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The Prostate Cancer database now includes several variables not released as part of the SEER Research Plus Data, which inform about the prognostic risk at the time of diagnosis and the initial cancer management strategy, including the treatment curative intent modality and the adjuvant treatment. The following variables are included:

  1. Watchful waiting recode (2010+)
  2. TNM Clin T (2016-2017)
  3. Prostate Cancer Initial Treatment (2010+)
  4. Prostate Cancer NCCN Risk Group (2010+)

The Prostate Cancer NCCN Risk Group field generally follows the recommendation of the National Comprehensive Cancer Network (NCCN) Guidelines for the initial risk stratification of clinically localized disease. The following clinical and pathologic features collected by SEER registries contribute to the stratification: clinical T element, grade group, PSA value, number of cores reviewed, number of cores positive, and the primary Gleason pattern. In addition, clinical N and M elements are used to identify cases with regional/distant cancer. While recommended by NCCN, PSA density and percent involvement of each core initial risk stratification are not available and have not been included in this stratification. Thus, very low and low risk cannot be distinguished and are combined in one category. To allow comparison with previous analyses, we will continue to release cT data element separately, the TNM Clin T (2016-2017) field.

The combination of two fields, active surveillance (Watchful waiting recode) and additional treatment modalities (Prostate Cancer Initial Treatment), allows the user to understand the intent of the first therapy: active surveillance/watchful waiting/observation versus curative intent. For the latter, the additional treatment modalities allow the selection of patients receiving surgical treatment versus radiation therapy. Furthermore, the field allows to identify whether androgen deprivation therapy (ADT) has been used as adjuvant therapy. Other surgery fields (i.e., surgery of primary site, lymph node surgery) could be used to select a specific surgical procedure.

Database Details

The databases are available in the Case Listing, Frequency, Rate, Survival, and Prevalence sessions in SEER*Stat for the November 2022 data submission. The databases are identical to the SEER Research Plus database other than the specialized fields described above.

There are two Prostate Cancer databases available to request, one with and one without Census Tract Attributes. The need for Census Tract Attributes should be described in the Purpose and Significance section of the application and the planned use of the attributes should be explained in the Analytic Plan section of the application.

  1. Prostate Cancer with Additional Treatment Modalities and Risk Stratification Fields Database
    • This one is linked to county-level attributes, which include county-level SES, rurality, and demographics.
    • It includes all tumor records from 2000-2020, but the Prostate fields are available just for 2010+.
    • This one is also included in SEER*Stat Prevalence sessions.
  2. Prostate Cancer with Additional Treatment Modalities and Risk Stratification Fields with Census Tract Attributes Database
    • There are no geographic identifiers included in this database due to confidentiality concerns.
    • It does not include Alaska Native Tumor Registry data.
    • It includes all tumor records from 2006-2020, but the Prostate fields are available just for 2010+.
    • For detailed information about census tract SES and rurality variables, refer to Census Tract-level SES and Rurality Database.

Data Limitations and Analytical Considerations

The SEER treatment data is limited to the first course of treatment, therefore does not have the full sequence of treatments (refer to the Treatment Data Limitations for more information). For patients who were coded with watchful waiting as their first course of treatment, if there was a switch to an active treatment, SEER would not capture the active treatment. Hence, identifying patients who received watchful waiting first and subsequently any of the active treatments using this database is not supported.