NEWS

SEER Doubles Coverage by Adding Registries for Four States

Mike Miller, Judith Swan

The Surveillance, Epidemiology, and End Results program at the National Cancer Institute announced in February that it will nearly double the number of people it monitors to collect data by adding four new registries to its portfolio.

The registries SEER added cover all of Kentucky, Louisiana, New Jersey, and California (which was represented in SEER previously by several smaller regions of the state). With these four new registries, SEER population coverage will go from 34.6 million people (14% of the total U.S. population) to 65.4 million (26% of the total U.S. population).

"This major increase in the program’s surveillance will give us a much better representation of the diversity and geographic distribution of the burden of cancer in the United States," said Brenda K. Edwards, Ph.D., associate director of NCI’s Surveillance Research Program.

According to Ben Hankey, Sc.D., chief of the Cancer Statistics Branch for the NCI, "the increased coverage will improve our ability to describe cancer incidence and outcomes in five population groups that have been under-represented by SEER in the past. With their inclusion, SEER will more accurately reflect cancer rates in this country." The populations Hankey refers to are non-Mexican Hispanics (Mexican Hispanics are already well represented in SEER), rural whites in Appalachia and other areas, American Indians, rural African Americans, and populations with high cancer mortality rates.

This expansion is taking place in conjunction with the Centers for Disease Control and Prevention. In 1994 the CDC began funding state health departments to enhance or develop cancer registries. For this latest effort, in addition to any current CDC funding, NCI is contributing nearly $10 million over an initial 21/2-year time period to help the four new registries meet the additional standards required by SEER for collection of statistics.

Now there is no Appalachian component in SEER, but with the new mandate, "we’ll be able to expand our current state registry to follow [an Appalachian population] over time and really have an impact on disease control and prevention," said Thomas C. Tucker, director of the Kentucky Cancer Registry.

Tucker noted that many cancer cases these days are no longer part of a centralized hospital registry, which makes tracking them much harder. "We’ve been good at finding cases, but getting detailed information and following up on them has been very difficult," he said. "This new SEER funding will greatly enhance our tracking abilities."

Earlier expansions increased the proportions of Hispanics, urban and some rural African Americans, Asian and Pacific Islanders, Arizona Indians, and Alaska Natives. This new expansion means that SEER will now represent 24% of African-Americans in the United States, 44% of Hispanics (and 34% of non-Mexican Hispanics), 42% of American Indians and Alaska Natives, and 59% of Asian and Pacific Islanders.

Looking beyond this latest expansion, Hankey noted that NCI staff are working with the North American Association of Central Cancer Registries and the CDC to provide technical guidance for all state registries. The goal is for the states to pool more precise data, leading to improvement of national estimates of cancer incidence and survival. Many registries worldwide are now Web-based, so SEER is also developing computer applications to unify cancer registration systems and to help analyze and disseminate cancer statistics, said Hankey.


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