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National Healthcare Disparities Report, 2007

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Effectiveness of Care: Cancer


Screening for Breast Cancer
Women age 40 and over who report they had a mammogram within the past 2 years
Rate of breast cancers diagnosed at advanced stage
Female Medicare beneficiaries age 65 and over who had a mammogram in the past year
Screening for Cervical Cancer
Women age 18 and over who report they had a Pap smear within the past 3 years
Rate of cervical cancer incidence diagnosed at advanced stage (all invasive tumors)
Screening for Colorectal Cancer
Composite measure: Adults age 50 and over who reported they ever received a colonoscopy, sigmoidoscopy, proctoscopy, or received fecal occult blood test within the past 2 years
Men and women 50 and over who report they ever had a flexible sigmoidoscopy/colonoscopy/proctoscopy
Men and women 50 and over who report they had a fecal occult blood test (FOBT) within the past 2 years
Rate of colorectal cancers diagnosed as regional or distant staged cancers
Cancer Treatment
Cancer deaths per 100,000 persons per year for all cancers
Cancer deaths per 100,000 male population per year for prostate cancer
Cancer deaths per 100,000 female population per year for breast cancer
Cancer deaths per 100,000 persons per year for lung cancer
Cancer deaths per 100,000 persons per year for colorectal cancer
Deaths per 1,000 admissions with esophageal resection for cancer
Deaths per 1,000 admissions with pancreatic resection for cancer
Radiation therapy to the breast is administered within 1 year of diagnosis for women under age 70 receiving breast conserving surgery: breast cancer
Percentage of women with Stage I-IIb breast cancer that received either axillary node dissection or sentinel lymph node biopsy (SLNB) at the time of surgery (lumpectomy or mastectomy): breast cancer
Surgical resection includes at least 12 lymph nodes: colorectal cancer

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Screening for Breast Cancer

Measure Title

Women age 40 and over who report they had a mammogram within the past 2 years.

Measure Source

Healthy People 2010.

National Tables

1a Women age 40 and over who reported they had a mammogram within the past 2 years, United States, 2005, by

  • Race.
  • Ethnicity.
  • Family income.

National Data Source

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), National Health Interview Survey (NHIS).

National Denominator

U.S female resident population age 40 and over.

National Numerator

Number of women age 40 and over who report receiving a mammogram within the past 2 years.

State Tables

1b Women age 40 and over who reported they had a mammogram within the past 2 years, California, 2005, by

  • Race.
  • Ethnicity.
  • Family income.
  • Asian ethnicity.

State Data Source

University of California, Los Angeles (UCLA), California Health Interview Survey (CHIS).

State Denominator

California female civilian population age 40 and over, excluding people residing in group quarters.

State Numerator

Number of women age 40 and over who report receiving a mammogram within the past 2 years.

Comments

Data reported in National table are age adjusted to the 2000 standard population. Age-adjusted rates are weighted sums of age-specific rates. For a discussion of age adjustment, see Part A, Section 5 of Tracking Healthy People 2010.

This measure and its tables are also presented in other relevant sections of the report.

This measure is referred to as measure 3-13 in Healthy People 2010 documentation.

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Screening for Breast Cancer

Measure Title

Rate of breast cancers diagnosed at advanced stage.

Measure Source

National Cancer Institute (NCI), Surveillance, Epidemiology, and End Results Program (SEER).

Table

2 Rate of breast cancer incidence per 100,000 women age 40 and over diagnosed at advanced stage (regional, distant stage, or local stage with tumor greater than 2 cm), United States, 2004

Data Source

NCI, SEER.

Denominator

Number of females age 40 and over.

Numerator

Number of women age 40 and over with new breast cancer diagnosed at an advanced stage.

Comments

Incidence rates are age adjusted to the 2000 U.S. standard population.

Advanced stage is defined as localized tumors in excess of 2 cm and regional or distant staged tumors. For more information on staging, see the SEER Cancer Statistics Review Web site at http://seer.cancer.gov/csr/1975_2003/.

This measure and its tables are also presented in other relevant sections of the report.

