McBean A M, Warren J L, Babish J D
Epidemiology Branch, Health Care Financing Administration, Baltimore, Maryland 21207.
Cancer. 1994 May 1;73(9):2417-25. doi: 10.1002/1097-0142(19940501)73:9<2417::aid-cncr2820730927>3.0.co;2-l.
The Surveillance, Epidemiology, and End Results (SEER) program of the National Cancer Institute is the most frequently used and best estimate of the incidence of cancer in the United States. Although synthetic estimates based on the SEER information can be used to plan cancer prevention and intervention programs, the evaluation of these action programs and the monitoring of cancer incidence in states or other geographic areas requires information on the population for whom the program is directed.
The age-adjusted incidence of six cancers among persons 65 years of age and older for 1986-1987 living in the five states participating in the SEER program was compared with the incidence derived from hospitalization records contained in the Health Care Financing Administration's (HCFA) administrative data files. Age-adjusted incidence rates for 1990 developed from HCFA data for persons living in the nine SEER program areas were contrasted with the incidence rates for persons living in the rest of the United States and were developed for each of the 50 states and the District of Columbia.
The comparison of the SEER and HCFA overall age-adjusted cancer incidence rates in the elderly for 1986-1987 showed that for four of the six cancers (breast, colon, lung, and corpus uteri) the rates differed by 5% or less. The HCFA derived rates were 6.37% and 7.65% greater than the SEER rates for prostate and esophagus cancer, respectively. The incidence of cancer between 1986 and 1990 was neither uniformly higher nor lower among elderly SEER program area residents compared with residents of the rest of the country. Incidence rates varied greatly among states for each of the cancers.
HCFA administrative data can be used by states or other geographic units to monitor the incidence of cancer in the elderly as well as to plan and evaluate cancer prevention and intervention programs.
美国国立癌症研究所的监测、流行病学和最终结果（SEER）计划是美国最常用且对癌症发病率的最佳估计。虽然基于SEER信息的综合估计可用于规划癌症预防和干预计划，但对这些行动计划的评估以及对各州或其他地理区域癌症发病率的监测需要有关该计划所针对人群的信息。
将1986 - 1987年居住在参与SEER计划的五个州的65岁及以上人群中六种癌症的年龄调整发病率与医疗保健财务管理局（HCFA）行政数据文件中包含的住院记录得出的发病率进行比较。根据HCFA数据得出的1990年居住在九个SEER计划区域的人群的年龄调整发病率与居住在美国其他地区的人群的发病率进行对比，并针对50个州和哥伦比亚特区分别得出。
1986 - 1987年SEER和HCFA对老年人总体年龄调整后的癌症发病率比较显示，六种癌症中的四种（乳腺癌、结肠癌、肺癌和子宫体癌）发病率差异在5%或以下。HCFA得出的前列腺癌和食管癌发病率分别比SEER发病率高6.37%和7.65%。与美国其他地区居民相比，1986年至1990年期间，SEER计划区域老年居民的癌症发病率既不是普遍更高也不是更低。每种癌症的发病率在各州之间差异很大。
各州或其他地理单位可以使用HCFA行政数据来监测老年人的癌症发病率，以及规划和评估癌症预防和干预计划。
