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Active surveillance (watchful waiting) information has been collected by SEER for prostate cancer cases diagnosed in 2010 and later. The database includes a variable that indicates whether the initial intent of the physician and patient was to manage the disease by active surveillance or watchful waiting. The decision or plan for active surveillance had to be documented. Information was collected as North American Association of Central Cancer Registries (NAACCR) item RX SUMM-Treatment status. Cases coded as Active Surveillance by at least one facility with no known reports of initial curative intent treatment have been recoded as Watchful Waiting ="yes." All other cases diagnosed 2010 and later have been by default recoded to "No/Unknown." This latter category includes patients who were recommended treatment but refused it. It also includes patients whose physicians decided not to treat for reasons such as the presence of comorbidities.

Clinical primary tumor category extension (cT) is a clinical feature with high prognostic risk value that is frequently used by clinicians and researchers for risk stratification. For cases diagnosed between 2004+, use the following to determine the cT and pT categories

  1. 2004-2015: The cT category can be found in the CS Extension (2004-2015) field.
  2. 2016-2017: the cT category can be found in the data field, TNM Clin T (2016-2017). This field is not in the Research or Research Plus data, but is included in this specialized database.
  3. 2018+: The cT category can be found in the EOD Primary Tumor (2018+) field.

Database Details

There are two Prostate Cancer with Additional Treatment Modalities and Risk Stratification Fields databases available to request:

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

  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 field is available just for 2010-2020.
    • 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 field is available just for 2010-2020.
    • 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.