 and a dataset size of 400 000 patients. Additionally, our analysis reveals a negative correlation between dataset size and re-identification risk. DISCUSSION: Re-identification risk is deemed low for the new NCI PPRL software. Token frequency analysis provides a reliable estimate of the re-identification risk in token-based PPRL tools.","journal":"Journal of the American Medical Informatics Association","year":2025,"id":579251,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9571,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1388674,"name":"Will Howe","orcid":"0009-0009-4227-5217","position":1,"is_corresponding":false},{"id":545444,"name":"Benmei Liu","orcid":"0000-0003-0096-139X","position":2,"is_corresponding":false},{"id":447318,"name":"Valentina I. Petkov","orcid":"0009-0009-8297-5381","position":3,"is_corresponding":false},{"id":618984,"name":"Esmeralda Casas-Silva","orcid":"0000-0002-9704-0812","position":4,"is_corresponding":false},{"id":1489473,"name":"Diana Velasquez-Kolnik","orcid":"0009-0003-1866-6281","position":5,"is_corresponding":false},{"id":320509,"name":"Bradley Malin","orcid":"0000-0003-3040-5175","position":6,"is_corresponding":false},{"id":356471,"name":"Lynne Penberthy","orcid":"0000-0001-9372-9869","position":7,"is_corresponding":false},{"id":381536,"name":"Murat Kantarcıoğlu","orcid":"0000-0001-9795-9063","position":0,"is_corresponding":true}],"reference_count":8,"raw_metadata":null,"created_at":"2026-07-19T02:58:30.282164Z","pmid":"41144319","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}