Race recode for USCS

Source of standard: North American Association of Central Cancer Registriesexternal icon

Source item name: Derived from Race 1, Race 2, IHS Link, and Race- NAPIIA (derived API)

Source item numbers: 160external icon (Race 1), 161external icon (Race 2), 192external icon (IHS Link), and 193external icon (Race-NAPIIA (derived API))

This variable indicates the derived code for the patient’s race. Race is coded separately from Hispanic ethnicity. This variable is created using NAACCR variables Race 1, Race 2, the Indian Health Service (IHS) Link variable, and Race-NAPIIA (derived API).

Race recode starts as Race 1. If Race 1 is White and Race 2 is a specified non-White race, then the value from Race 2 is used. After this check, if Race is still White and there is a positive IHS link, then Race/Ethnicity is set to American Indian/Alaskan Native (AI/AN).

Considerations for Use

  • This variable is available only in the U.S. Data 2001–2018 public use database. It is not available in the U.S. and Puerto Rico 2005–2018 database.
  • States have the option to suppress race-specific and Hispanic-specific data every submission year. While these states can be included in an aggregated analysis, their race and ethnicity information cannot be reported at the state level.
  • The following states have state-level race data presentation restrictions—
    • Data for American Indian and Alaska Native people cannot be displayed for Delaware, Illinois, Kansas, Kentucky, New Jersey, and New York.
    • Data for Asian and Pacific Islander people cannot be displayed for Delaware, Kansas, and Kentucky.
    • Data for race and ethnicity combinations—White Hispanic, White non-Hispanic, Black Hispanic, and Black non-Hispanic—cannot be displayed for Delaware, Kansas, Kentucky, Massachusetts, and Pennsylvania.

    Race is defined by specific physical, hereditary, and cultural traditions or origins, not necessarily by birthplace, place of residence, or citizenship. “Origin” is defined by the U.S. Census Bureau as the heritage, nationality group, lineage, or in some cases, the country of birth of the person or the person’s parents or ancestors before their arrival in the United States. As a standard practice, central cancer registries classify race as coded in the medical record. To address AI/AN misclassification in cancer registry data, registries supported by CDC’s National Program of Cancer Registries Program (NPCR) and the National Cancer Institute’s Surveillance Epidemiology End Results (SEER) Program link their central cancer registry data to the IHS administrative records database.

    • SEER registries link their data annually, with the most recent linkage occurring among cases diagnosed from 1998 to 2018. Annually, 31 NPCR registries with Purchase/Referred Care Service Delivery Area (PRCSDA) counties in their state link their data. All NPCR registries link every five years, with the most recent linkage occurring in 2016.
    • Although the linkage with IHS does not completely resolve the classification of race for AI/AN cases, it helps provide a more comprehensive and accurate picture of the cancer burden in this population.
    • When interpreting data results, be aware that AI/AN populations may be undercounted during years when linkages did not occur in all NPCR registries.
    • If a project is looking specifically at AI/AN populations, analysts may consider restricting the NPCR states included in the analysis to NPCR registries that conduct annual IHS linkages.
  • In all separate records of tumors for the same patient, the patient should have the same race code.
  • This variable contains “other unspecified” and “unknown” categories. These groups are coded as “unknown race” for the purpose of analyses as specified in the SEER documentation.external icon Population data are not available for the “other race” and “unknown race” categories.

NPCR–Indian Health Services (IHS) Linkage Schedule

All NPCR-funded registries link with the Indian Health Service every five years. The most recent linkage year was 2016.

All state central cancer registries with Purchase/Referred Care Delivery Area (PRCDA)1 counties link with the Indian Health Service every year. These include—

  • Alabama
  • Alaska
  • Arizona
  • California
  • Colorado
  • Florida
  • Idaho
  • Indiana
  • Kansas
  • Louisiana
  • Maine
  • Massachusetts
  • Michigan
  • Minnesota
  • Mississippi
  • Montana
  • Nebraska
  • Nevada
  • New York
  • North Carolina
  • North Dakota
  • Oklahoma
  • Oregon
  • Pennsylvania
  • Rhode Island
  • South Carolina
  • South Dakota
  • Texas
  • Washington
  • Wisconsin
  • Wyoming

1Purchased/Referred Care Delivery Area (PRCDA) was previously referred to as Contract Health Service Delivery Area (CHSDA).