overview of all seer-medicare publications through 2012 mark d. danese, mhs, phd july 24, 2012

Overview of All SEER-Medicare Publications Through 2012

Mark D. Danese, MHS, PhD

July 24, 2012

Overview

• Information was extracted from the National Cancer Institute (NCI) online reference database for “SEER Medicare” publications

– http://healthservices.cancer.gov/seermedicare/overview/pubsearch.html

– Data accessed May 15, 2012- articles published in 2012 may be underrepresented due to reporting lag.

– 714 citations retrieved– NCI classified all publications according to the following:

• 14 topic areas (e.g., economics of cancer, outcomes, etc.)• 19 tumor types (e.g., breast, prostate, etc.)

• Summary measures were calculated by year, tumor site, topic area, and author

• Exploratory analyses were conducted to assess publication frequency relative to cancer incidence, prevalence, and deaths

July 24, 2012 2SEER Medicare Publications

http://healthservices.cancer.gov/seermedicare/overview/pubsearch.html

SEER-Medicare Publications Search

Topic:

1. Economics of Cancer

2. Health Care Systems

3. Health Disparities4. Outcomes (All)5. Clinical

Outcomes6. Palliative & End-

of-Life Care7. Prevention8. Quality of Care9. Research

Methodology10. Risk Factors11. Screening12. Surveillance13. Survivorship14. Treatment

Tumor Site:

1. All sites or no specific site

2. Brain & CNS3. Breast4. Cervical5. Colorectal6. Corpus Uteri7. Esophagus8. Gastric 9. Head and Neck10. Leukemia11. Liver12. Lung13. Lymphoma14. Ovary15. Pancreas16. Prostate17. Renal18. Urinary Bladder19. Other


BY TUMOR SITE, YEAR, AND TOPIC AREA

Summary of Publications


Publications by Tumor Site (All Years)

0

50

100

150

200

250

Tumor Site

Freq

uency


Publications by Tumor Site (2006-2012)

Breas

t

Color

ecta

l

Prost

ate

Lung

All or

no

spec

ific s

iteOth

er

Other

Urinar

y Bla

dder

Pancr

eas

Lym

phom

a

Ovary

Head

and

Neck

Renal

Esoph

agus

Live

r

Leuk

emia

Gastri

c

Corpu

s Ute

ri

Brain

& C

NS

Cervic

al0

50

100

150

200

250

Tumor Site

Fre

qu

en

cy


Publications by Year (1993-2012)

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

2012

*0

20

40

60

80

100

120

140

Year

Fre

qu

ency


*2012 publications through May 15 are under-counted due to reporting lags

Publications by Top 4 Tumor Sites and Year19

93

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

0

5

10

15

20

25

30

35

Breast

Colorectal

Prostate

Lung

Fre

qu

ency


SEER Medicare Publications 9

Publications by Topic Area (All Years)

Treat

men

t

Out

com

es (A

ll)

Health

Disp

aritie

s

Resea

rch

Met

hodo

logy

Econo

mics

of C

ance

r

Health

Car

e Sys

tem

s

Surviv

orsh

ip

Risk F

acto

rs

Scree

ning

Palliat

ive &

End

-of-L

ife C

are

Surve

illanc

e

Clinica

l Out

com

es

Preve

ntion

Qua

lity o

f Car

e0

100

200

300

400

500

600

Topic Area

Fre

qu

ency

July 24, 2012


Publications by Topic Area (2006-2012)

Treat

men

t

Out

com

es (A

ll)

Health

Disp

aritie

s

Econo

mics

of C

ance

r

Surviv

orsh

ip

Risk F

acto

rs

Health

Car

e Sys

tem

s

Resea

rch

Met

hodo

logy

Scree

ning

Palliat

ive &

End

-of-L

ife C

are

Surve

illanc

e

Clinica

l Out

com

es

Preve

ntion

Qua

lity o

f Car

e0

100

200

300

400

500

600

Topic Area

Pu

bli

cati

on

s

July 24, 2012

PUBLICATIONS RELATIVE TO POPULATION SIZE

Exploratory Analyses



Methodology

• Publication counts were plotted against tumor type• Counts of incident and prevalent patients, as well as

deaths from cancer, were taken from SEER estimates (see Appendix for references)

• Ratios of publications to these patient counts were estimated– Publications divided by incidence (per 10,000 patients)– Publications divided by prevalence (per 100,000 patients)– Publications divided by deaths (per 1,000 deaths)*– Higher numbers reflect more publications per patient– The median publication ratio across all tumors was used

as an index for establishing high versus low ratios

July 24, 2012

(*Note that the deaths were divided by 10,000 for creating the figure.)

