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SEER 

SEER . . . as a Research Resource 

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 

s a Research Resource National Institutes of Health 

National Cancer Institute 
SEER . . . as a Research Resource

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“The SEER Program is one of NCI’s most important data collection and dissemination 

activities. In addition to providing essential information for tracking the Nation’s 

progress against cancer, SEER data and data analysis tools provide researchers with 

unique opportunities to explore and explain cancer trends. The impact of SEER on 

science, policy, and practice reflects both the quality of the data collected and the 

creative expertise of the many scientists who use it.” 

Robert T. Croyle, Ph.D. 

Director, Division of Cancer Control and Population Sciences, NCI 
SEER
 . . . as a Research Resource 

www.seer.cancer.gov 

The Surveillance, Epidemiology, 

and End Results (SEER) 

Program of the National Cancer 

Institute (NCI) is a coordinated 

system of population-based 

cancer registries strategically 

located across the United States. Th ese registries 

monitor cancer trends and provide timely, 

accurate, and continuous data on cancer incidence, 

the extent of disease at diagnosis, therapy, and 

patient survival. 

As a research resource, SEER serves as a platform 

for studies that address emerging issues in the fi eld 

of cancer and cancer-related care. SEER also plays 

a critical role in increasing the breadth of scientifi c 

research to include various factors such as health 

disparities, access to and quality of health care, 

geographic determinants, and other attributes. Th e 

results of these studies can then be translated into 

public health policy, planning, and practice. 

Reporting 

The SEER Program currently collects cancer 

incidence and survival data from 18 geographic 

areas in the United States. There are nine states 

(New Mexico, Hawaii, Utah, Iowa, Connecticut, 

Greater California, Kentucky, Louisiana, New 

Jersey), five metropolitan areas (Metro Atlanta plus 

a sample of rural Georgia, the Greater Bay Area 

[San Francisco-Oakland and San-Jose Monterey], 

Los Angeles, Seattle, Detroit), and the Alaska 

Native Tumor Registry, which together represent 

approximately 26 percent of the U.S. population. 

This broad coverage allows SEER to account 

for various diverse populations throughout the 

United States. SEER registries routinely collect 

data on patient demographics, primary tumor 

site, morphology, stage at diagnosis, fi rst course 

of treatment, and follow-up for vital status. Th ese 

data then are made available to researchers and 

the general public through the dissemination of 

factsheets, reports, databases, analytical software, 

Web sites, and linkages to other national data 

sources. 

For more information, visit SEER’s online resources: 

The SEER Web site: www.seer.cancer.gov 

Fast*Stats: http://seer.cancer.gov/faststats 

Cancer Query System: http://seer.cancer.gov/canques 

SEER*Stat: http://seer.cancer.gov/seerstat 

Cancer Statistics Review: http://seer.cancer.gov/csr/ 

1975_2005 

Annual Report to the Nation: http://seer.cancer. 

govreport_to_nation 

Several of the most frequently used resources 

include the following: 

SEER Cancer Statistics Review, 1975–: Th e 

SEER Cancer Statistics Review (CSR) is the 

annual report of the most recent cancer incidence, 

mortality, survival, prevalence, and lifetime risk 

statistics. The current edition includes statistics 

from 1975 through the most recent year for which 

data are available. More information about SEER’s 

Cancer Statistics Review is available at http://seer. 

cancer.gov/csr/1975_2005/index.html. 

SEER Bibliography: The SEER Program produces 

various publications related to cancer statistics. 

SEER’s Web-based, searchable bibliography has 

more than 5,000 entries, with more to come in 

the near future. These publications address areas 

such as basic research, clinical oncology, general 

medical research, public health, and internal/ 

general medicine. Find more information at http:// 

seer.cancer.gov/publications, and view the SEER 

Bibliography at http://www.seer.cancer.gov/pubsearch. 

SEER . . . as a Research Resource 

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Surveillance Partnerships and 

Collaborations 

The SEER program engages in a number of 

ongoing public and private partnerships. Th ese 

partnerships ensure the sharing of high-quality 

data, along with the use of common standards for 

data collection and reporting. SEER collaborates 

with the American Cancer Society (ACS), Centers 

for Disease Control and Prevention (CDC), 

North American Association of Central Cancer 

Registries (NAACCR), and various other external 

organizations. These cooperative eff orts result 

in joint reports such as the Annual Report to the 

Nation and monographs, which provide detailed 

information on cancer statistics and trends among 

specific population groups in the United States. 

