Effectiveness of Care: Cancer

2008 National Healthcare Quality and Disparities Reports

The National Healthcare Quality Report (NHQR) is a comprehensive national overview of quality of health care in the United States. It is organized around four dimensions of quality of care: effectiveness, patient safety, timeliness, and patient centeredness.

Breast Cancer
Women age 40 and over who received a mammogram in the last 2 years
Breast cancer diagnosed at advanced stage (regional, distant stage, or local stage with tumor greater than 2 cm) per 100,000 women age 40 and over
Women under age 70 treated for breast cancer with breast-conserving surgery who received radiation therapy to the breast within 1 year of diagnosis
Women with Stage I-IIb breast cancer who received axillary node dissection or sentinel lymph node biopsy (SLNB) at the time of surgery (lumpectomy or mastectomy)
Breast cancer deaths per 100,000 female population per year

Cervical Cancer
Women age 18 and over who received a Pap smear in the last 3 years
Cervical cancer diagnosed at advanced stage (all invasive tumors) per 100,000 women age 20 and over

Colorectal Cancer
Composite measure: Adults age 50 and over who received colorectal cancer screening (colonoscopy, sigmoidoscopy, proctoscopy, or (in the last 2 years) fecal occult blood test [FOBT])
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 (tumors diagnosed at regional or distant stage) per 100,000 population age 50 and over
Patients with colon cancer who received surgical resection of colon cancer that included at least 12 lymph nodes pathologically examined
Colorectal cancer deaths per 100,000 population per year

Other Cancers
Cancer deaths per 100,000 population per year
Prostate cancer deaths per 100,000 male population per year
Lung cancer deaths per 100,000 population per year
 


Breast Cancer

Measure Title

Women age 40 and over who received a mammogram in the last 2 years.

Measure Source

Healthy People 2010.

State Tables

1_1_1.1 Women age 40 and over who received a mammogram in the last 2 years, by State, 2000 and 2006.

State Data Source

Centers for Disease Control and Prevention (CDC), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), 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 last 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 3-13 in Healthy People 2010 documentation.

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Breast Cancer

Measure Title

Breast cancer diagnosed at advanced stage (regional, distant stage, or local stage with tumor greater than 2 cm) per 100,000 women age 40 and over.

Measure Source

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

Tables

1_1_2.1 Breast cancer diagnosed at advanced stage (regional, distant stage, or local stage with tumor greater than 2 cm) per 100,000 women age 40 and over, United States, 2000 and 2005.

Data Source

NCI, SEER.

Denominator

Women age 40 and over.

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 stage tumors.

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.

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Breast Cancer

Measure Title

Women under age 70 treated for breast cancer with breast-conserving surgery who received radiation therapy to the breast within 1 year of diagnosis.

Measure Source

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

Tables

1_1_3.1 Women under age 70 treated for breast cancer with breast-conserving surgery who received radiation therapy to the breast within 1 year of diagnosis, United States, 1999 and 2005.

1_1_3.2 Women under age 70 treated for breast cancer with breast-conserving surgery who received radiation therapy to the breast within 1 year of diagnosis, United States, 2005, by:

  • Race.
  • Ethnicity.
  • Family income.

Data Source

ACS, CoC, NCDB.

Denominator

Women ages 18–69 with American Joint Committee on Cancer Stage I, II, 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 known to be alive within 1 year of their diagnosis

Numerator

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

Comments

Breast-conserving surgery is defined for this measure as surgical excision less than mastectomy.

Includes only women who received all or part of their first course of treatment at a facility with a CoC-approved cancer program.

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Breast Cancer

Measure Title

Women with Stage I-IIb breast cancer who received axillary node dissection or sentinel lymph node biopsy (SLNB) at the time of surgery (lumpectomy or mastectomy).

Measure Source

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

Tables

1_1_4.1 Women with Stage I-IIb breast cancer who received axillary node dissection or sentinel lymph node biopsy (SLNB) at the time of surgery (lumpectomy or mastectomy), United States, 1999 and 2005.

1_1_4.2 Women with Stage I-IIb breast cancer who received axillary node dissection or sentinel lymph node biopsy (SLNB) at the time of surgery (lumpectomy or mastectomy), United States, 2005, by:

  • Race.
  • Ethnicity.
  • Family income.

Data Source

ACS, CoC, NCDB.

