Surveillance, Epidemiology and End Results (SEER)-Medicare

Database Name: SEER-Medicare

Description

Data Source

Population-based cancer registry covering 28% of the US population. Data have been collected since 1973. The SEER program is overseen by the National Cancer Institute. These data are linked to Medicare Claims data.

Overview of data contents

Includes all the data in the SEER database plus Medical claims. Demographic information including age, sex, race/ethnicity, registry location, county level socioeconomic status, and marital status. Clinic variables include histology, stage, grade, and site-specific factors. SEER has low loss to follow-up and also has data on cause of death, which is a major strength of the database. Claims data include procedures, dates of services, and amount charged. Physician and hospital data can be utilized with special permission.

Patient ages included

65+years

Practice setting

Data are collected by registry staff from medical records. Follow-up data are primarily from the National Death Index. Medicare claims are collected by CMS.

Date range available

SEER data available from 1973-present. Medicare linked data available from 1991-present.

Relevant Work

Example publications
 

Brooks, G.A., et al., Regional variation in spending and survival for older adults with advanced cancer. J Natl Cancer Inst, 2013. 105(9):p.634-42.

Bleicher, R.J., et al., Preoperative delays in the US Medicare population with breast cancer. J Clin Oncol, 2012.30(36):p.4485-92.

Sanoff, H.K., et al., Effect of adjuvant chemotherapy on survival of patients with stage III colon cancer diagnosed after age 75 years. J Clin Oncol, 2012. 30(21):p.2624-34.

Access 

Cost estimate(s)

Costs vary based on how many years and sites are requested (may range from $2,000-$10,000+). Application must be approved before receiving data and mush have IRB approval for study before submitting application.

Contact/website information

http://appliedresearch.cancer.gov/seermedicare/

Practicalities 

Ease of use

Requires a lot of storage as the claims files is very large and SAS or comparable statistical software are needed. An experienced data manager/analyst is required. SEER-Medicare workshop material is posted on the SEER-Medicare website.

Data analysis

Cohort formation can be challenging as only patients enrolled in Parts A & B have claims data so enrollment windows need to be determined prior to data analysis. Determining which codes (CPT, HCPCS and ICD-9) used to identify treatment is challenging.

Pros

It affords a more detailed treatment analyses. Very detailed information on treatment (type of chemotherapy, radiation and surgery, dates of administration) are available. Cost data are also available. Pre-diagnosis comorbidity data are available as well.

Cons

Limited to patients aged 65+. Patients enrolled in HMO are not included, generalizability is a limitation. Claims data are not easy to use and the data can be expensive. Incidence and mortality rates cannot be assessed.