SEER Area 

Funded by NCI 

SEER/NPCR Area 

Funded by NCI and CDC 

NPCR – National Program of Cancer Registries 

CDC – Centers for Disease Control and Prevention 

AK 

(Alaska

Natives)

AZ 

(Arizona

Indians) Los Angeles 

Detroit 

Atlanta 

Rural Georgia 

Seattle-Puget Sound 

San FranciscoOakland 

San JoseMonterey 

NM 

LA 

KY 

IA 

CT 

NJ 

UT 

CA 

HI 

National Longitudinal Mortality Study (NLMS) 

Database: The National Longitudinal Mortality 

Study (NLMS) is a database that was developed 

and is sponsored by NCI; the National Heart, 

Lung, and Blood Institute (NHLBI); National 

Institute on Aging; National Center for Health 

Statistics (NCHS); and the U.S. Census Bureau. 

The purpose of the database is to examine 

the relationships between mortality and selfreported demographic and socioeconomic 

characteristics among a representative sample 

of the U.S. noninstitutionalized population. 

Sociodemographic data, collected by the U.S. 

Census Bureau via in-person and telephone 

interviews as part of the annual Current 

Population Surveys (CPS), are combined with 

cause-of-death information from offi cial state 

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SEER . . . as a Research Resource 
death certificates for study cohorts ranging from 

1979–2002. The NLMS database includes records 

on approximately 3 million persons and causeof-death information on more than 250,000 

individuals. Additional data have been linked to 

the NLMS and are available for analysis, including 

Medicare claims data for the period 1991–2001 

and tobacco use supplements for the NLMS 

cohort years of 1985, 1992, 1993, 1995, 1996, 

1999, and 2001. A bibliography of NLMS-related 

publications and studies can be found at http:// 

www.census.gov/nlms/bibliography.html. 

The Linked SEER-NLMS Database: SEER patient 

records for 1973–2003 have been linked with 

1979–2002 NLMS cohorts to provide additional 

individual-level socioeconomic and demographic 

information on SEER cancer cases, expanding 

opportunities for analyzing differentials in cancer 

incidence, survival, and tumor characteristics. In 

addition, the tobacco use and Medicare claims data 

that have been linked to the NLMS also are linked 

to the SEER-NLMS database and are available 

for analysis. Studies conducted using these data 

have shown that the SEER-NLMS database serves 

as a significant resource for evaluating disparities 

in cancer outcomes according to a variety of 

individual-level socioeconomic, demographic, 

racial, and health care characteristics. Find more 

information about the NLMS and the linked 

SEER-NLMS database at http://surveillance.cancer. 

gov/disparities/nlms. 

The SEER-Medicare Database: Th e SEERMedicare database is a unique resource that 

can be used for research related to the health 

care provided to persons age 65 and older with 

cancer. The database results from the linkage of 

two large population-based data sources: SEER 

cancer registries data and Medicare enrollment 

and claims files. Medicare’s master enrollment 

file is used to identify persons in the SEER data 

who are Medicare beneficiaries. For people who 

are Medicare eligible, the SEER-Medicare data 

include claims for covered health care services, 

including hospital, physician, outpatient, home 

health, and hospice bills. Currently, the SEERMedicare database includes more than 2.4 million 

persons with cancer. The linked SEER-Medicare 

data can be used for various studies that span the 

continuum of cancer control activities, such as: 

•	 Treatment and outcomes 

•	 Quality of care 

•	 Health care systems and services 

•	 Screening and surveillance 

•	 Economics of cancer 

•	 Survivorship and end-of-life issues 

The SEER-Medicare Database is a collaborative 

effort of NCI, the SEER registries, and the Centers 

for Medicare and Medicaid Services (CMS). More 

information is available at http://healthservices. 

cancer.gov/seermedicare. 

