# Fast Stats Help

**Fast Stats** is an interactive tool for quick access to key SEER and US cancer statistics for major cancer sites by age, sex, and race. Statistics may be viewed as graphs or tables.

# Help Using Fast Stats

- Select the way you would like to see the statistics stratified.

From the**Fast Stats**home page or the navigation menu on the left of every Fast Stats page, select one of the following views:

- Cancer Site
- Race/Ethnicity
- Sex, Race/Sex
- Age at Diagnosis/Death
- Data Type.
- Use the controls to select variables from the top down. Don’t make selections out of order as the selections may determine the variables available in another control. The available controls are:

- Listboxes – Click on the arrow at the right to open the listbox. Select one of the choices with your mouse.
- Radio Buttons – Click the button to select output., a graph or a table. Only one button can be selected at a time.
- Checkboxes – Click on a box to check or uncheck it. Checked boxes are selected. Multiple boxes may be checked.

- When all your selections have been made click on the
**Get Data**button. The graph or table will appear at the bottom of the page.

- To download your output select the
**Download Image**link for graphs and the**Download Data**link for tables. Graphs are downloaded as .jpg files and tables are downloaded as .csv files.

- To make changes in the data, scroll to the top of the page to make different selections.

The page you selected will open with controls for selecting variables.

# Available Data and Statistics in Fast Stats

The types of data and statistics available are dependent on which cancer site you choose. Those that could be available include:

## Incidence and Mortality

Cancer incidence and mortality are generally expressed as rates.

A cancer incidence rate is the number of newly diagnosed cancers of a specific site/type occurring in a specified population during a year (or group of years). It is usually expressed as the number of cancers per 100,000 population at risk. The number of new cancers may include multiple primary cancers occurring in one patient. The primary site reported is the site of origin and not the metastatic site. In general, the incidence rate does not include recurrences. The population used depends on the rate to be calculated. For cancer sites that occur in only one sex, the sex-specific population (e.g., females for cervical cancer) is used. The incidence rate can be computed for a given cancer site or for all cancers combined.

A cancer mortality rate is the number of reported cancer deaths of a specific site/type occurring in a specified population during a year (or group of years), usually expressed as the number of cancers per 100,000 population at risk . The population used depends on the rate to be calculated. For cancer sites that occur in only one sex, the sex-specific population (e.g., females for cervical cancer) is used. The mortality rate can be computed for a given cancer site or for all cancers combined.

Fast Stats can access the following types of incidence and mortality data:

### Delay-adjusted SEER Incidence

Due to reporting delays, it is difficult to get a timely and accurate calculation of cancer incidence rates. The **Delay-adjusted SEER Incidence** method applies an algorithm to the data that makes up for the delay in receiving reports. The result is an estimate of what the Incidence rates would be if there were no delays in reporting. Delay-adjusted incidence is only available for age-adjusted rates and trends of age-adjusted rates for the SEER 9 data from 1975 to the most current data year.

### Trends (Annual Percent Change) of Rates

This is the average rate of change in a rate over several years and is used to measure trends over time.

For incidence, trends are available for 1975 to the most current data year for the SEER 9 registries and 1992 to the most current data year for the SEER 13 registries by race (all races, white, black), by sex, for non-sex specific sites (both sexes, male, female) and by race and sex (all races-both sexes, all races-males, etc.). These groupings can be further subset by age (all ages, <65, 65+, <50, 50+, 20-54, 55-64, 65-74, 75+).

Trend data by race for SEER 13 includes the "expanded" race categories: White, Black, American Indian/Alaska Native, Asian/Pacific Islander. It also includes the ethnic groups Hispanic and Non-Hispanic, which are not mutually exclusive from White, Black, American Indian/Alaska Native, and Asian/Pacific Islander. This was made possible by the inclusion of intercensal population information for these additional racial groups by the Bureau if the Census after 1990. Beyond "expanded" race, SEER 13 trend data can be categorized in a similar manner as SEER 9.

For mortality, trends for US mortality can be obtained to correspond to those available in incidence.

### Age-Adjusted Rates for Individual Years

Age-adjustment is a method that allows comparisons of populations that takes into account the differences in ages of these populations. Since cancer is much more likely to be diagnosed in older individuals, age-adjusted rates allow you to compare rates for multiple geographic areas (such as states) or rates across time and be assured that differences you are seeing are not due to differences in the age distributions of the areas you are comparing or the aging of a population across time.

