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National Healthcare Quality & National Healthcare Disparities Reports: Measure Specification Appendix, 2013

Effectiveness of Care: Colorectal Cancer

Measures

Patients with colon cancer who received surgical resection that included at least 12 lymph nodes pathologically examined
Composite measure—Adults ages 50-75 who report receiving any type of colorectal cancer screening
Adults age 50 and over who ever received a colonoscopy, sigmoidoscopy, or proctoscopy
Adults age 50 and over who received a fecal occult blood test (FOBT) in the last 2 years
Colorectal cancer diagnosed at advanced stage per 100,000 adults age 50 and over
Colorectal cancer deaths per 100,000 population
 


 

Measure Title

Patients with colon cancer who received surgical resection that included at least 12 lymph nodes pathologically examined

Measure Source

Commission on Cancer (CoC), American College of Surgeons (ACoS) and American Cancer Society (ACS), National Cancer Data Base (NCDB).

Table Description

Geographic Representation

National, States

Years Available

State: 2004-2010

National: 2004-2010

Population Subgroups

Activity limitation, age, education, health insurance, income, race/ ethnicity, geographic location (residence)

Data Sources

National and State

Commission on Cancer (CoC), American College of Surgeons (ACoS) and American Cancer Society (ACS), National Cancer Data Base (NCDB)

Denominator

People age 18 and over with 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

Comments

Staging describes the severity of a person’s cancer based on the extent of the original (primary) tumor and whether cancer has spread in the body. Higher numbers indicate more extensive disease. Stage I, II, and III cancers indicate a larger tumor size or spread of the cancer beyond the organ in which it first developed to nearby lymph nodes or organs adjacent to the location of the primary tumor.

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Measure Title

Composite measure—Adults ages 50-75 who report receiving any type of colorectal cancer screening

Measure Source

Healthy People 2020

Table Description

Geographic Representation

National, States

Years Available

State: 2010

National: 2000, 2003, 2005, 2008, 2010

Population Subgroups

Activity limitation, age, education, health insurance, income, race/ ethnicity, geographic location (residence)

Data Sources

National

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

State

CDC, Behavioral Risk Factor Surveillance System (BRFSS)

Denominator

U.S. civilian noninstitutionalized population of adults ages 50-75

Numerator

Number of adults ages 50-75 who report receiving a blood stool test in the past year, a sigmoidoscopy in the past 5 years and a blood stool test in the past 3 years, or a colonoscopy in the past 10 years

Comments

This measure is based on measure C-16 in Healthy People 2020 documentation. Data are age adjusted to the 2000 U.S. standard population, except where indicated. Age-adjusted rates are weighted sums of age-specific rates. Estimates are age adjusted to the 2000 U.S. standard population using two age groups: 50-64 and 65-75.

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Measure Title

Adults age 50 and over who ever received a colonoscopy, sigmoidoscopy, or proctoscopy

Measure Source

Healthy People 2010

Table Description

Geographic Representation

National, States

Years Available

State: 2000, 2003, 2005, 2008

National: 2000, 2003, 2005, 2008

Population Subgroups

Activity limitation, age, education, health insurance, income, race/ ethnicity, geographic location (residence)

Data Sources

National

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

State

CDC, Behavioral Risk Factor Surveillance System (BRFSS)

Denominator

Number of civilian noninstitutionalized adults age 50 and over

Numerator

Subset of denominator who report ever receiving a sigmoidoscopy, colonoscopy, or proctoscopy

Comments

This measure is referred to as measure 3-12b in Healthy People 2010 documentation. Data are age adjusted to the 2000 U.S. standard population, except where indicated. State estimates are age adjusted to the 2000 U.S. standard population using two age groups: 50-64 and 65 and over. Age-adjusted rates are weighted sums of age-specific rates.