Residual Tissue Repository (RTR) Program: Th e 

SEER Program provides a unique potential for 

performing biospecimen studies on representative 

samples of cancer cases from specifi c geographic 

areas. NCI created the SEER Residual Tissue 

Repository (RTR) program to prevent, to the 

extent possible, loss of biological specimens from 

SEER patients. The RTR was initiated to preserve 

pathology specimens associated with SEER cancer 

cases that otherwise would be discarded, and to 

use these specimens to test hypotheses relevant to 

population-based samples. 

Th e RTR: 

•	 Enables studies on rare cancers for which no 

single registry has enough cases to allow statistically valid conclusions to be drawn. 

•	 Allows validation studies on specimens from 

population-based registries. 

•	 Allows comparison of cases with biospecimens 

to all cases in the registry for the purpose of 

assessing population-based representativeness. 

SEER . . . as a Research Resource 

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•	 Allows analysis of trends in incidence and the 

potential for correlation with treatment trends 

based on the long history and diversity of the 

SEER registries. 

•	 Makes possible updating of information after 

the tissue microarray (TMA) is formed without 

violating confidentiality and privacy protections. 

Find more information about the RTR Program at 

http://www.seer.cancer.gov/biospecimen. 

State Cancer Profiles: The State Cancer Profi les 

Web site is a comprehensive system of interactive 

maps and graphs that enable the investigation of 

cancer trends at the national, state, and county 

levels. It is part of Cancer Control P.L.A.N.E.T., 

a portal that provides access to data and researchtested resources for the design, implementation, 

and evaluation of cancer control programs. 

The objectives of the State Cancer Profi les Web 

site are to characterize the cancer burden in a 

standardized manner, integrate surveillance into 

cancer control planning, differentiate areas and 

demographic groups, and expose health disparities. 

Th e Profiles focus on cancer sites for which there 

are evidence-based interventions. Interactive 

graphics and maps provide visual support for 

deciding where to focus cancer control eff orts. 

Data for State Cancer Profiles are collected from 

public health surveillance systems through their 

published reports or public use fi les. 

The target audiences for the State Cancer Profi les 

Web site primarily are health planners, policy 

makers, and cancer information providers. Th e site 

provides quick and easy access to descriptive cancer 

statistics that can assist in prioritizing investments 

in cancer control. In addition, epidemiologists 

may find the site useful for identifying research 

opportunities. State Cancer Profiles are a 

collaborative effort of NCI and CDC. For more 

information on State Cancer Profi les, see http:// 

statecancerprofi les.cancer.gov. 

The Rapid Response Surveillance Studies: Th e 

Rapid Response Surveillance Studies began in 

1987, when the SEER registries conducted the 

first population-based Patterns of Care Study. In 

1992, the Rapid Response Surveillance Studies 

were expanded to include a broader range of 

topics, including emerging issues related to 

cancer prevention and control. Th is mechanism 

allows studies to move from the initial concept 

through completion in a relatively short interval, 

usually within 2 years. Research areas addressed 

have included evaluation of cancer surveillance 

methodologies, comparing cancer treatment 

outcomes, and monitoring screening practices 

linked to cancer outcomes. In addition, Rapid 

Response Surveillance Studies have supported 

research on procedures for enhanced monitoring of 

health behaviors and risk factors, pilot linkage of 

SEER with other databases, and improvement of 

the technical aspects of cancer registry operations. 

Studies conducted under this mechanism have 

served as background for larger research initiatives 

funded by other federal and private mechanisms. 

Research areas addressed by Rapid Response 

Surveillance Studies include: 

•	 Evaluation of cancer surveillance methodologies 

•	 Evaluation of cancer treatment and outcomes 

•	 Monitoring screening practices 

•	 Health behaviors and risk factors 

•	 Linking databases 

•	 Improving technical aspects of registry operations 

More information about Rapid Response Surveillance Studies is available at http://seer.cancer.gov/ 

rapidresponse. 

SEER . . . as a Research Resource 

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“SEER has been a vital source of information for tracking the use of recommended 

cancer care in the community. It is the foundation for many studies evaluating a number 

of diverse issues among cancer patients and survivors, including quality of life, health 

behaviors, and treatment outcomes.” 

Rachel Ballard-Barbash, M.D., M.P.H. 

Associate Director, Applied Research Program, NCI 
NIH Publication No. 10-7519
 

Printed February 2010