How to use the Surveillance, Epidemiology, and End Results (SEER) data: research design and methodology

Abstract

In the United States (US), the Surveillance, Epidemiology, and End Results (SEER) program is the only comprehensive source of population-based information that includes stage of cancer at the time of diagnosis and patient survival data. This program aims to provide a database about cancer incidence and survival for studies of surveillance and the development of analytical and methodological tools in the cancer field. Currently, the SEER program covers approximately half of the total cancer patients in the US. A growing number of clinical studies have applied the SEER database in various aspects. However, the intrinsic features of the SEER database, such as the huge data volume and complexity of data types, have hindered its application. In this review, we provided a systematic overview of the commonly used methodologies and study designs for retrospective epidemiological research in order to illustrate the application of the SEER database. Therefore, the goal of this review is to assist researchers in the selection of appropriate methods and study designs for enhancing the robustness and reliability of clinical studies by mining the SEER database.

Keywords: Big data; Epidemiology; Methodologies; Study design; Surveillance, Epidemiology, and End results (SEER).

Fig. 1

Research articles based on the Surveillance, Epidemiology, and End Results (SEER) (not SEER-Medicare) that had been published in journals from 1998 to 2022 searched by PubMed. The joinpoint analysis program chose the most suitable loglinear regression model to detect calendar years (known as “joinpoints”) with significant changes in APCs, allowing for the minimum number of joinpoints necessary to fit the data. Joinpoint regression analyses detected three segments (1998 – 2008, 2008 – 2015, and 2015 – 2022) that had significant APC changes in the number of published papers. The diamond dots reflect the observed value, whereas the line formed via joinpoint analysis represents the predicted value. The data were assessed on April 23, 2023. Asterisks (*) represent a P-value less than 0.05. APC annual percentage change

Fig. 2

The available methodologies and study designs used in Surveillance, Epidemiology, and End Results (SEER)-based analyses. There are more than 10 analytic methodologies and 7 study designs available for the analysis of the SEER data. The selection of proper study design and analytic methodologies is crucial for utilizing SEER data to generate clinical benefits