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Screening for Breast Cancer

Measure Title

Female Medicare beneficiaries age 65 and over who had a mammogram in the past year.

Measure Source

Centers for Medicare & Medicaid Services (CMS), Medicare Current Beneficiary Survey (MCBS).

Tables

265 Female Medicare beneficiaries age 65 and over who had a mammogram in the past year, 2003, by

  • Race
  • Ethnicity
  • Family income

Data Source

CMS, MCBS.

Denominator

Number of female Medicare beneficiaries age 65 and older residing in the community for the full year.

Numerator

Number of Medicare beneficiaries age 65 and older residing in the community for the full year who reported having a mammogram in the past year.

Comments

This measure and its tables are also presented in other relevant sections of the report.

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Screening for Cervical Cancer

Measure Title

Women age 18 and over who report they had a Pap smear within the past 3 years.

Measure Source

Healthy People 2010.

Tables

3 Women age 18 and over who reported they had a Pap smear within the past 3 years, United States, 2005, by

  • Race.
  • Ethnicity.
  • Family income.

Data Source

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), National Health Interview Survey (NHIS).

Denominator

U.S. female resident population age 18 and over.

Numerator

Number of women age 18 and over who report receiving a Pap test within the past 3 years; respondents whose response to the question "When did you have your most recent Pap smear test?" indicated a test within 3 years of the measure year.

Comments

Data include women without a uterine cervix.

Data are age adjusted to the 2000 standard population. Age-adjusted rates are weighted sums of age-specific rates. For a discussion of age adjustment, see Part A, Section 5 of Tracking Healthy People 2010.

This measure and its tables are also presented in other relevant sections of the report.

This measure is referred to as measure 3-11b in Healthy People 2010 documentation.

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Screening for Cervical Cancer

Measure Title

Rate of cervical cancer incidence diagnosed at advanced stage (all invasive tumors).

Measure Source

National Cancer Institute (NCI), Surveillance, Epidemiology, and End Results Program (SEER).

Table

4 Rate of cervical cancer incidence per 100,000 women age 20 and over diagnosed at advanced stage (all invasive tumors), United States, 2004

Data Source

NCI, SEER.

Denominator

Number of females age 20 and over.

Numerator

Number of females age 20 and over with new cervical cancers diagnosed as invasive in the survey years.

Comments

Incidence rates are age adjusted to the 2000 U.S. standard population.

Invasive cervical cancer is defined as cancer that has spread from the surface of the cervix to tissue deeper in the cervix or to other parts of the body. For more information on staging, see the SEER Cancer Statistics Review Web site at http://seer.cancer.gov/csr/1975_2003/.

This measure and its tables are also presented in other relevant sections of the report.

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Screening for Colorectal Cancer

Measure Title

Composite measure: Adults age 50 and over who reported they ever received a colonoscopy, sigmoidoscopy, proctoscopy, or received fecal occult blood test within the past 2 years.

Measure Source

Healthy People 2010.

Tables

5 Men and women age 50 and over who reported they ever had a colonoscopy, sigmoidoscopy, or proctoscopy, or had a fecal occult blood test within the past 2 years, United States, 2005, by

  • Race.
  • Ethnicity.
  • Family income.

Data Source

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), National Health Interview Survey (NHIS).

Denominator

U.S. resident population age 50 and over.

Numerator

Number of adults age 50 and over who report ever receiving a colonoscopy, sigmoidoscopy, proctoscopy, or receiving a fecal occult blood test in past 2 years.

Comments

Data are age adjusted to the 2000 standard population. Age-adjusted rates are weighted sums of age-specific rates. For a discussion of age adjustment, see Part A, Section 5 of Tracking Healthy People 2010.

This measure is referred to as measure 3-12b in Healthy People 2010 documentation.

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Screening for Colorectal Cancer

Measure Title

Men and women 50 and over who report they ever had a flexible sigmoidoscopy/colonoscopy/proctoscopy.

Measure Source

Healthy People 2010.

