Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
Cancer Causes Control. 2021 Mar;32(3):211-220. doi: 10.1007/s10552-020-01375-0. Epub 2021 Jan 3.
SEER data are widely used to study rural-urban disparities in cancer. However, no studies have directly assessed how well the rural areas covered by SEER represent the broader rural United States.
Public data sources were used to calculate county level measures of sociodemographics, health behaviors, health access and all cause cancer incidence. Driving time from each census tract to nearest Commission on Cancer certified facility was calculated and analyzed in rural SEER and non-SEER areas.
Rural SEER and non-SEER counties were similar with respect to the distribution of age, race, sex, poverty, health behaviors, provider density, and cancer screening. Overall cancer incidence was similar in rural SEER vs non-SEER counties. However, incidence for White, Hispanic, and Asian patients was higher in rural SEER vs non-SEER counties. Unadjusted median travel time was 53 min (IQR 34-82) in rural SEER tracts and 54 min (IQR 35-82) in rural non-SEER census tracts. Linear modeling showed shorter travel times across all levels of rurality in SEER vs non-SEER census tracts when controlling for region (Large Rural: 13.4 min shorter in SEER areas 95% CI 9.1;17.6; Small Rural: 16.3 min shorter 95% CI 9.1;23.6; Isolated Rural: 15.7 min shorter 95% CI 9.9;21.6).
The rural population covered by SEER data is comparable to the rural population in non-SEER areas. However, patients in rural SEER regions have shorter travel times to care than rural patients in non-SEER regions. This needs to be considered when using SEER-Medicare to study access to cancer care.
SEER 数据被广泛用于研究癌症的城乡差异。然而，尚无研究直接评估 SEER 涵盖的农村地区在多大程度上代表了更广泛的美国农村地区。
使用公共数据源计算县一级的社会人口统计学、健康行为、健康获取和所有原因癌症发病率指标。从每个普查区到最近的癌症委员会认证机构的行车时间被计算出来，并在农村 SEER 和非 SEER 地区进行了分析。
农村 SEER 和非 SEER 县在年龄、种族、性别、贫困、健康行为、医疗服务提供者密度和癌症筛查方面的分布相似。农村 SEER 与非 SEER 县的总体癌症发病率相似。然而，白种人、西班牙裔和亚洲患者的癌症发病率在农村 SEER 县高于非 SEER 县。农村 SEER 县的未调整中位旅行时间为 53 分钟（IQR 34-82），农村非 SEER 县的为 54 分钟（IQR 35-82）。线性模型显示，在控制区域因素的情况下，SEER 县农村普查区的旅行时间比非 SEER 县农村普查区更短（大农村：SEER 地区短 13.4 分钟，95%CI 9.1；17.6；小农村：SEER 地区短 16.3 分钟，95%CI 9.1；23.6；孤立农村：SEER 地区短 15.7 分钟，95%CI 9.9；21.6）。
SEER 数据涵盖的农村人口与非 SEER 地区的农村人口相当。然而，与非 SEER 地区的农村患者相比，SEER 地区的农村患者到医疗服务的旅行时间更短。在使用 SEER-Medicare 研究癌症护理的可及性时，需要考虑这一点。
