BACKGROUND: Surveillance, Epidemiology, and End Results (SEER) registry data have been used to suggest underuse and disparities in receipt of radiotherapy. Prior studies have cautioned that SEER may underascertain radiotherapy but lacked adequate representation to assess whether underascertainment varies by geography or patient sociodemographic characteristics. The authors sought to determine rates and correlates of underascertainment of radiotherapy in recent SEER data. METHODS: The authors evaluated data from 2290 survey respondents with nonmetastatic breast cancer, aged 20 to 79 years, diagnosed from June of 2005 to February 2007 in Detroit and Los Angeles and reported to SEER registries (73% response rate). Survey responses regarding treatment and sociodemographic factors were merged with SEER data. The authors compared radiotherapy receipt as reported by patients versus SEER records. The authors then assessed correlates of radiotherapy underascertainment in SEER. RESULTS: Of 1292 patients who reported receiving radiotherapy, 273 were coded as not receiving radiotherapy in SEER (underascertained). Underascertainment was more common in Los Angeles than in Detroit (32.0% vs 11.25%, P < .001). On multivariate analysis, radiotherapy underascertainment was significantly associated in each registry (Los Angeles, Detroit) with stage (P = .008, P = .026), income (P < .001, P = .050), mastectomy receipt (P < .001, P < .001), chemotherapy receipt (P < .001, P = .045), and diagnosis at a hospital that was not accredited by the American College of Surgeons (P < .001, P < .001). In Los Angeles, additional significant variables included younger age (P < .001), nonprivate insurance (P < .001), and delayed receipt of radiotherapy (P < .001). CONCLUSIONS: 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.
BACKGROUND: Surveillance, Epidemiology, and End Results (SEER) registry data have been used to suggest underuse and disparities in receipt of radiotherapy. Prior studies have cautioned that SEER may underascertain radiotherapy but lacked adequate representation to assess whether underascertainment varies by geography or patient sociodemographic characteristics. The authors sought to determine rates and correlates of underascertainment of radiotherapy in recent SEER data. METHODS: The authors evaluated data from 2290 survey respondents with nonmetastatic breast cancer, aged 20 to 79 years, diagnosed from June of 2005 to February 2007 in Detroit and Los Angeles and reported to SEER registries (73% response rate). Survey responses regarding treatment and sociodemographic factors were merged with SEER data. The authors compared radiotherapy receipt as reported by patients versus SEER records. The authors then assessed correlates of radiotherapy underascertainment in SEER. RESULTS: Of 1292 patients who reported receiving radiotherapy, 273 were coded as not receiving radiotherapy in SEER (underascertained). Underascertainment was more common in Los Angeles than in Detroit (32.0% vs 11.25%, P < .001). On multivariate analysis, radiotherapy underascertainment was significantly associated in each registry (Los Angeles, Detroit) with stage (P = .008, P = .026), income (P < .001, P = .050), mastectomy receipt (P < .001, P < .001), chemotherapy receipt (P < .001, P = .045), and diagnosis at a hospital that was not accredited by the American College of Surgeons (P < .001, P < .001). In Los Angeles, additional significant variables included younger age (P < .001), nonprivate insurance (P < .001), and delayed receipt of radiotherapy (P < .001). CONCLUSIONS: 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.
Authors: Linda C Harlan; Jeffrey Abrams; Joan L Warren; Lin Clegg; Jennifer Stevens; Rachel Ballard-Barbash Journal: J Clin Oncol Date: 2002-04-01 Impact factor: 44.544
Authors: Jennifer L Malin; Katherine L Kahn; John Adams; Lorna Kwan; Marianne Laouri; Patricia A Ganz Journal: J Natl Cancer Inst Date: 2002-06-05 Impact factor: 13.506
Authors: Kelly-Anne Phillips; Roger L Milne; Saundra Buys; Michael L Friedlander; John H Ward; Margaret R E McCredie; Graham G Giles; John L Hopper Journal: J Clin Oncol Date: 2005-04-25 Impact factor: 44.544
Authors: Beth A Virnig; Joan L Warren; Gregory S Cooper; Carrie N Klabunde; Nicola Schussler; Jean Freeman Journal: Med Care Date: 2002-08 Impact factor: 2.983
Authors: Sarah B Bateni; Anders J Davidson; Mili Arora; Megan E Daly; Susan L Stewart; Richard J Bold; Robert J Canter; Candice A M Sauder Journal: Ann Surg Oncol Date: 2019-02-13 Impact factor: 5.344
Authors: Payal D Soni; Holly E Hartman; Robert T Dess; Ahmed Abugharib; Steven G Allen; Felix Y Feng; Anthony L Zietman; Reshma Jagsi; Matthew J Schipper; Daniel E Spratt Journal: J Clin Oncol Date: 2019-03-21 Impact factor: 44.544
Authors: Chun Chieh Lin; Suanna S Bruinooge; M Kelsey Kirkwood; Dawn L Hershman; Ahmedin Jemal; B Ashleigh Guadagnolo; James B Yu; Shane Hopkins; Michael Goldstein; Dean Bajorin; Sharon H Giordano; Michael Kosty; Anna Arnone; Amy Hanley; Stephanie Stevens; Christine Olsen Journal: Int J Radiat Oncol Biol Phys Date: 2015-12-17 Impact factor: 7.038