3

Cancer

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3-1

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Overall cancer deaths

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3-2

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Lung cancer deaths

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3-3

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Breast cancer deaths

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3-4

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Cervical cancer deaths

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3-5

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Colorectal cancer deaths

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3-6

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Oropharyngeal cancer deaths

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3-7

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Prostate cancer deaths

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3-8

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Melanoma deaths

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3-9

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Sun exposure and skin cancer

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3-9a

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Adolescents in grades 9-12

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3-9b

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Adults aged 18 years and older

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3-10

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Provider counseling about cancer prevention

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3-10a

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Internists—smoking cessation

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3-10b

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Family physicians—smoking cessation

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3-10c

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Dentists—smoking cessation

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3-10d

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Primary care providers—blood stool tests

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3-10e

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Primary care providers—proctoscopic examinations

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3-10f

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Primary care providers—mammograms

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3-10g

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Primary care providers—Pap tests

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3-10h

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Primary care providers—physical activity

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3-11

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Pap tests

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3-11a

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Ever received a Pap test

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3-11b

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Received a Pap test within the preceding 3 years

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3-12

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Colorectal cancer screening

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3-12a

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Fecal occult blood test

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3-12b

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Sigmoidoscopy

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3-13

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Mammograms

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3-14

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Statewide cancer registries

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3-15

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Cancer survival

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3-1.

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Reduce the overall cancer death rate.

National Data Source

National Vital Statistics System (NVSS), CDC, NCHS.

State Data Source

National Vital Statistics System (NVSS), CDC, NCHS.

Healthy People 2000 Objective

16.1 (Cancer) (also 2.2), age adjusted to the 2000 standard population.

Measure

Rate per 100,000 population (age adjusted—see Comments).

Baseline

202.4 (1998).

Numerator

Number of deaths due to cancer (ICD-9 codes 140-208).

Denominator

Number of persons.

Population Targeted

U.S. resident population.

Questions Used To Obtain the National Data

Not applicable.

Expected Periodicity

Annual.

Comments

Data are age adjusted to the 2000 standard population. Age-adjusted rates are weighted sums of age-specific rates. For a discussion on age adjustment, see Part A, section 5.


This objective differs from Healthy People 2000 objective 16.1, which age adjusted the death rates using the 1940 standard population. See Appendix C for comparison data.


See Part C for a description of NVSS and Appendix A for focus area contact information.

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3-2.

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Reduce the lung cancer death rate.

National Data Source

National Vital Statistics System (NVSS), CDC, NCHS.

State Data Source

National Vital Statistics System (NVSS), CDC, NCHS.

Healthy People 2000 Objective

Adapted from 16.2 (Cancer) (also 3.2).

Measure

Rate per 100,000 population (age adjusted—see Comments).

Baseline

57.6 (1998).

Numerator

Number of deaths due to lung cancer (ICD-9 code 162).

Denominator

Number of persons.

Population Targeted

U.S. resident population.

Questions Used To Obtain the National Data

Not applicable.

Expected Periodicity

Annual.

Comments

Data are age adjusted to the 2000 standard population. Age-adjusted rates are weighted sums of age-specific rates. For a discussion on age adjustment, see Part A, section 5.


This objective is measured with slightly different  ICD-9 codes from those used to measure the comparable Healthy People 2000 objective 16.2 (ICD-9 code 162 vs. 162.2-162.9). Additionally, the Healthy People 2000 objective age adjusted the death rates using the 1940 standard population. See Appendix C for comparison data.


See Part C for a description of NVSS and Appendix A for focus area contact information.

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3-3.

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Reduce the breast cancer death rate.

National Data Source

National Vital Statistics System (NVSS), CDC, NCHS.

State Data Source

National Vital Statistics System (NVSS), CDC, NCHS.

Healthy People 2000 Objective

16.3 (Cancer), age adjusted to the 2000 standard population.

Measure

Rate per 100,000 female population (age adjusted—see Comments).

Baseline

27.9 (1998).

Numerator

Number of female deaths due to breast cancer (ICD-9 code 174).

Denominator

Number of females.

Population Targeted

U.S. resident population.

Questions Used To Obtain the National Data

Not applicable.

Expected Periodicity

Annual.

Comments

Data are age adjusted to the 2000 standard population. Age-adjusted rates are weighted sums of age-specific rates. For a discussion on age adjustment, see Part A, section 5.