Publications Relative to Incidence, Prevalence, and Deaths


0.0

5.0

10.0

15.0

20.0

25.0

30.0

0

20

40

60

80

100

120

140

160

180

200

Incident cases per 10,000 (2012)

Prevalent cases per 100,000 (2009)

Deaths per 10,000 (2012)

Total Publications

Tumor

Cases

Publicati

ons

Publications per Patient According to Incidence, Prevalence, and Death

Notes: Higher numbers indicate more publications per patient. See next slide for comparisons to the median ratios.

Breast

Colorecta

l

Prostate

Lung

Urinary

Bladder

Pancreas

Ovary

Head &

Neck

Lymphoma

LiverEsophag

us

Renal

Gastric

Leukemia

Corpus

Uteri

Cervical

Brain & CNS

Total Publications 194 167 151 81 32 30 28 24 22 18 17 16 12 11 8 7 6

% incident patients ≥ 65 years (2004-2009)

41% 61% 59% 68% 72% 67% 46% 44% 50% 45% 60% 49% 63% 53% 41% 19% 35%

Pub/Incidence ratio (per 10,000)

8.6 11.6 6.2 3.6 4.4 6.8 12.6 4.6 2.8 6.3 9.7 2.5 5.6 2.3 1.7 5.8 2.6

Pub/Prevalence ratio (per 100,000)

7.1 14.6 6.0 20.9 5.8 78.3 15.3 6.8 3.3 50.6 53.4 5.0 17.1 4.0 1.4 2.8 4.4

Pub/Death ratio (per 1,000)

4.9 3.2 5.4 0.5 2.2 0.8 1.8 2.1 1.1 0.9 1.1 1.2 1.1 0.5 1.0 1.7 0.4


Publication Ratios Standardized to the Median Ratio

Notes: Ratios reflect the tumor-specific publication ratio relative to median publication ratio (see previous slide for non-standardized ratios). Values above 1.0 indicate ratios higher than the median, and values below 1.0 indicate ratios below the median (shaded orange).

Breast

Colorecta

l

Prostate

Lung

Urinary

Bladder

Pancreas

Ovary

Head &

Neck

Lymphoma

LiverEsophag

us

Renal

Gastric

Leukemia

Corpus

Uteri

Cervical

Brain & CNS

Total Publications 194 167 151 81 32 30 28 24 22 18 17 16 12 11 8 7 6

% incident patients ≥65 years (2004-2009)

41% 61% 59% 68% 72% 67% 46% 44% 50% 45% 60% 49% 63% 53% 41% 19% 35%

Pub/Incidence ratio (per 10,000)

1.5 2.1 1.1 0.6 0.8 1.2 2.2 0.8 0.5 1.1 1.7 0.4 1.0 0.4 0.3 1.0 0.5

Pub/Prevalence ratio (per 100,000)

1.0 2.2 0.9 3.1 0.9 11.5 2.3 1.0 0.5 7.5 7.9 0.7 2.5 0.6 0.2 0.4 0.7

Pub/Death ratio (per 1,000)

4.3 2.8 4.7 0.4 1.9 0.7 1.6 1.8 1.0 0.8 1.0 1.0 1.0 0.4 0.9 0.9 0.4


Conclusions

• There has been steady growth in the number of publications over time using the SEER-Medicare data

• Breast, colorectal, prostate, and lung are the tumor sites with the highest number of publications– This corresponds well with estimates of incidence and

prevalence in the United States population

• The number of publications appears to align better with incidence and prevalence than with death, particularly for more common cancers

• Leukemia, lymphoma, lung, and renal might be under-represented in terms of the absolute number of publications


