Clin Colon Rectal Surg 2019; 32(01): 061-068
DOI: 10.1055/s-0038-1673355
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Surveillance, Epidemiology, and End Results (SEER) and SEER-Medicare Databases: Use in Clinical Research for Improving Colorectal Cancer Outcomes

Meghan C. Daly
1   Department of Surgery, University of Cincinnati School of Medicine, Cincinnati, Ohio
2   Department of Surgery, Cincinnati Research in Outcomes and Safety in Surgery (CROSS), Cincinnati, Ohio
Ian M. Paquette
1   Department of Surgery, University of Cincinnati School of Medicine, Cincinnati, Ohio
2   Department of Surgery, Cincinnati Research in Outcomes and Safety in Surgery (CROSS), Cincinnati, Ohio
› Author Affiliations
Source of Funding None.
Further Information

Publication History

Publication Date:
08 January 2019 (online)


The Surveillance, Epidemiology, and End Results (SEER) program is a clinical database, funded by the National Cancer Institute (NCI), which was created to collect cancer incidence, prevalence, and survival data from U.S. cancer registries. By capturing approximately 30% of the U.S. population, it serves as a powerful resource for researchers focused on understanding the natural history of colorectal cancer and improvement in patient care. The linked SEER-Medicare database is a robust database allowing investigators to perform studies focusing on health disparities, quality of care, and cost of treatment in oncologic disease. Since its infancy in the early 1970s, the database has been utilized for thousands of studies resulting in novel publications that have shaped our management of colorectal cancer among other malignancies.