This objective differs from Healthy People 2000 objective 16.3, which age adjusted the death rates using the 1940 standard population. See Appendix C for comparison data.


See Part C for a description of NVSS and Appendix A for focus area contact information.

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3-4.

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Reduce the death rate from cancer of the uterine cervix.

National Data Source

National Vital Statistics System (NVSS), CDC, NCHS.

State Data Source

National Vital Statistics System (NVSS), CDC, NCHS.

Healthy People 2000 Objective

16.4 (Cancer), age adjusted to the 2000 standard population.

Measure

Rate per 100,000 female population (age adjusted—see Comments).

Baseline

3.0 (1998).

Numerator

Number of female deaths due to cancer of the uterine cervix (ICD-9 code 180).

Denominator

Number of females.

Population Targeted

U.S. resident population.

Questions Used To Obtain the National Data

Not applicable.

Expected Periodicity

Annual.

Comments

Data are age adjusted to the 2000 standard population. Age-adjusted rates are weighted sums of age-specific rates. For a discussion on age adjustment, see Part A, section 5.


This objective differs from Healthy People 2000 objective 16.4, which age adjusted the death rates using the 1940 standard population. See Appendix C for comparison data.


See Part C for a description of NVSS and Appendix A for focus area contact information.

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3-5.

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Reduce the colorectal cancer death rate.

National Data Source

National Vital Statistics System (NVSS), CDC, NCHS.

State Data Source

National Vital Statistics System (NVSS), CDC, NCHS.

Healthy People 2000 Objective

Adapted from 16.5 (Cancer) (also 2.23).

Measure

Rate per 100,000 population (age adjusted—see Comments).

Baseline

21.2 (1998).

Numerator

Number of deaths due to colorectal cancer (ICD-9 codes 153, 154).

Denominator

Number of persons.

Population Targeted

U.S. resident population.

Questions Used To Obtain the National Data

Not applicable.

Expected Periodicity

Annual.

Comments

Data are age adjusted to the 2000 standard population. Age-adjusted rates are weighted sums of age-specific rates. For a discussion on age adjustment, see Part A, section 5.


This objective is measured with slightly different  ICD-9 codes from those used to measure the comparable Healthy People 2000 objective 16.5 (ICD-9 codes 153.0-154.3, 154.8, 159.0). Additionally, the Healthy People 2000 objective age adjusted the death rates using the 1940 standard population. See Appendix C for comparison data.


See Part C for a description of NVSS and Appendix A for focus area contact information.

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3-6.

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Reduce the oropharyngeal cancer death rate.

National Data Source

National Vital Statistics System (NVSS), CDC, NCHS.

State Data Source

National Vital Statistics System (NVSS), CDC, NCHS.

Healthy People 2000 Objective

Adapted from 13.7 (Oral Health) (also 3.17 and 16.17).

Measure

Rate per 100,000 population (age adjusted—see Comments).

Baseline

3.0 (1998).

Numerator

Number of deaths due to oropharyngeal cancer (ICD-9 codes 140-149).

Denominator

Number of persons.

Population Targeted

U.S. resident population.

Questions Used To Obtain the National Data

Not applicable.

Expected Periodicity

Annual.

Comments

Data are age adjusted to the 2000 standard population. Age-adjusted rates are weighted sums of age-specific rates. For a discussion on age adjustment, see Part A, section 5.


This objective differs from Healthy People 2000 objective 16.17, which age adjusted the death rates using the 1940 standard population. Additionally, the Healthy People 2010 objective targets the total population while the Healthy People 2000 objective targeted only persons 45 to 74 years. See Appendix C for comparison data.


See Part C for a description of NVSS and Appendix A for focus area contact information.

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3-7.

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Reduce the prostate cancer death rate.

National Data Source

National Vital Statistics System (NVSS), CDC, NCHS.

State Data Source

National Vital Statistics System (NVSS), CDC, NCHS.

Healthy People 2000 Objective

Not applicable.

Measure

Rate per 100,000 male population (age adjusted—see Comments).

Baseline

32.0 (1998).

Numerator

Number of male deaths due to prostate cancer (ICD-9 code 185).

Denominator

Number of males.

Population Targeted

U.S. resident population.

Questions Used To Obtain the National Data

Not applicable.

Expected Periodicity

Annual.

Comments

Data are age adjusted to the 2000 standard population. Age-adjusted rates are weighted sums of age-specific rates. For a discussion on age adjustment, see Part A, section 5.


See Part C for a description of NVSS and Appendix A for focus area contact information.

