SEER

["John Williams" <JohnWi@law.com>]

http://www.seer.cancer.gov/



The SEER Program is considered as the standard for quality among 

cancer registries around the world. Quality control has been an 

integral part of SEER since its inception. Every year, studies are 

conducted in the SEER areas to evaluate the quality and completeness 

of the data being reported (SEER's standard for case ascertainment is 

98 percent). In some studies, a sample of cases is reabstracted to 

evaluate the accuracy of each of the data elements collected from the 

medical records. In other studies, targeted information gathering is 

performed to address specific data quality needs. Computer edits also 

are used by registries to ensure accurate and consistent data.



The Surveillance, Epidemiology, and End Results (SEER) Program of the 

National Cancer Institute is the most authoritative source of 

information on cancer incidence and survival in the United States. 

Case ascertainment for SEER began on January 1, 1973, in the states 

of Connecticut, Iowa, New Mexico, Utah, and Hawaii and the 

metropolitan areas of Detroit and San Francisco-Oakland. In 1974-

1975, the metropolitan area of Atlanta and the 13-county Seattle-

Puget Sound area were added. In 1978, 10 predominantly black rural 

counties in Georgia were added, followed in 1980 by the addition of 

American Indians residing in Arizona. Three additional geographic 

areas participated in the SEER program prior to 1990: New Orleans, 

Louisiana (1974-1977); four counties in New Jersey (1979-1989); and 

Puerto Rico (1973-1989). The National Cancer Institute also began 

funding a cancer registry that, with technical assistance from SEER, 

collects information on cancer cases among Alaska Native populations 

residing in Alaska. In 1992, the SEER Program was expanded to 

increase coverage of minority populations, especially Hispanics, by 

adding Los Angeles County and four counties in the San Jose-Monterey 

area south of San Francisco. 



Geographic areas were selected for inclusion in the SEER Program 

based on their ability to operate and maintain a high quality 

population-based cancer reporting system and for their 

epidemiologically significant population subgroups. The population 

covered by SEER is comparable to the general U.S. population with 

regard to measures of poverty and education. The SEER population 

tends to be somewhat more urban and has a higher proportion of 

foreign-born persons than the general U.S. population. 



The SEER Program currently collects and publishes cancer incidence 

and survival data from 11 population-based cancer registries and 

three supplemental registries covering approximately 14 percent of 

the U.S. population. Information on more than 2.5 million in situ and 

invasive cancer cases is included in the SEER database, and 

approximately 160,000 new cases are accessioned each year within the 

SEER catchment areas. The SEER registries routinely collect data on 

patient demographics, primary tumor site, morphology, stage at 

diagnosis, first course of treatment, and follow-up for vital status. 

The SEER Program is the only comprehensive source of population-based 

information in the United States that includes stage of cancer at the 

time of diagnosis and survival rates within each stage. The mortality 

data reported by SEER are provided by the National Center for Health 

Statistics. 



Updated annually and provided as a public service in print and 

electronic formats, SEER data are used by thousands of researchers, 

clinicians, public health officials, legislators, policymakers, 

community groups, and the public. The SEER Program provides cancer 

incidence, mortality, and survival data in an annual cancer 

statistics review, in monographs on relevant topics, through the SEER 

Web site ( http://seer.cancer.gov ), in various specially-developed 

software packages (e.g., SEER*Stat, SEER*Prep), and in a public-use 

data file. SEER data and resources are available free of charge. 

Instructions for obtaining the software, publications, and electronic 

data are available at the above links. 



In addition to annual reports, SEER data are used in an ongoing 

program of special studies to address emerging cancer research 

questions. These special studies may include the collection of 

additional information about the SEER cancer cases through surveys, 

personal interviews, additional records abstraction, or the 

collection of biological materials. SEER records have also been 

linked with other data systems in order to meet research needs. 

Examples of SEER special studies include efforts to identify and to 

understand the reasons for geographic and population differences in 

cancer patterns. The influence of occupational, environmental, 

sociocultural, and personal lifestyle factors on cancer incidence and 

survival are being investigated. Other special studies focus on the 

quality of life of cancer patients, cancer treatment outcomes, and 

the extent and speed with which state-of-the-art treatments are 

implemented across the country. 



NCI staff responsible for managing the SEER Program provide liaison 

and coordinate activities with a number of organizations that are 

also involved in cancer surveillance and related disciplines. These 

include the North American Association of Central Cancer Registries, 

the American Cancer Society, the American College of Surgeons, the 

National Cancer Registrars Association, the International Association 

of Cancer Registries, the International Association for Research on 

Cancer, the World Health Organization, and the federal Centers for 

Disease Control and Prevention. Activities include setting standards 

for data collection by cancer registries, providing for the 

interchange of ideas and tools for cancer surveillance, training and 

providing educational materials for the credentialing of cancer 

registrars, leading workshops to provide advanced training in data 

collection and coding, collaborating in the analysis and reporting of 

cancer rates, and supporting efforts to expand existing cancer 

surveillance and to establish new cancer reporting systems. NCI staff 

also provide technical assistance to non-SEER registries upon 

request, subject to available resources. This may include conducting 

workshops on data collection procedures and registry operations or 

training classes in the use of personal computer software used to 

format registry databases and to perform statistical analysis of the 

registry data. 



John Williams





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