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Comparison of SEER Treatment Data With Medicare Claims

Noone, Anne-Michelle MS; Lund, Jennifer L. PhD; Mariotto, Angela PhD; Cronin, Kathleen PhD; McNeel, Timothy BA; Deapen, Dennis DrPH; Warren, Joan L. PhD

doi: 10.1097/MLR.0000000000000073
Applied Methods

Background: The population-based Surveillance, Epidemiology, and End Results (SEER) registries collect information on first-course treatment, including surgery, chemotherapy, radiation therapy, and hormone therapy. However, the SEER program does not release data on chemotherapy or hormone therapy due to uncertainties regarding data completeness. Activities are ongoing to investigate the opportunity to supplement SEER treatment data with other data sources.

Methods: Using the linked SEER-Medicare data, we examined the validity of the SEER data to identify receipt of chemotherapy and radiation therapy among those aged 65 and older diagnosed from 2000 to 2006 with bladder, female breast, colorectal, lung, ovarian, pancreas, or prostate cancer and hormone therapy among men diagnosed with prostate cancer at age 65 or older. Treatment collected by SEER was compared with treatment as determined by Medicare claims, using Medicare claims as the gold standard. The κ, sensitivity, specificity, positive predictive values, and negative predictive values were calculated for the receipt of each treatment modality.

Results: The overall sensitivity of SEER data to identify chemotherapy, radiation, and hormone therapy receipt was moderate (68%, 80%, and 69%, respectively) and varied by cancer site, stage, and patient characteristics. The overall positive predictive value was high (>85%) for all treatment types and cancer sites except chemotherapy for prostate cancer.

Conclusions: SEER data should not generally be used for comparisons of treated and untreated individuals or to estimate the proportion of treated individuals in the population. Augmenting SEER data with other data sources will provide the most accurate treatment information.

*Division of Cancer Control and Population Sciences, Surveillance Research Program, National Cancer Institute, Bethesda, MD

Department of Epidemiology, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC

Information Management Services Inc., Calverton, MD

§Los Angeles Cancer Surveillance Program, Keck School of Medicine, University of Southern California, Los Angeles, CA

Division of Cancer Control and Population Sciences, Applied Research Program, National Cancer Institute, Bethesda, MD

D.D. would like to acknowledge the following funding sources: The collection of cancer incidence data used in this study was supported by the California Department of Public Health as part of the statewide cancer reporting program mandated by California Health and Safety Code Section 103885; the National Cancer Institute’s Surveillance, Epidemiology and End Results Program under contract HH5N261201000140C awarded to the Cancer Prevention Institute of California, contract HHSN261201000035C awarded to the University of Southern California, and contract HHSN261201000034C awarded to the Public Health Institute; and the Centers for Disease Control and Prevention’s National Program of Cancer Registries, under agreement U58DP003862-01 awarded to the California Department of Public Health.

The authors declare no conflict of interest.

Reprints: Anne-Michelle Noone, MS, Division of Cancer Control and Population Sciences, Surveillance Research Program, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD 20850. E-mail: noonea@mail.nih.gov.

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