Tables

6 Men and women age 50 and over who reported they ever had a colonoscopy, sigmoidoscopy, or proctoscopy, United States, 2005, by

  • Race.
  • Ethnicity.
  • Family income.

Data Source

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), National Health Interview Survey (NHIS).

Denominator

U.S. resident population age 50 and over.

Numerator

Number of adults age 50 and over who report ever receiving a colonoscopy, sigmoidoscopy, or proctoscopy.

Comments

Data are age adjusted to the 2000 standard population. Age-adjusted rates are weighted sums of age-specific rates. For a discussion of age adjustment, see Part A, Section 5 of Tracking Healthy People 2010.

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Screening for Colorectal Cancer

Measure Title

Men and women 50 and over who report they had a fecal occult blood test (FOBT) within the past 2 years.

Measure Source

Healthy People 2010.

Tables

7 Men and women age 50 and over who reported they had a fecal occult blood test within the past 2 years, United States, 2005, by

  • Race.
  • Ethnicity.
  • Family income.

Data Source

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), National Health Interview Survey (NHIS).

Denominator

U.S. resident population age 50 and over.

Numerator

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

Comments

Data are age adjusted to the 2000 standard population. Age-adjusted rates are weighted sums of age-specific rates. For a discussion of age adjustment, see Part A, Section 5 of Tracking Healthy People 2010.

This measure is referred to as measure 3-12a in Healthy People 2010 documentation.

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Screening for Colorectal Cancer

Measure Title

Rate of colorectal cancers diagnosed as regional or distant staged cancers.

Measure Source

National Cancer Institute (NCI), Surveillance, Epidemiology, and End Results Program (SEER).

Table

8 Rate of colorectal cancer incidence per 100,000 men and women age 50 and over diagnosed at advanced stage (tumors diagnosed at regional or distant stage), United States, 2004

Data Source

NCI, SEER.

Denominator

U.S.population age 50 and over.

Numerator

Number of new colorectal cancers diagnosed in the survey years as regional or distant staged cancers.

Comments

Incidence rates are age adjusted to the 2000 U.S. standard population.

Regional stage is defined as a neoplasm that has extended beyond the limits of the organ of origin, either directly into surrounding organs or tissues or into regional lymph nodes. Distant stage is defined as a neoplasm that has spread to parts of the body remote from the primary tumor, either by direct extension or by discontinuous metastasis. For more information on staging, see the SEER Cancer Statistics Review Web site at http://seer.cancer.gov/csr/1975_2003/.

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Cancer Treatment

Measure Title

Cancer deaths per 100,000 persons per year for all cancers.

Measure Source

Healthy People 2010.

Tables

9 Cancer deaths per 100,000 population per year for all cancers, United States, 2004, by

  • Race.
  • Ethnicity.
  • Education.

Data Source

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), National Vital Statistics System—Mortality (NVSS-M).

Denominator

U.S. resident population.

Numerator

Number of deaths due to cancer (ICD-10-CM codes C00-C97).

Comments

Data are age adjusted to the 2000 standard population. Age-adjusted rates are weighted sums of age-specific rates. For a discussion of age adjustment, see Part A, Section 5 of Tracking Healthy People 2010.

This measure differs from Healthy People 2000 objective 16.1, which age adjusted the death rates using the 1940 standard population. See Appendix C of Tracking Healthy People 2010 for comparison data.

Education data are for persons age 25-64 years only.

This measure is referred to as measure 3-1 in Healthy People 2010 documentation.

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Cancer Treatment

Measure Title

Cancer deaths per 100,000 male population per year for prostate cancer.

Measure Source

Healthy People 2010.

Tables

10 Cancer deaths per 100,000 male population per year for prostate cancer, United States, 2004, by

  • Race.
  • Ethnicity.
  • Education.

Data Source

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), National Vital Statistics System—Mortality (NVSS-M).

Denominator

U.S. male resident population.

Numerator

Number of deaths due to prostate cancer (ICD-10-CM code C61).

Comments

Data are age adjusted to the 2000 standard population. Age-adjusted rates are weighted sums of age-specific rates. For a discussion of age adjustment, see Part A, Section 5 of Tracking Healthy People 2010.

