SEER Cause-specific Death Classification

Cause-specific survival is a net survival measure representing survival of a specified cause of death in the absence of other causes of death. Estimates are calculated by specifying the cause of death. Individuals who die of causes other than the specified cause are considered to be censored. This requires a cause of death variable that accurately captures all causes related to the specific cause. Cancer registries use algorithms to process causes of death from death certificate in order to identify a single, disease-specific, underlying cause of death. In some cases, attribution of a single cause of death may be difficult and misattribution may occur. For example a death may be attributed to the site of metastasis instead of the primary site.

To capture deaths related to the specific cancer but not coded as such, the SEER cause-specific death classification variables are defined by taking into account causes of deaths in conjunction with tumor sequence (i.e., only one tumor or the first of subsequent tumors), site of the original cancer diagnosis, comorbidities (e.g., AIDS and/or site-related diseases).

The SEER Cause-specific Death Classification definitions have changed over time. The previous coding system for 1973-2007 SEER Research Data (November 2009 Submission) is available.

1973-2008 SEER Research Data (November 2010 submission) and Later Releases

There are two variables in the SEER data for estimating cause-specific survival probability due to ‘cancer’ or due to ‘other-causes’. The idea is to use these variables independently to estimate survival of specified cause of death (e.g. cancer, non-cancer). The ‘SEER cause-specific death classification’ variable is used to obtain cancer-specific survival probability for a given cohort of cancer patients. While, ‘SEER other cause of death classification’ variable is used to obtain the other-cause survival probability for the same cohort of patients. In the first variable, (SEER cause-specific death classification) deaths attributed to the cancer of interest are treated as events and deaths from other causes are treated as censored observation. The event of interest in the second variable (the ‘SEER other cause of death classification’) is the reverse, i.e., deaths attributed to causes other than cancer are treated as events and deaths from cancer are treated as censored observation. The causes of deaths codes are the same in both variables. Also, these variables have a cause of death classification of 'N/A not first tumor', which is coded for all primaries that are not sequence numbers 0 or 1.

The following tables show causes of death codes which are treated as deaths for a respective cancer site. Separate tables are provided for ICD-8, ICD-9, ICD-10 coding systems.

More Information

For more on survival, see Measures of Cancer SurvivalExternal Web Site Policy.

Further information and comparisons between cause-specific survival using the SEER cause-specific death classification and relative survival were published in the following article:

Howlader N, Ries LA, Mariotto AB, Reichman ME, Ruhl J, Cronin KA. Improved Estimates of Cancer-Specific Survival Rates From Population-Based Data. J Natl Cancer Inst 2010 Oct 20;102(20):1584-98. Epub 2010 Oct 11. [View AbstractExternal Web Site Policy]