ADDITIONAL RESULTS AND INFORMATION

Appendix


JOURNALSummary of Publications



Publications by Journal (All Years)

Cance

r

J Clin

Onc

ol

Med

Car

e

J Nat

l Can

cer I

nst

J Uro

l

J Am

Ger

iatr S

oc

JAM

A

Int J

Rad

iat O

ncol

Biol P

hys

Health

Ser

v Res

J Gen

Inte

rn M

ed

Arch

Inte

rn M

ed

Urolog

y

Ann S

urg

Breas

t Can

cer R

es T

reat

Gyn

ecol

Onc

ol

Value

Health

Cance

r Cau

ses

Contro

l

Ann In

tern

Med

J Clin

Epid

emiol

J Gas

troint

est S

urg

0

20

40

60

80

100

Journal

Pu

bli

cati

on

s

July 24, 2012


Publications by Journal (2006-2012)

Cance

r

J Clin

Onco

l

J Natl

Cance

r Inst

Med Care

J Urol

J Am Geri

atr So

c

Int J Rad

iat O

ncol B

iol Phys

Arch In

tern M

ed

J Gen

Inter

n Med

JAMA

Breast

Cance

r Res

Treat

Health

Serv

Res

Urology

Ann Surg

Value H

ealth

J Gast

rointest S

urg

Prostate

Cance

r Prosta

tic Dis

Gynec

ol Onco

l

Ann Surg

Oncol

Cance

r Epidem

iol Biomark

ers Prev

01020304050607080

Journal

Publicati

ons

July 24, 2012

AUTHORS (ANY POSITION)Summary of Publications



Publications by Journal (2006-2012)

0

10

20

30

40

50

60

70

80

Author

Pu

bli

cati

on

s

July 24, 2012


Publications by Author (2006-2012)

Earle

CC

Du XL

Neville

BA

Goo

dwin

JS

Kuo Y

F

War

ren

JL

Freem

an JL

Gior

dano

SH

Schra

g D

Baldwin

LM

Armst

rong

K

Fang

S

Gro

ss C

P

Hollen

beck

BK

Elkin

EB

Buchh

olz T

A

Saigal

CS

Hersh

man

DL

Neugu

t AI

Keatin

g NL

0

10

20

30

40

50

60

Author

Pu

bli

cati

on

s

July 24, 2012

Data Sources

• Incidence (2012), Deaths (2012) and Prevalence (2009)– http://seer.cancer.gov/statfacts/index.html– Howlader N, Noone AM, Krapcho M, Neyman N, Aminou R, Altekruse SF, Kosary CL,

Ruhl J, Tatalovich Z, Cho H, Mariotto A, Eisner MP, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds).SEER Cancer Statistics Review, 1975-2009 (Vintage 2009 Populations), National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2009_pops09/, based on November 2011 SEER data submission, posted to the SEER web site, 2012.

• Proportion of patients age ≥65 at diagnosis– Surveillance, Epidemiology, and End Results (SEER) Program (www.seer.cancer.gov)

SEER*Stat Database: Incidence - SEER 18 Regs Research Data + Hurricane Katrina Impacted Louisiana Cases, Nov 2011 Sub, Vintage 2009 Pops (2000-2009) <Katrina/Rita Population Adjustment> - Linked To County Attributes - Total U.S., 1969-2010 Counties, National Cancer Institute, DCCPS, Surveillance Research Program, Surveillance Systems Branch, released April 2012, based on the November 2011 submission.

– Year of diagnosis = 2004-2009

• All Site and Morphology classifications were aligned among all data sources with the exception of Head & Neck

– Head & Neck was defined using two readily available categories: Larynx + Oral Cavity and Pharynx

July 24, 2012 SEER Medicare Publications 24

http://seer.cancer.gov/statfacts/index.html

Acknowledgements

• Thanks to Jennifer Duryea for the SEER*Stat analyses and to Marc Halperin for extracting the data from the NCI website


Contact Information

• Mark D. Danese• 340 N. Westlake Blvd, Suite 200, Westlake

Village, CA 91362• 805-498-0034• [email protected]• www.outins.com


http://www.outins.com/

overview of all seer-medicare publications through 2012 mark d. danese, mhs, phd july 24, 2012

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