title: Comparison of SEER Treatment Data With Medicare Claims.
abstract: 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.
authors.affiliation: *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.
authors.forename: Anne-Michelle
authors.initials: AM
authors.lastname: Noone
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Lund
authors.forename: Angela
authors.initials: A
authors.lastname: Mariotto
authors.forename: Kathleen
authors.initials: K
authors.lastname: Cronin
authors.forename: Timothy
authors.initials: T
authors.lastname: McNeel
authors.forename: Dennis
authors.initials: D
authors.lastname: Deapen
authors.forename: Joan L
authors.initials: JL
authors.lastname: Warren
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000628:therapy; D015179:Colorectal Neoplasms / Q000628:therapy; D004358:Drug Therapy / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000628:therapy; D008297:Male; D006278:Medicare / Q000706:statistics & numerical data*; D010051:Ovarian Neoplasms / Q000628:therapy; D010190:Pancreatic Neoplasms / Q000628:therapy; D011237:Predictive Value of Tests; D011471:Prostatic Neoplasms / Q000628:therapy; D011878:Radiotherapy / Q000706:statistics & numerical data*; D018426:SEER Program / Q000706:statistics & numerical data*; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D014481:United States; D001749:Urinary Bladder Neoplasms / Q000628:therapy
chemical_list: D018931:Antineoplastic Agents, Hormonal