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Measure Title

Adults age 50 and over who received a fecal occult blood test (FOBT) in the last 2 years

Measure Source

Healthy People 2010

Table Description

Geographic Representation

National, States

Years Available

State: 2000, 2003, 2005, 2008

National: 2000, 2003, 2005, 2008

Population Subgroups

Activity limitation, age, education, health insurance, income, race/ ethnicity, geographic location (residence)

Data Sources

National

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

State

CDC, Behavioral Risk Factor Surveillance System (BRFSS)

Denominator

Number of civilian noninstitutionalized adults age 50 and over

Numerator

Subset of denominator who report having received a fecal occult blood test within the last 2 years

Comments

This measure is referred to as measure 3-12a in Healthy People 2010 documentation. Data are age adjusted to the 2000 U.S. standard population. State estimates are age adjusted to the 2000 U.S. standard population using two age groups: 50-64 and 65 and over. Age-adjusted rates are weighted sums of age-specific rates.

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Measure Title

Colorectal cancer diagnosed at advanced stage per 100,000 adults age 50 and over

Measure Source

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

Table Description

Geographic Representation

National, States

Years Available

State: 2001-2010

National: 2000, 2003, 2005, 2008, 2010

Population Subgroups

Activity limitation, age, education, health insurance, income, race/ ethnicity, geographic location (residence)

Data Sources

National and State

Centers for Disease Control and Prevention (CDC), National Cancer Institute (NCI), National Program of Cancer Registries (NPCR), United States Cancer Statistics

Denominator

U.S. population age 50 and over

Numerator

Subset of denominator with new colorectal cancers diagnosed as regional or distant staged cancers in the survey years

Comments

All rates are age adjusted to the 2000 standard U.S. population by 5-year age groups, except where indicated. State estimates are per 100,000 population, age 50 and over, and are age adjusted to the 2000 U.S. standard million population by 5-year age groups.

The 2005 data were adjusted for areas affected by Hurricanes Katrina and Rita. Hurricanes Katrina and Rita had a huge impact on the populations within the Gulf Coast region for the second half of 2005. Katrina also significantly affected the Louisiana Cancer Registry’s ability to report data for that time period. In an effort to provide the most accurate and complete data and statistics possible, the SEER Program has made several changes for the releases of data and statistics through 2005.

Advanced stage refers to tumors diagnosed at regional or distant stage. 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.

Cancer stage historically has been collected using three different staging systems having three different purposes, datasets, and rules. The American Joint Committee on Cancer (AJCC), in collaboration with North American standard setters, has developed a unified dataset that combines and standardizes the information needed to assign stage in the AJCC (Tumor, Node, Metastasis, [TNM]), SEER (Extent of Disease [EOD]), and Summary Stage (SS) 1977 and 2000 systems and to derive the TNM stage group, EOD, and SS applicable to each cancer site beginning with cancers diagnosed in 2004.

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Measure Title

Colorectal cancer deaths per 100,000 population

Measure Source

Healthy People 2020

Table Description

Geographic Representation

National, State

Years Available

National: 2000-2010

State: 2000-2010

Population Subgroups

Activity limitation, age, education, health insurance, income, race/ ethnicity, geographic location (residence)

Data Sources

National and State

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

Denominator

U.S. resident population

Numerator

Number of deaths per year due to colorectal cancer

Comments

This measure is referred to as measure C-5 in Healthy People 2020 documentation. Estimates are age adjusted to the 2000 U.S. standard population. Respondents for whom age is not reported are not included in the age adjustment calculations and are excluded from numerators.

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Page last reviewed July 2014
Page originally created July 2014
Internet Citation: National Healthcare Quality & National Healthcare Disparities Reports: Measure Specification Appendix, 2013. Content last reviewed July 2014. Agency for Healthcare Research and Quality, Rockville, MD. https://www.ahrq.gov/research/findings/nhqrdr/nhqrdr13/measurespec/colo-cancer.html

 

The information on this page is archived and provided for reference purposes only.

 

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