  • References

  • 1 Cutler SJ, Scotto J, Devesa SS, Connelly RR. Third National Cancer Survey--an overview of available information. J Natl Cancer Inst 1974; 53 (06) 1565-1575
  • 2 Hankey BF, Ries LA, Edwards BK. The surveillance, epidemiology, and end results program: a national resource. Cancer Epidemiol Biomarkers Prev 1999; 8 (12) 1117-1121
  • 3 Surveillance, Epidemiology, and End Results Program. Available at: . Accessed May 10, 2016
  • 4 Murphy M, Alavi K, Maykel J. Working with existing databases. Clin Colon Rectal Surg 2013; 26 (01) 5-11
  • 5 Yu JB, Gross CP, Wilson LD, Smith BD. NCI SEER public-use data: applications and limitations in oncology research. Oncology (Williston Park) 2009; 23 (03) 288-295
  • 6 Das A. Cancer registry databases: an overview of techniques of statistical analysis and impact on cancer epidemiology. Methods Mol Biol 2009; 471: 31-49
  • 7 SEER*Stat. Available at: . Accessed May 10, 2016
  • 8 Engels EA, Pfeiffer RM, Ricker W, Wheeler W, Parsons R, Warren JL. Use of Surveillance, Epidemiology, and End Results-Medicare data to conduct case-control studies of cancer among the US elderly. Am J Epidemiol 2011; 174 (07) 860-870
  • 9 Warren JL, Klabunde CN, Schrag D, Bach PB, Riley GF. Overview of the SEER-Medicare data: content, research applications, and generalizability to the United States elderly population. Med Care 2002; 40 (8, Suppl): IV-3-IV-18
  • 10 McClish DK, Penberthy L, Whittemore M. , et al. Ability of Medicare claims data and cancer registries to identify cancer cases and treatment. Am J Epidemiol 1997; 145 (03) 227-233
  • 11 Potosky AL, Riley GF, Lubitz JD, Mentnech RM, Kessler LG. Potential for cancer related health services research using a linked Medicare-tumor registry database. Med Care 1993; 31 (08) 732-748
  • 12 Brown ML, Riley GF, Schussler N, Etzioni R. Estimating health care costs related to cancer treatment from SEER-Medicare data. Med Care 2002; 40 (8, Suppl): IV-104-IV-117
  • 13 Doebbeling BN, Wyant DK, McCoy KD. , et al. Linked insurance-tumor registry database for health services research. Med Care 1999; 37 (11) 1105-1115
  • 14 National Cancer Institute. Division of Cancer Control and Population Sciences. Available at: . Accessed May 9, 2016
  • 15 Brown ML, Potosky AL. The presidential effect: the public health response to media coverage about Ronald Reagan's colon cancer episode. Public Opin Q 1990; 54 (03) 317-329
  • 16 Chu KC, Tarone RE, Chow WH, Hankey BF, Ries LAG. Temporal patterns in colorectal cancer incidence, survival, and mortality from 1950 through 1990. J Natl Cancer Inst 1994; 86 (13) 997-1006
  • 17 Paquette IM, Ying J, Shah SA, Abbott DE, Ho SM. African Americans should be screened at an earlier age for colorectal cancer. Gastrointest Endosc 2015; 82 (05) 878-883
  • 18 Robbins AS, Siegel RL, Jemal A. Racial disparities in stage-specific colorectal cancer mortality rates from 1985 to 2008. J Clin Oncol 2012; 30 (04) 401-405
  • 19 Alexander DD, Waterbor J, Hughes T, Funkhouser E, Grizzle W, Manne U. African-American and Caucasian disparities in colorectal cancer mortality and survival by data source: an epidemiologic review. Cancer Biomark 2007; 3 (06) 301-313
  • 20 Stoffel EM, Ruterbusch J, Rozek LS, Cote ML. Racial disparities in survival after young-onset colorectal cancer. J Clin Oncol 2015;33(3)
  • 21 Morris AM, Wei Y, Birkmeyer NJ, Birkmeyer JD. Racial disparities in late survival after rectal cancer surgery. J Am Coll Surg 2006; 203 (06) 787-794
  • 22 Li Q, Cai G, Li D, Wang Y, Zhuo C, Cai S. Better long-term survival in young patients with non-metastatic colorectal cancer after surgery, an analysis of 69,835 patients in SEER database. PLoS One 2014; 9 (04) e93756
  • 23 Hendifar A, Yang D, Lenz F. , et al. Gender disparities in metastatic colorectal cancer survival. Clin Cancer Res 2009; 15 (20) 6391-6397
  • 24 Lee YC, Lee YL, Chuang JP, Lee JC. Differences in survival between colon and rectal cancer from SEER data. PLoS One 2013; 8 (11) e78709
  • 25 Paquette I, Finlayson SR. Rural versus urban colorectal and lung cancer patients: differences in stage at presentation. J Am Coll Surg 2007; 205 (05) 636-641
  • 26 Meyer JE, Narang T, Schnoll-Sussman FH, Pochapin MB, Christos PJ, Sherr DL. Increasing incidence of rectal cancer in patients aged younger than 40 years: an analysis of the surveillance, epidemiology, and end results database. Cancer 2010; 116 (18) 4354-4359
  • 27 Tawadros PS, Paquette IM, Hanly AM, Mellgren AF, Rothenberger DA, Madoff RD. Adenocarcinoma of the rectum in patients under age 40 is increasing: impact of signet-ring cell histology. Dis Colon Rectum 2015; 58 (05) 474-478
  • 28 Gunderson LL, Jessup JM, Sargent DJ, Greene FL, Stewart A. Revised tumor and node categorization for rectal cancer based on surveillance, epidemiology, and end results and rectal pooled analysis outcomes. J Clin Oncol 2010; 28 (02) 256-263
  • 29 Silber JH, Rosenbaum PR, Ross RN. , et al. Racial disparities in colon cancer survival: a matched cohort study. Ann Intern Med 2014; 161 (12) 845-854
  • 30 Schrag D, Panageas KS, Riedel E. , et al. Hospital and surgeon procedure volume as predictors of outcome following rectal cancer resection. Ann Surg 2002; 236 (05) 583-592
  • 31 Lang K, Korn JR, Lee DW, Lines LM, Earle CC, Menzin J. Factors associated with improved survival among older colorectal cancer patients in the US: a population-based analysis. BMC Cancer 2009; 9: 227
  • 32 Brown ML, Riley GF, Potosky AL, Etzioni RD. Obtaining long-term disease specific costs of care: application to Medicare enrollees diagnosed with colorectal cancer. Med Care 1999; 37 (12) 1249-1259
  • 33 Mack CD, Brookhart MA, Glynn RJ. , et al. Comparative effectiveness of oxaliplatin versus 5-flourouricil in older adults: an instrumental variable analysis. Epidemiology 2015; 26 (05) 690-699
  • 34 Bikov KA, Mullins CD, Seal B, Onukwugha E, Hanna N. Algorithm for identifying chemotherapy/biological regimens for metastatic colon cancer in SEER-Medicare. Med Care 2015; 53 (08) e58-e64
  • 35 Fu AZ, Tsai HT, Marshall JL, Freedman AN, Potosky AL. Utilization of bevacizumab in US elderly patients with colorectal cancer receiving chemotherapy. J Oncol Pharm Pract 2014; 20 (05) 332-340
  • 36 Dodgion CM, Neville BA, Lipsitz SR. , et al. Hospital variation in sphincter preservation for elderly rectal cancer patients. J Surg Res 2014; 191 (01) 161-168
  • 37 Zheng Z, Onukwugha E, Hanna N, Bikov K, Seal B, Mullins CD. Cost-effectiveness of second-line chemotherapy/biologics among elderly metastatic colon cancer patients. Adv Ther 2014; 31 (07) 724-734
  • 38 Weiss JM, Schumacher J, Allen GO. , et al. Adjuvant chemotherapy for stage II right-sided and left-sided colon cancer: analysis of SEER-Medicare data. Ann Surg Oncol 2014; 21 (06) 1781-1791
  • 39 Xu F, Rimm AA, Fu P, Krishnamurthi SS, Cooper GS. The impact of delayed chemotherapy on its completion and survival outcomes in stage II colon cancer patients. PLoS One 2014; 9 (09) e107993
  • 40 Lund JL, Stürmer T, Sanoff HK, Brookhart A, Sandler RS, Warren JL. Determinants of adjuvant oxaliplatin receipt among older stage II and III colorectal cancer patients. Cancer 2013; 119 (11) 2038-2047
  • 41 Satram-Hoang S, Lee L, Yu S. , et al. Comparative effectiveness of chemotherapy in elderly patients with metastatic colorectal cancer. J Gastrointest Cancer 2013; 44 (01) 79-88
  • 42 Neugut AI, Matasar M, Wang X. , et al. Duration of adjuvant chemotherapy for colon cancer and survival among the elderly. J Clin Oncol 2006; 24 (15) 2368-2375
  • 43 Haynes AB, You YN, Hu CY. , et al. Postoperative chemotherapy use after neoadjuvant chemoradiotherapy for rectal cancer: analysis of Surveillance, Epidemiology, and End Results-Medicare data, 1998-2007. Cancer 2014; 120 (08) 1162-1170
  • 44 Weir HK, Thompson TD, Soman A, Møller B, Leadbetter S. The past, present, and future of cancer incidence in the United States: 1975 through 2020. Cancer 2015; 121 (11) 1827-1837