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3-8.

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Reduce the rate of melanoma cancer deaths.

National Data Source

National Vital Statistics System (NVSS), CDC, NCHS.

State Data Source

National Vital Statistics System (NVSS), CDC, NCHS.

Healthy People 2000 Objective

Not applicable.

Measure

Rate per 100,000 population (age adjusted—see Comments).

Baseline

2.8 (1998).

Numerator

Number of deaths due to melanoma cancer (ICD-9 code 172).

Denominator

Number of persons.

Population Targeted

U.S. resident population.

Questions Used To Obtain the National Data

Not applicable.

Expected Periodicity

Annual.

Comments

Data are age adjusted to the 2000 standard population. Age-adjusted rates are weighted sums of age-specific rates. For a discussion on age adjustment, see Part A, section 5.


See Part C for a description of NVSS and Appendix A for focus area contact information.

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3-9.

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Increase the proportion of persons who use at least one of the following protective measures that may reduce the risk of skin cancer: avoid the sun between 10 a.m. and 4 p.m., wear sun-protective clothing when exposed to sunlight, use sunscreen with a sun protective factor (SPF) of 15 or higher, and avoid artificial sources of ultraviolet light.

3-9a.      (Developmental) Increase the proportion of adolescents in grades 9 through 12 who follow protective measures that may reduce the risk of skin cancer.

Comments

An operational definition could not be specified at the time of publication.


The Youth Risk Behavior Surveillance System (YRBSS), CDC, NCCDPHP, is a proposed data source for this objective.


See Appendix A for focus area contact information.

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3-9b.      Increase the proportion of adults aged 18 years and older who follow protective measures that may reduce the risk of skin cancer.

National Data Source

National Health Interview Survey (NHIS), CDC, NCHS.

State Data Source

Behavioral Risk Factor Surveillance System (BRFSS), CDC, NCCDPHP.

Healthy People 2000 Objective

Adapted from 16.9 (Cancer).

Measure

Percent (age adjusted—see Comments).

Baseline

47 (1998).

Numerator

Number of adults aged 18 years and older who report that they are very likely to limit sun exposure, use sunscreen, or wear protective clothing.

Denominator

Number of adults aged 18 years and older.

Population Targeted

U.S. civilian, noninstitutionalized population.

Questions Used To Obtain the National Data

From the 1998 National Health Interview Survey:

 

Ø       If you were to go outside on a very sunny day for MORE than one hour, are you very likely, somewhat likely, or unlikely to wear protective clothing such as wide brimmed hats or long sleeved shirts?


Ø       If you were to go outside on a very sunny day for MORE than one hour, are you very likely, somewhat likely, or unlikely to avoid the sun by staying in the shade?


Ø       If you were to go outside on a very sunny day for MORE than one hour, are you very likely, somewhat likely, or unlikely to use sunscreen or sun block lotion?

Expected Periodicity

Annual.

Comments

For this objective, a person is defined as following protective measures if the person answers “very likely” to one or more of the questions listed above.


Data are age adjusted to the 2000 standard population. Age-adjusted percents are weighted sums of age-specific percents. For a discussion of age adjustment, see Part A, section 5.


Although similar questions are used to measure this objective and the comparable Healthy People 2000 objective 16.9, the data for the Healthy People 2010 objective are age adjusted while data for the Healthy People 2000 objective are unadjusted rates. Additionally, the Healthy People 2010 objective combines the data from the three questions into one measure while the Healthy People 2000 objective considered them individually.


See Part C for a description of NHIS and BRFSS, and Appendix A for focus area contact information.

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3-10.

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Increase the proportion of physicians and dentists who counsel their at-risk patients about tobacco use cessation, physical activity, and cancer screening.

3-10a.    Internists who counsel about smoking cessation.

Comments

A complete operational definition was not specified at the time of publication.


This objective is adapted from Healthy People 2000 objectives 16.10 and 3.16.


See Appendix A for focus area contact information.

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3-10b.    Family physicians who counsel about smoking cessation.

Comments

A complete operational definition was not specified at the time of publication.


This objective is adapted from Healthy People 2000 objectives 16.10 and 3.16.


See Appendix A for focus area contact information.

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3-10c.    Dentists who counsel about smoking cessation.

Comments

A complete operational definition was not specified at the time of publication.


This objective is adapted from Healthy People 2000 objectives 16.10 and 3.16.


See Appendix A for focus area contact information.

