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The Metropolitan Detroit Cancer Surveillance System (MDCSS) was organized in 1949 as a central pathology registry to serve 25 hospitals in Wayne, Oakland, and Macomb Counties.   Population-based cancer reporting, the collection of cancer data for all residents of the tri-county area, was initiated in 1969 with the MDCSS's participation in the Third National Cancer Survey of the National Cancer Institute (NCI).  The MDCSS was also appointed by the Michigan Department of Community Health (MDCH) to collect cancer data in the tri-county area for the statewide cancer reporting system.  Two years later, Congress passed legislation mandating the collection, analysis, and dissemination of cancer data on a national basis, leading to the establishment of the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute in 1973. MDCSS is a founding member of the SEER Program.

The National SEER Program

The SEER Program collects data from 18 geographic areas in the United States.  There are nine states (New Mexico, Hawaii, Utah, Iowa, Connecticut, Greater California, Kentucky, Louisiana, and New Jersey) and six metropolitan areas (Atlanta, San Francisco, Seattle, Detroit, San Jose-Monterey, and Los Angeles), two Native American areas (Alaska Native Tumor Registy, Arizona Indians) and one rural area (Rural Georgia) which represents approximately 26% of the U.S. population.

The goals of the Detroit SEER Program are as follows:

  1. To assemble and report estimates of cancer incidence and mortality in the United States.
  2. To monitor annual cancer incidence trends and identify unusual changes in specific forms of cancer in population subgroups.
  3. To provide continuing information on changes over time in the extent of disease at diagnosis, trends in therapy, and patient survival.
  4. To promote studies designed to identify factors leading to cancer control.

Operation of the Detroit Registry

The charge of the MDCSS is to register all newly diagnosed cancer cases in residents of the Detroit Metropolitan Area and provide active follow-up on all living patients.  The data collected for all cases of cancer include patient demographics, type of cancer, tumor characteristics, the extent of disease at time of diagnosis, and type of treatment received for the first course of therapy.  Follow-up on each patient is conducted annually to assess current vital status.  Data are submitted annually to the NCI, excluding any patient, physician, or hospital identifier information, and on a quarterly basis to the MDCH for state registry purposes.

Cancer data are compiled by the staff of the Cancer Surveillance Unit of the Epidemiology Section.  Approximately 50 members of this unit are involved in the collection, data entry and editing of this information.  A staff of 29 cancer registrars collect data from medical records in area hospitals, radiation oncology facilities, and private pathology laboratories.  In addition, death certificates, nursing homes, and other sources are checked for information on cancer cases.  Over the past 46 years, data on approximately 941,200 SEER reportable cases have been collected.

Utilization of SEER Data for Planning, Education, and Outreach Purposes

MDCSS data are utilized in a number of ways by local hospitals, physicians, and service agencies.  Physicians and hospitals often request updated information on their own patients for long-range planning, evaluation of treatment or equipment needs, or other purposes.  Service agencies, as well as professionals and members of the general public, also seek information on patterns of cancer in the Detroit Metropolitan Area for educational and program planning purposes.

Research Utilizing the MDCSS Database

The MDCSS database is employed extensively for research purposes.  Used alone, the data provide the capability for describing subgroups of the Detroit area population in terms of cancer incidence, survival, stage of diagnosis, and treatment patterns.  The database also provides a springboard for launching more extensive studies which attempt to determine environmental, socioeconomic, dietary, and occupational exposures which may have an impact on cancer patterns and to assess the impact of screening, early detection and treatment on the length and quality of patient survival.  The Detroit Metropolitan Area is particularly well-suited to these types of studies because of its diverse population and urban, industrial environment.  The confidentiality of all identifier data is strictly maintained.

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