SEER-Medicare Linked Database
The SEER-Medicare data are the result of linking Medicare-eligible persons with cancer in the SEER data with their Medicare claims. The resulting files provide a unique population-based source of information about health care that spans the continuum of care from the period of initial diagnosis and treatment to long-term followup and care. Investigators using this combined dataset have conducted studies on patterns of care for persons with cancer as well as studies focused on disparities in cancer-related care, use of cancer tests, and the costs of cancer treatment. As of April 2003, more than 100 peer-reviewed publications have used SEER-Medicare data. In the quality-of-care arena, one study examined the use of mammography following a diagnosis of breast cancer and found that, among women treated with breast-conserving surgery without radiation therapy (those most likely to have a recurrence), more than 20 percent had no mammogram in the 2 years following their initial diagnosis. Another analysis demonstrated that men who had radical prostatectomy by surgeons who performed fewer of these procedures were more likely to have late urinary complications than men treated by surgeons who performed the surgery frequently.
The SEER-Medicare database also is a source of data that allows derivation of estimates of cancer-related medical costs by site and stage of disease, by treatment approach, and for each gender in 65 and older age groups. These estimates can be incidence-based, meaning they provide the average cost per patient, or prevalence-based, which provides aggregate expenditures by cancer type. In one study, data on Medicare payments were obtained for colorectal cancer patients for the years 1990-1994 from the SEER-Medicare linked database. Estimates of long-term cost (up to 25 years following the date of diagnosis) were obtained by combining treatment-specific cost estimates with estimates of long-term survival from SEER. The resulting paper demonstrated that valid estimates of cancer-related longterm cost can be obtained from administrative claims data linked to cancer registry data.
Potosky AL, Riley GF, Lubitz JD, Mentnech RM, Kessler LG. Potential for cancer related health services research using a linked Medicare-tumor registry database. Medical Care 1993;31(8):732-748.
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;37:1249-1259.
Schapira MM, McAuliffe TL, Nattinger AB. Underutilization of mammography in older breast cancer survivors. Med Care 2000;38(3):281-289.
Begg CB, Riedel ER, Bach PB, Kattan MW, Schrag D, Warren JL, Scardino PT. Variations in morbidity after radical prostatectomy. N Engl J Med 2002;346(15):1138-1144.
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-3-18.
More information about the SEER-Medicare data can be found at http://healthservices.cancer.gov/seermedicare/