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2006 National Healthcare Quality Report

Effectiveness of Care: Cancer

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Screening for Breast Cancer
Women who report they had a mammogram within the past 2 years
Breast cancer incidence per 100,000 women age 40+ diagnosed at advanced stage
Screening for Cervical Cancer
Women (age 18+) who report that they had a Pap smear within the past 3 years
Cervical cancer incidence per 100,000 women age 20+ diagnosed at advanced stage
Screening for Colorectal Cancer
Composite measure: Men and women age 50+ who report they ever received a colonoscopy, sigmoidoscopy, proctoscopy, or fecal occult blood test
Men and women age 50+ who report they ever had a flexible sigmoidoscopy/colonoscopy
Men and women (age 50+) who report fecal occult blood test within the past 2 years
Rate of colorectal cancer incidence per 100,000 men and women age 50+ diagnosed at advanced stage
Cancer Treatment
Cancer deaths per 100,000 persons per year for all cancers
Cancer deaths per 100,000 persons per year for most common cancers: prostate cancer
Cancer deaths per 100,000 persons per year for most common cancers: breast cancer
Cancer deaths per 100,000 persons per year for most common cancers: lung cancer
Cancer deaths per 100,000 persons per year for most common cancers: colorectal cancer
Deaths per 1,000 admissions with esophageal resection for cancer
Deaths per 1,000 admissions with pancreatic resection for cancer


Screening for Breast Cancer

Measure Title

Percent of women (age 40 and over) who report they had a mammogram within the past 2 years.

Measure Source

Healthy People 2010, measure 3-13.

National Table

1.1a. Percent of women age 40 and over who reported they had a mammogram within the past 2 years, United States, 1999 and 2003.

National Data Source

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

National Denominator

Number of women age 40 and over.

National Numerator

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

State Table

1.1b. Percent of women age 40 and over who reported they had a mammogram within the past 2 years, by State, 2000 and 2004.

State Data Source

CDC, National Center for Chronic Disease Prevention and Health Promotion, Behavioral Risk Factor Surveillance System (BRFSS).

State Denominator

Number of women age 40 and over.

State Numerator

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

Comments

Percents 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 of Tracking Healthy People 2010.

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Screening for Breast Cancer

Measure Title

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

Measure Source

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

National Table

1.2a. 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 2cm), United States, 2000 and 2003.

National Data Source

NCI, SEER 13 Registry Database. The ethnicity category uses SEER 13 excluding Alaska.

National Denominator

Women age 40 and over.

National Numerator

Women age 40 and over with new breast cancer diagnosed at advanced stage.

State Table

1.2b. Female breast cancer incidence rate per 100,000 for women age 40 and over diagnosed at advanced stage (regional and distant SEER summary stage), by State, 2001 and 2002.

State Data Source

Centers for Disease Control and Prevention (CDC), National Program of Cancer Registries (NPCR).

State Denominator

Women age 40 and over.

State Numerator

Women age 40 and over with new breast cancer diagnosed at advanced stage.

Comments

All rates except as noted are per 100,000 females age 40 and over and are age adjusted to the 2000 U.S. standard million population by 5-year age groups.

Advanced stage for this table is defined as localized tumors in excess of 2 cm and regional or distant staged tumors.

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Screening for Cervical Cancer

Measure Title

Percent of women (age 18 and over) who report that they had a Pap smear within the past 3 years.

Measure Source

Healthy People 2010, measure 3-11b.

National Table

1.3a. Percent of women age 18 and over who reported they had a Pap smear within the past 3 years, United States, 1999 and 2003.

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 population, age 18 and over.

National Numerator

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

State Table

1.3b. Percent of women age 18 and over who reported they had a Pap smear within the past 3 years, by State, 2000 and 2004.

State Data Source

CDC, National Center for Chronic Disease Prevention and Health Promotion, Behavioral Risk Factor Surveillance System (BRFSS).

State Denominator

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

State Numerator

Number of women age 18 and over who report receiving a Pap test within the past 3 years; respondents who answered "Within the past year," "Within the past 2 years" or "Within the past 3 years" to the question "How long has it been since you had your last Pap smear?"

Comments

Data include women without a uterine cervix.

Percents 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 of Tracking Healthy People 2010.

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Screening for Cervical Cancer

Measure Title

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

Measure Source

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

National Table

1.4a. Rate of cervical cancer incidence per 100,000 women age 20 and over diagnosed at advanced stage (all invasive tumors), United States, 2000 and 2003.

National Data Source

NCI, SEER 13 Registry Database. The ethnicity category uses SEER 13 excluding Alaska.

National Denominator

Number of women age 20 and over.

National Numerator

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

State Table

1.4b. Cervical cancer incidence rate per 100,000 women age 20 and over diagnosed at advanced stage (all invasive tumors), by State, 2001 and 2002.

State Data Source

Centers for Disease Control and Prevention (CDC), National Program of Cancer Registries (NPCR).

State Denominator

Number of women age 20 and over.

State Numerator

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

Comments

All rates except as noted are per 100,000 females age 20 and over and are age adjusted to the 2000 U.S. standard million population by 5-year age groups.

Invasive cervical cancer is defined for this table as cancer that has spread from the surface of the cervix to tissue deeper in the cervix or to other parts of the body.

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Screening for Colorectal Cancer

Measure Title

Composite measure: Percent of men and women age 50 and over who report they ever received a colonoscopy, sigmoidoscopy, proctoscopy, or fecal occult blood test.

Measure Source

Healthy People 2010, measure 3-12b.

Table

1.5. Percent of 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, 2000 and 2003.

Data Source

Centers for Disease Control and Prevention, National Center for Health Statistics, 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 fecal occult blood test.

Comments

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 of Tracking Healthy People 2010.

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Screening for Colorectal Cancer

Measure Title

Percent of men and women (age 50 and over) who report they ever had a flexible sigmoidoscopy/colonoscopy.

Measure Source

Healthy People 2010, measure 3-12b.

National Table

1.6a. Percent of men and women age 50 and over who reported they ever received a colonoscopy, sigmoidoscopy, or proctoscopy, United States, 2000 and 2003.

National Data Source

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

National Denominator

Number of adults age 50 and over.

National Numerator

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

State Table

1.6b. Percent of men and women age 50 and over who reported they ever received a flexible sigmoidoscopy or colonoscopy, by State, 2001 and 2004.

State Data Source

CDC, National Center for Chronic Disease Prevention and Health Promotion, Behavioral Risk Factor Surveillance System (BRFSS).

State Denominator

Number of adults age 50 and over.

State Numerator

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

Comments

Percents 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 of Tracking Healthy People 2010.

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Screening for Colorectal Cancer

Measure Title

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

Measure Source

Healthy People 2010, measure 3-12a.

National Table

1.7a. Percent of men and women age 50 and over who reported they had a fecal occult blood test within the past 2 years, United States, 2000 and 2003.

National Data Source

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

National Denominator

Number of adults age 50 and over.

National Numerator

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

State Table

1.7b. Percent of men and women age 50 and over who reported they had a fecal occult blood test within the past 2 years, by State, 2001 and 2004.

State Data Source

CDC, National Center for Chronic Disease Prevention and Health Promotion, Behavioral Risk Factor Surveillance System (BRFSS).

State Denominator

Number of adults age 50 and over.

State Numerator

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

Comments

Percents 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 of Tracking Healthy People 2010.

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Screening for Colorectal Cancer

Measure Title

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).

Measure Source

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

National Table

1.8a 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, 2000 and 2003.

National Data Source

NCI, SEER 13 Registry Database. The ethnicity category uses SEER 13 excluding Alaska.

National Denominator

U.S. population age 50 and over.

National Numerator

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

State Table

1.8b. Colorectal cancer incidence rate per 100,000 for men and women age 50 and over diagnosed at advanced stage (regional and distant SEER summary stage), by State, 2001 and 2002.

State Data Source

Centers for Disease Control and Prevention (CDC), National Program of Cancer Registries (NPCR).

State Denominator

Population age 50 and over.

State Numerator

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

Comments

All rates except as noted are per 100,000 men and women age 50 and over and are age adjusted to the 2000 U.S. standard million population by 5-year age groups.

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 Ries LAG, Harkins D, Krapcho M, Mariotto A, Miller BA, Feuer EJ, Clegg L, Eisner MP, Horner MJ, Howlader N, Hayat M, Hankey BF, Edwards BK (eds). SEER Cancer Statistics Review, 1975-2003, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2003/, based on November 2005 SEER data submission, posted to the SEER web site, 2006.

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Cancer Treatment

Measure Title

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

Measure Source

Healthy People 2010, measure 3-1.

Tables

1.9a. Cancer deaths per 100,000 population per year for all cancers, United States, 1999 and 2003.

1.9b. Cancer deaths per 100,000 population per year for all cancers, by State, 1999 and 2003.

Data Source

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

Denominator

U.S. population.

Numerator

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

Comments

Rates 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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Cancer Treatment

Measure Title

Cancer deaths per 100,000 persons per year for most common cancers: prostate cancer.

Measure Source

Healthy People 2010, measure 3-7.

Tables

1.10a. Cancer deaths per 100,000 male population per year for prostate cancer, United States, 1999 and 2003.

1.10b. Cancer deaths per 100,000 male population per year for prostate cancer, by State, 1999 and 2003.

Data Source

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

Denominator

U.S. male population.

Numerator

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

Comments

Rates 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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Cancer Treatment

Measure Title

Cancer deaths per 100,000 persons per year for most common cancers: breast cancer.

Measure Source

Healthy People 2010, measure 3-3.

Tables

1.11a. Cancer deaths per 100,000 female population per year for breast cancer, United States, 1999 and 2003.

1.11b. Cancer deaths per 100,000 female population per year for breast cancer, by State, 1999 and 2003.

Data Source

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

Denominator

U.S. female population.

Numerator

Number of female deaths per year due to breast cancer (ICD-10-CM code C50).

Comments

Rates 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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Cancer Treatment

Measure Title

Cancer deaths per 100,000 persons per year for most common cancers: lung cancer.

Measure Source

Healthy People 2010, measure 3-2.

Tables

1.12a. Cancer deaths per 100,000 population per year for lung cancer, United States, 1999 and 2003.

1.12b. Cancer deaths per 100,000 population per year for lung cancer, by State, 1999 and 2003.

Data Source

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

Denominator

U.S. population.

Numerator

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

Comments

Rates 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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Cancer Treatment

Measure Title

Cancer deaths per 100,000 persons per year for most common cancers: colorectal cancer.

Measure Source

Healthy People 2010, measure 3-5.

Tables

1.13a. Cancer deaths per 100,000 population per year for colorectal cancer, United States, 1999 and 2003.

1.13b. Cancer deaths per 100,000 population per year for colorectal cancer, by State, 1999 and 2003.

Data Source

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

Denominator

U.S. population.

Numerator

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

Comments

Rates 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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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.

Table

1.14. Deaths per 1,000 admissions with esophageal resection for cancer (excluding obstetric and neonatal admissions and transfers to another hospital), United States, 2001 and 2003.

Data Source

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

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 150.0-1505, 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.

Comments

Rates are adjusted by age, gender, age-gender interactions, and APR-DRG risk of mortality score. When reporting is by age, the adjustment is by gender and APR-DRG risk of mortality score; when reporting is by gender, the adjustment is by age and APR-DRG risk of mortality score.

Although not all States participate in the HCUP database, the Nationwide Inpatient Sample is weighted to give national estimates using weights based on all U.S. community, non-rehabilitation hospitals in the American Hospital Association Annual Survey of Hospitals.

This table was created using version 2.1, revision 3, of the AHRQ Inpatient Quality Indicators software. This measure is referred to as indicator 8 in the software documentation. More information about the AHRQ Quality Indicators is available at http://www.qualityindicators.ahrq.gov.

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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.

Table

1.15. Deaths per 1,000 admissions with pancreatic resection for cancer (excluding obstetric and neonatal admissions and transfers to another hospital), United States, 2001 and 2003.

Data Source

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

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.

Comments

Rates are adjusted by age, gender, age-gender interactions, and APR-DRG risk of mortality score. When reporting is by age, the adjustment is by gender and APR-DRG risk of mortality score; when reporting is by gender, the adjustment is by age and APR-DRG risk of mortality score.

Although not all States participate in the HCUP database, the Nationwide Inpatient Sample is weighted to give national estimates using weights based on all U.S. community, non-rehabilitation hospitals in the American Hospital Association Annual Survey of Hospitals.

This table was created using version 2.1, revision 3, of the AHRQ Inpatient Quality Indicators software. This measure is referred to as indicator 9 in the software documentation. More information about the AHRQ Quality Indicators is available at http://www.qualityindicators.ahrq.gov.

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