Education data are for persons age 25-64 years only.

This measure is referred to as measure 3-7 in Healthy People 2010 documentation.

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Cancer Treatment

Measure Title

Cancer deaths per 100,000 female population per year for breast cancer.

Measure Source

Healthy People 2010.

Tables

11 Cancer deaths per 100,000 female population per year for breast cancer, United States, 2004, by

  • Race.
  • Ethnicity.
  • Education.

Data Source

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), National Vital Statistics System—Mortality (NVSS-M).

Denominator

U.S. female resident population.

Numerator

Number of deaths due to female breast cancer (ICD-10-CM code C50 [female only]).

Comments

Data are age adjusted to the 2000 standard population. Age-adjusted rates are weighted sums of age-specific rates. For a discussion of age adjustment, see Part A, Section 5 of Tracking Healthy People 2010.

This measure differs from Healthy People 2000 objective 16.1, which age adjusted the death rates using the 1940 standard population. See Appendix C of Tracking Healthy People 2010 for comparison data.

Education data are for persons age 25-64 years only.

This measure and its tables are also presented in other relevant sections of the report.

This measure is referred to as measure 3-3 in Healthy People 2010 documentation.

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Cancer Treatment

Measure Title

Cancer deaths per 100,000 persons per year for lung cancer.

Measure Source

Healthy People 2010.

Tables

12 Cancer deaths per 100,000 population per year for lung cancer, United States, 2004, by

  • Race.
  • Ethnicity.
  • Education.

Data Source

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), National Vital Statistics System—Mortality (NVSS-M).

Denominator

U.S. resident population.

Numerator

Number of deaths due to lung cancer (ICD-10-CM codes C33-C34).

Comments

Data are age adjusted to the 2000 standard population. Age-adjusted rates are weighted sums of age-specific rates. For a discussion of age adjustment, see Part A, Section 5 of Tracking Healthy People 2010.

This objective is measured with slightly different ICD-9-CM codes from those used to measure the comparable Healthy People 2000 objective 16.2 (ICD-9-CM 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 of Tracking Healthy People 2010 for comparison data.

This measure is referred to as measure 3-12 in Healthy People 2010 documentation.

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Cancer Treatment

Measure Title

Cancer deaths per 100,000 persons per year for colorectal cancer.

Measure Source

Healthy People 2010.

Tables

13 Cancer deaths per 100,000 population per year for colorectal cancer, United States, 2004, by

  • Race.
  • Ethnicity.
  • Education.

Data Source

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), National Vital Statistics System—Mortality (NVSS-M).

Denominator

U.S. resident population.

Numerator

Number of deaths due to colorectal cancer (ICD-10-CM codes C18-C21).

Comments

Data are age adjusted to the 2000 standard population. Age-adjusted rates are weighted sums of age-specific rates. For a discussion of age adjustment, see Part A, Section 5 of Tracking Healthy People 2010.

This objective is measured with slightly different ICD-9-CM codes from those used to measure the comparable Healthy People 2000 objective 16.5 (ICD-9-CM 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 of Tracking Healthy People 2010 for comparison data.

This measure is referred to as measure 3-5 in Healthy People 2010 documentation.

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Cancer Treatment

Measure Title

Deaths per 1,000 admissions with esophageal resection for cancer.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Inpatient Quality Indicators (IQI).

Table

14 Deaths per 1,000 admissions with esophageal resection for cancer (excluding obstetric and neonatal admissions and transfers to another hospital), age 18 and over, United States, 2004, by

  • Race/ethnicity.

Data Source

AHRQ, Center for Delivery, Organization, and Markets (CDOM), Healthcare Cost and Utilization Project (HCUP).

Denominator

Hospital inpatient discharges with an esophageal resection (ICD-9-CM code 42.40-42.42) in any procedure field and a diagnosis code of esophageal cancer in any field (ICD-9-CM 150.0-150.5, 150.8, 150.9), excluding obstetric and neonatal admissions and transfers to another hospital.

Numerator

Number of deaths with a code of esophageal resection in any procedure field.

