Data Processing Steps and Important Definitions

Data Sources

• SEER – used to validate calculations
• Florida Cancer Data System (FCDS) – used to obtain cancer incidence and mortality cases across Florida
• American Community Survey (ACS) – both 1-year and 5-year estimates used to obtain county- and state-level population measures
• US 2000 Standard Population Proportion data – used to calculate age-adjusted rates

Data Processing

• Import the initial diagnosis dataset: DR385_001_Dataset.dat (N = 1,269,382)
• This contains patients diagnosed from year Jan 1st, 2012 - Dec 31st, 2020
• Merge with the Cancer Site Description file: "Merged ICD-O3 code and Site Description" for diagnosis, and "Cancer Cause of Death AI.xlsx" for cause of death
• Death was then matched by "CAUSE_OF_DEATH_N1910"
• This was used to identify cancer types for each diagnosis by matching with "PRIMARY_SITE_N400"
• Remove 3 diagnoses with age of -1 (N = 1,269,379)
• Remove recurrent cancer diagnoses within 5 years (N = 1,242,965)
• For those only have diagnosis year, we used June 15th as the diagnosis date
• For those only have diagnosis year and month, we used 15th as the diagnosis date
• This study is focused on Year 2016-2020, so the time frame of the diagnosis data was also filtered to 2016-2020. (N = 717,967)

Terminology

• A cancer incidence rate is the number of new cancers of a specific site/type occurring in a specified population during a year, usually expressed as the number of cancers per 100,000 population at risk. Incidence rate = (New cancers / Population) × 100,000
• Advanced stage cancer is defined as the case diagnosed in the regional or distant stage
• A cancer mortality rate is the number of deaths, with cancer as the underlying cause of death, occurring in a specified population during a year. Cancer mortality is usually expressed as the number of deaths due to cancer per 100,000 population. Mortality Rate = (Cancer Deaths / Population) × 100,000.
• Age Adjusted Rate calculation: We take the crude rate of each age group and multiply it by the proportion of the US 2000 Standard Population in that age group. We then sum up these values to get the age-adjusted rate

Notes

• Population information was obtained from 5-year American Community Survey APIs
• For cancer sites that occur in only one sex, sex-specific populations were used
• This applied to cervix, uterus, ovary, other female genital, prostate, and other male genital cancers
• Measures generated for breast cancer were computed for females only
• The US 2000 Standard Populations were used to calculate age-adjusted measures

Data sets or sources

• UFHCC or UFHCI: indicates that it is decided by the cancer institute and/or COE
• ACS: American Community Survey, 1 or 5-year estimates; data provided by the U.S. Census Bureau
• FCDS: Florida Cancer Data System –– Florida's statewide cancer registry
• FDOH: Florida Department of Health
• Vital stats: Bureau within FDOH that collects and distributes all statewide mortality data.

Mortality cases can be linked with FCDS cancer cases through certain types of data requests.

*Asterisks indicates that the site can't be coded without knowing the histology. Therefore, cancers for these sites are grouped broadly.