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3-10d.    Primary care providers who counsel about blood stool tests.

Comments

A complete operational definition was not specified at the time of publication.


This objective is adapted from Healthy People 2000 objective 16.10.


See Appendix A for focus area contact information.

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3-10e.    Primary care providers who counsel about proctoscopic examinations.

Comments

A complete operational definition was not specified at the time of publication.


This objective is adapted from Healthy People 2000 objective 16.10.


See Appendix A for focus area contact information.

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3-10f.     Primary care providers who counsel about mammograms.

Comments

A complete operational definition was not specified at the time of publication.


This objective is adapted from Healthy People 2000 objective 16.10.


See Appendix A for focus area contact information.

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3-10g.    Primary care providers who counsel about Pap tests.

Comments

A complete operational definition was not specified at the time of publication.


This objective is adapted from Healthy People 2000 objective 16.10.


See Appendix A for focus area contact information.

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3-10h.    Primary care providers who counsel about physical activity.

Comments

A complete operational definition was not specified at the time of publication.


This objective is adapted from Healthy People 2000 objective 16.10.


See Appendix A for focus area contact information.

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3-11.

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Increase the proportion of women who receive a Pap test.

3-11a.    Women aged 18 years and older who have ever received a Pap test.

National Data Source

National Health Interview Survey (NHIS), CDC, NCHS.

State Data Source

Behavioral Risk Factor Surveillance System (BRFSS), CDC, NCCDPHP.

Healthy People 2000 Objective

16.12 (Cancer), age adjusted to the 2000 standard population.

Measure

Percent (age adjusted—see Comments).

Baseline

92 (1998).

Numerator

Number of women aged 18 years and older who report ever receiving a Pap test.

Denominator

Number of women aged 18 years and older.

Population Targeted

U.S. civilian, noninstitutionalized population.

Questions Used To Obtain the National Data

From the 1998 National Health Interview Survey:


Ø       Have you ever had a pap smear test?

Expected Periodicity

Periodic.

Comments

Data include women without a uterine cervix.


Data are age adjusted to the 2000 standard population. Age-adjusted percents are weighted sums of age-specific percents. For a discussion of age adjustment, see Part A, section 5.


See Part C for a description of NHIS and BRFSS, and Appendix A for focus area contact information.

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3-11b.    Women aged 18 years and older who received a Pap test within the preceding 3 years.

National Data Source

National Health Interview Survey (NHIS), CDC, NCHS.

State Data Source

Behavioral Risk Factor Surveillance System (BRFSS), CDC, NCCDPHP.

Healthy People 2000 Objective

16.12 (Cancer), age adjusted to the 2000 standard population.

Measure

Percent (age adjusted—see Comments).

Baseline

79 (1998).

Numerator

Number of women aged 18 years and older who report receiving a Pap test within the past 3 years.

Denominator

Number of women aged 18 years and older.

Population Targeted

U.S. civilian, noninstitutionalized population.

Questions Used To Obtain the National Data

From the 1998 National Health Interview Survey:


Ø       Have you ever had a pap smear test?


[If yes:]

o        When did you have your most recent pap smear test?  Was it a year ago or less, more than 1 year but not more than two years, more than two years but not more than three years, more than three years but not more than five years, or over 5 years ago?

Expected Periodicity

Periodic.

Comments

Data include women without a uterine cervix.


Data are age adjusted to the 2000 standard population. Age-adjusted percents are weighted sums of age-specific percents. For a discussion of age adjustment, see Part A, section 5.


See Part C for a description of NHIS and BRFSS, and Appendix A for focus area contact information.

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3-12.   Increase the proportion of adults who receive a colorectal cancer screeningexamination.

3-12a.    Adults aged 50 years and older who have received a fecal occult blood test (FOBT) within the preceding 2 years.

National Data Source

National Health Interview Survey (NHIS), CDC, NCHS.

State Data Source

Behavioral Risk Factor Surveillance System (BRFSS), CDC, NCCDPHP.

Healthy People 2000 Objective

16.13 (Cancer), age adjusted to the 2000 standard population.

Measure

Percent (age adjusted—see Comments).

Baseline

35 (1998).

Numerator

Number of adults aged 50 years and older who report receiving fecal occult blood testing within the preceding 2 years.

Denominator

Number of adults aged 50 years and older.

Population Targeted

U.S. civilian, noninstitutionalized population.

Questions Used To Obtain the National Data

From the 1998 National Health Interview Survey: