SEER may not see actual breast cancer radiation rates

A key health care database may not be accurately reflecting the use of radiation treatments after breast-conserving surgery among breast cancer patients, indicates a recent analysis.

The Surveillance Epidemiology and End Results (SEER) registry is maintained by the National Cancer Institute as an important source of information on cancer incidence, prevalence, and survival in the United States. In an evaluation appearing in the journal Cancer (online ahead of print), Reshma Jagsi, MD, DPhil, and colleagues assessed survey results from 2,290 women in two SEER markets—Detroit and Los Angeles—who had been treated for nonmetastatic breast cancer. The women, aged 20 to 79 years, received a diagnosis of breast cancer and were reported to SEER registries between June 2005 and February 2007.

After comparing survey responses reflecting treatments received with SEER data, the investigators discovered that the records of approximately 20% (273) of 1,292 women who said they received radiation did not include such treatment. In Los Angeles, the database did not match the patient report in 32% of cases; in Detroit, radiation was incorrectly noted in 11.25% of cases.

These outcomes led the study team to suggest that SEER registry data as currently collected may not be an appropriate source for documentation of rates of radiotherapy receipt or investigation of geographic variation in the radiation treatment of breast cancer.

“With increased interest in comparative effectiveness research, more and more researchers are using registry databases like SEER,” Jagsi commented in a statement announcing her team's findings. “If the quality of the data in some of these databases has limitations, these must be understood to avoid potentially misleading conclusions that affect both clinical decision-making and policy.”

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