Technical Notes: The SEER Program
The National Cancer Act of 1971 mandated the collection, analysis, and dissemination of data useful in the prevention, diagnosis, and treatment of cancer. This mandate led to the establishment of the SEER Program. The population-based cancer registries participating in NCI's SEER Program routinely collect data on all cancers occurring in residents of the participating areas. Trends in cancer incidence and patient survival in the US are derived from this database.
The SEER Program is a sequel to two earlier NCI programs—the End Results Program and the Third National Cancer Survey. The initial SEER reporting areas were the States of Connecticut, Iowa, New Mexico, Utah, and Hawaii; the metropolitan areas of Detroit, Michigan, and San Francisco-Oakland, California; and the Commonwealth of Puerto Rico. Case ascertainment began with January 1, 1973, diagnoses.
In 1974-1975, the program was expanded to include the metropolitan area of New Orleans, Louisiana, the thirteen-county Seattle-Puget Sound area in the State of Washington, and the metropolitan area of Atlanta, Georgia. New Orleans participated in the program only through the 1977 data collection year. In 1978, ten predominantly African-American counties in rural Georgia were added. American Indian residents of Arizona were added in 1980. In 1983, four counties in New Jersey were added with coverage retrospective to 1979. New Jersey and Puerto Rico participated in the program until the end of the 1989 reporting year. The National Cancer Institute also began funding a cancer registry that, with technical assistance from SEER, collects information on cancer cases among Alaska Native populations residing in Alaska. In 1992, the SEER Program was expanded to increase coverage of minority populations, especially Hispanics, by adding Los Angeles County and four counties in the San Jose-Monterey area south of San Francisco. In 2001, the SEER Program expanded coverage to include Kentucky, Greater California (the counties of California that were not already covered by SEER), New Jersey, and Louisiana.
The long-term incidence trends and survival data for this report are from five states (Connecticut, Hawaii, Iowa, New Mexico, and Utah) and four metropolitan areas (Detroit, Atlanta, San Francisco-Oakland, and Seattle-Puget Sound) (Fig. I-1); this set of registries is called the SEER 9. Additional tables show more recent incidence trends for the SEER 13 areas (the 9 areas above plus Los Angeles, San Jose-Monterey, Alaska Native Registry, and rural Georgia) since 1992 and additional information on race and ethnicity. Other tables give statistics for the SEER 17 areas; these are the SEER 13 plus Kentucky, Greater California, New Jersey, and Louisiana.
The participating regions were selected principally for their ability to operate and maintain a population-based cancer reporting system and for their epidemiologically significant population subgroups. With respect to selected demographic and epidemiologic factors, they are when combined a reasonably representative subset of the US population. Data from the 9, 13, or 17 SEER geographic areas are used in this report; the given areas contain, respectively, approximately 9,14, or 26 percent of the US population. By the end of the 2006 diagnosis year, the database of 13 SEER and 4 expansion registries (plus Arizona Indians) contained information on over 7 million cases diagnosed since 1973. New cases added in the most recent data year numbered over 385,000.
The goals of the SEER Program are:
- to assemble and report, on a periodic basis, estimates of cancer incidence, mortality, survival, and prevalence in the US;
- to monitor annual cancer incidence trends to identify unusual changes in specific forms of cancer occurring in population subgroups defined by geographic and demographic characteristics;
- to provide continuing information on trends over time in the extent of disease at diagnosis, trends in therapy, and associated changes in patient survival; and
- to promote studies designed to identify factors amenable to cancer control interventions, such as:
- environmental, occupational, socioeconomic, dietary, and health-related exposures;
- screening practices, early detection and treatment; and
- determinants of the length and quality of patient survival.