SEER incidence rates and US mortality rates are age-adjusted to the US population as was recorded in the 2000 census. The US 2000 standard is one of many available standards. No one standard is superior to any other, the important thing is that this is a method for controlling potential differences in the age distribution. The thing to note, when comparing rates from one source to rates from another is to make sure that all rates that you are comparing are age-adjusted to the same standard. Currently, all cancer rates published in the US are age-standardized to the same standard (US 2000). You will want to be careful, however, when working with rates from various international sources, where the standards differ.

Age-adjusted incidence rates are available from 1975 to the most current data year for the SEER 9 registries, 1992 to the most current data year for the SEER 13 registries, and 2000 to the most current data year for SEER 18 registries. The available age, race (or expanded race), and sex categories are the same as those for trends. Age-adjusted mortality rates correspond to the same available years as incidence. The available age, race (or expanded race), and sex categories are also the same.

### Age-adjusted Rates and 95% Confidence Intervals

Confidence intervals provide a range of values that have a specified probability of containing the rate or trend. The 95% (p-value = .05) and 99% (p-value = .01) confidence intervals are the most commonly used.

The data presented will include both the rate, as calculated from the data, and an upper and lower limit for this calculated rate. For 95% confidence intervals, it can be stated that 95% of the time the true rate will lie within these limits.

Age-adjusted incidence rates and 95% confidence intervals are available for 1992 to the most current data year for the SEER 13 registries and 2000 to the most current data year for the SEER 18 registries. The available age, race (or expanded race), and sex categories are the same as those for trends and age-adjusted rates for individual years.

Age-adjusted mortality rates and 95% confidence intervals are available for the same two time periods by state, race and sex and by "expanded" race and sex. The available age groups remain the same as previously seen.

### Age-Specific Rates

An age-specific rates refers to a rate for a specified age group. Fast Stats provides data for 19 separate age groups, ages; 0, 0-4, 5-9, 10-14, 15.19, 20-24, 24-29, 30- 34, 34-39, 40-44, 45-49, 50-54, 55-59, 60-64, 65-69, 70-74,75-79, 80-84, and 85+. The potential age groups available is generally dictated by the available population data.

Age-specific rates for the 19 age groups are available for 1992 to the most current data year for the SEER 13 registries and 2000 to the most current data year for the SEER 18 registries. They are available by "expanded" race, by sex (for non-sex specific cancers) and by "expanded" race and sex.

## Survival

Cancer survival is the proportion of patients alive at some point subsequent to the diagnosis of their cancer. It is represented as the probability of a group of patients "surviving" a specified amount of time (e.g. 3 years, 5 years, 20 years).

There are numerous methods which can be used to calculate survival. The method used in Fast Stats attempts to look at survival from the standpoint of evaluating a patients outcome in the absence of other causes of death and is referred to as "Relative Survival". Cancer survival in the absence of other causes of death is calculated using survival life tables. Relative survival is defined as the ratio of the proportion of observed survivors (all causes of death) in a cohort of cancer patients to the proportion of expected survivors in a comparable cohort of cancer-free individuals. The formulation is based on the assumption of independent competing causes of death. Since a cohort of cancer-free individuals is difficult to obtain, we use expected life tables and assume that the cancer deaths are a negligible proportion of all deaths.

### Relative Survival Rates

Survival curves, line charts of survival over time from diagnosis to some end point, are available from this section. These results are based on SEER 9 data and cover cancers diagnosed from 1988 to the most recent available year. Survival curves are available by race, by sex, and by race and sex for all ages, < 65, 65+, <45, 45-54, 55-64, 65-74, and 75+.

### 5-Year Relative Survival Rates

5-year relative survival rates based on SEER 9 data are available for 1992 to the most current data year. These data are available by race, by sex, and by race and sex for all ages, < 65, 65+, <45, 45-54, 55-64, 65-74, and 75+.

### Conditional 5-Year Relative Survival Rates

It is easy to look at a survival curve and take it to somehow represent prognosis forever. But in fact odds change over time. Survival odds, given the precondition of having already survived a certain length of time, are technically referred to as conditional survival (the term relates to conditional probability in mathematics).

Fast Stats presents data on the probability of surviving 5 years given that you have already survived 1, 3, 5 and 10 years (conditional period). This data is presented as a line chart for the selected cancer for cases diagnosed from 1975 to the latest year available. Data is from the SEER 9 Registries.