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Cancer Treatment

Measure Title

Deaths per 1,000 admissions with pancreatic resection for cancer.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Inpatient Quality Indicators (IQI).

Table

15 Deaths per 1,000 admissions with pancreatic resection for cancer (excluding obstetric and neonatal admissions and transfers to another hospital), age 18 and over, United States, 2004, by

  • Race/ethnicity.

Data Source

AHRQ, Center for Delivery, Organization, and Markets (CDOM), Healthcare Cost and Utilization Project (HCUP).

Denominator

Hospital inpatient discharges with a pancreatic resection (ICD-9-CM codes of 52.6 or 52.7) in any procedure field and a diagnosis code of pancreatic cancer in any field (ICD-9-CM 152.0, 156.1, 156.2, 157.0-157.4, 157.8, 157.9), excluding patients transferring to another short-term hospital and obstetric and neonatal admissions.

Numerator

Number of deaths with a code of pancreatic resection in any procedure field.

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Cancer Treatment

Measure Title

Radiation therapy to the breast is administered within 1 year of diagnosis for women under age 70 receiving breast conserving surgery: breast cancer.

Measure Source

American College of Surgeons (ACS), Commission on Cancer (CoC), National Cancer Database (NCDB).

Tables

16 Patients with breast cancer who received recommended treatment: radiation therapy to the breast within 1 year of diagnosis for women under age 70 receiving breast conserving surgery, United States, 2004, by

  • Race.
  • Ethnicity.
  • Family income.

Data Source

ACS, CoC, NCDB.

Denominator

Women age 18-69 with Amrican Joint Committee on Cancer (AJCC) Stage I, I,I or III primary invasive epithelial breast cancer that was surgically treated by breast conservation surgery. Breast cancer diagnoses are known or assumed first or only cancer diagnosis, and patients were know to be alive within 1 year of their diagnosis

Numerator

Subset of denominator for whom radiation therapy to the breast was initiated within 1 year (365 days) of date of diagnosis.

Comments

This measure and its tables are also presented in other relevant sections of the report.

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Cancer Treatment

Measure Title

Percentage of women with Stage I-IIb breast cancer that received either axillary node dissection or sentinel lymph node biopsy (SLNB) at the time of surgery (lumpectomy or mastectomy): breast cancer.

Measure Source

American College of Surgeons (ACS), Commission on Cancer (CoC), National Cancer Database (NCDB).

Tables

17 Patients with breast cancer who received recommended treatment: axillary node dissection or sentinel lymph node biopsy at the time of surgery (lumpectomy or mastectomy) for women with Stage I-IIb breast cancer, United States, 2004, by

  • Race.
  • Ethnicity.
  • Family income.

Data Source

ACS, CoC, NCDB.

Denominator

Women age 18 and over with American Joint Committee on Cancer (AJCC) Stage I or IIA primary invasive epithelial breast cancer that was surgically treated by breast conservation surgery or mastectomy. Breast cancer diagnoses are known or assumed first or only cancer diagnosis.

Numerator

Subset of denominator who received lymph node surgery (axillary node dissection or sentinel lymph node biopsy) at the time of their breast cancer surgery.

Comments

This measure and its tables are also presented in other relevant sections of the report.

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Cancer Treatment

Measure Title

Surgical resection includes at least 12 lymph nodes: colorectal cancer.

Measure Source

American College of Surgeons (ACS), Commission on Cancer (CoC), National Cancer Database (NCDB).

Tables

18 Patients with colon cancer who received recommended treatment: resected colon specimen had at least 12 regional lymph nodes pathologically examined, United States, 2004, by

  • Race.
  • Ethnicity.
  • Family income.

Data Source

ACS, CoC, NCDB.

Denominator

Persons age 18 and over with American Joint Committee on Cancer (AJCC) Stage I, II, or III primary invasive epithelial colon cancer that underwent surgical resection (surgery more than local excision). Colon cancer diagnoses are known or assumed first or only cancer diagnosis

Numerator

Subset of denominator with 12 or more regional lymph nodes pathologically examined.

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