## Prevalence

Cancer prevalence is defined as the number or percent of people alive on a certain date in a population who previously had a diagnosis of the disease. It includes new (incidence) and preexisting cases, and is a function of both past incidence and survival.

In Fast Stats, prevalence is calculated using the "first malignant cancer ever" method. This method for calculating prevalence includes only the first malignant tumor in the analysis. The SEER registries collect the number (but not the site or behavior) of cancers that occur prior to the start of the registry, or prior to the person moving to a SEER catchment area. SEER makes the assumption that these cancers are malignant, as is true of the majority of SEER cancers. Thus, if SEER indicates that the first SEER-registered tumor is the person's second tumor (the other was a non-SEER cancer) this person's cancers are excluded using this option.

Two options for prevalence are available in Fast Stats:

### Limited Duration Prevalence

Limited-Duration Prevalence represents the proportion of people alive on a certain day who had a diagnosis of the disease within the past x years (e.g. x = 5, 10 or 20 years). Registries of shorter duration, less than 40 or 50 years of data collection, can only estimate limited-duration prevalence. The SEER Program has information on cancer cases since 1973; however, prevalence calculations usually begin in 1975 due to a different number of registries participating in years 1973-1974. Thus prevalence can be estimated from SEER using data from 1975 through the most recent year for which data is available.

Limited-duration prevalence can be further classified into periods from year of diagnosis. For example, 20-years prevalence could be further classified into the prevalence of those diagnosed in the last 0 to < 5 years, 5 to < 10 years, 10 to < 15 years, and 15 to < 20 years.

In Fast Stats, limited duration prevalence is available by "expanded" race and sex and by age-group (same 19 groups as age-specific incidence and mortality rates), expanded" race and sex. Prevalence for Asian/Pacific Islanders and Hispanics can only be calculated for cases diagnosed from 1990 forward. Data is for all cancer sites combined only.

### Complete Prevalence

Complete Prevalence represents the proportion of people alive on a certain day who previously had a diagnosis of the disease, regardless of how long ago the diagnosis was, or if the patient is still under treatment or is "cured". In the United States, the only registry with sufficient incidence and follow-up data to approximate complete cancer prevalence is the Connecticut Tumor Registry. The Connecticut registry has information on cancer cases from as early as 1935, although computations do not usually include cases diagnosed prior to 1940. However, projecting estimates of US prevalence from Connecticut is not optimal because Connecticut is less representative of the United States than SEER. Moreover, from SEER, prevalence can be estimated by race and ethnicity. The completeness index , a statistical model to estimate complete prevalence from limited-duration prevalence, has been derived and used to estimate complete prevalence from SEER limited-duration prevalence, survival, and incidence data.

In Fast Stats, complete prevalence is available by cancer site, race and sex.

## Lifetime Risk

Lifetime risk is the probability of an event occurring during a person's life. Cancer statistics provide two types of lifetime risk -- the probability of developing cancer and the probability of dying of cancer from birth or conditional on a certain age.

### Probability of Developing/Dying of Cancer

The most recent 3 years of data from SEER 18 are used to calculate the probability of developing/dying of cancer. This data is available by sex, by race and by sex and race.

# How are the data presented in Fast Stats?

Depending on the statistic selected, data may be presented as either a graph (bar or line) or table, or can be downloaded in comma-delimited text format. The two radio buttons below the series selections provide the choice of generating a "Graph" or a "Table". Next to each graph/table that is generated there is a link to download the same data in textual delimited format.

## Example of Bar Graph Output

- The graph is generated as an JPEG image, with the following elements: title, graph, axes labels, footnotes, and legend (where applicable).
- The title describes the data and statistic type, selection parameters, series parameter, and year range.
- The selection parameters for this graph may include: statistics type, cancer site, the SEER registry year range, and any race, age, or sex choices.
- The series selected will be labelled in the legend (in line graphs) or under/next to each bar (in bar graphs).
- Any associated footnotes will appear at the bottom of the graph.
- Certain cases there will be values in one or more series that have been suppressed and thus some line charts' series will not be completely continuous lines. In these cases, the footnotes and an error message above or in the graph will warn of the suppressed values.
- A "Download Image", "Download Data", and "Send link to this page" links will appear to the right of each graph or table. A "Go to top" link will appear in below each graph.