Denominator

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

Numerator

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

Comments

Includes only women who received all or part of their first course of treatment at a facility with a CoC-approved cancer program. There is not full agreement regarding the appropriate population (denominator) for this measure, addressing lymph node surgery in women with breast cancer. The measure from the National Quality Forum only includes women with stage I/II cancer. Women classified as having stage III disease during lymph node surgery (based on four or more positive nodes) are excluded if their stage prior to surgery (i.e., clinical stage) was not recorded. This approach may artificially lower the rates for this measure.

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Breast Cancer

Measure Title

Breast cancer deaths per 100,000 female population per year.

Measure Source

Healthy People 2010.

National Tables

1_1_5.1 Breast cancer deaths per 100,000 female population per year, United States, 1999 and 2005.

1_1_5.2 Breast cancer deaths per 100,000 female population per year, United States, 2005, by:

  • Race.
  • Ethnicity.
  • Education.

National Data Source

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

National Denominator

U.S. female resident population.

National Numerator

Number of female deaths per year due to breast cancer (International Classification of Diseases, Tenth Revision, Clinical Modification [ICD-10-CM] code C50).

State Tables

1_1_5.3 Breast cancer deaths per 100,000 female population per year, by State, 1999 and 2005.

State Data Source

CDC, NCHS, NVSS-M.

State Denominator

Population, by State.

State Numerator

Same as national.

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 3-3 in Healthy People 2010 documentation.

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Cervical Cancer

Measure Title

Women age 18 and over who received a Pap smear in the last 3 years.

Measure Source

Healthy People 2010.

State Tables

1_2_1.1 Women age 18 and over who received a Pap smear within the last 3 years, by State, 2000 and 2006.

State Data Source

Centers for Disease Control and Prevention (CDC), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), 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 smear within the last 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.

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 3-11b in Healthy People 2010 documentation.

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Cervical Cancer

Measure Title

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

Measure Source

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

Tables

1_2_2.1 Cervical cancer diagnosed at advanced stage (all invasive tumors) per 100,000 women age 20 and over, United States, 2000 and 2005.

Data Source

NCI, SEER.

Denominator

Number of women age 20 and over.

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.

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.

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Colorectal Cancer

Measure Title

Composite measure: Adults age 50 and over who received colorectal cancer screening (colonoscopy, sigmoidoscopy, proctoscopy, or (in the last 2 years) fecal occult blood test [FOBT]).

Measure Source

Healthy People 2010.

Tables

1_3_1.1 Adults age 50 and over who received colorectal cancer screening (ever received colonoscopy, sigmoidoscopy, proctoscopy, or (in the last 2 years) a fecal occult blood test), United States, 2000 and 2005.

1_3_1.2 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 last 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. civilian noninstitutionalized population age 50 and over.

Numerator

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

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 based on two Healthy People 2010 measures, referred to as 3-12a and 3-12b in Healthy People 2010 documentation.

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Colorectal Cancer

Measure Title

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

Measure Source

Healthy People 2010.

State Tables

1_3_2.1 Adults age 50 and over who ever received a colonoscopy, sigmoidoscopy, or proctoscopy, by State, 2001 and 2006.

State Data Source

Centers for Disease Control and Prevention (CDC), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), 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

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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Colorectal Cancer

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.

State Tables

1_3_3.1 Adults age 50 and over who received a fecal occult blood test in the last 2 years, by State, 2001 and 2006.

State Data Source

Centers for Disease Control and Prevention (CDC), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), 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

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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Colorectal Cancer

Measure Title

Colorectal cancer diagnosed at advanced stage (tumors diagnosed at regional or distant stage) per 100,000 population age 50 and over.

Measure Source

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

Tables

1_3_4.1 Colorectal cancer diagnosed at advanced stage (tumors diagnosed at regional or distant stage) per 100,000 population age 50 and over, United States, 2000 and 2005.

Data Source

NCI, SEER.

Denominator

U.S. population age 50 and over.

Numerator

Number of new colorectal cancers diagnosed in the survey years at regional or distant stage.

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.

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.

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Colorectal Cancer

Measure Title

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

Measure Source

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

Tables

1_3_5.1 Patients with colon cancer who received recommended treatment: resected colon specimen had at least 12 regional lymph nodes pathologically examined, United States, 2003 and 2005.

1_3_5.2 Patients with colon cancer who received recommended treatment: resected colon specimen had at least 12 regional lymph nodes pathologically examined, United States, 2005, by:

  • Race.
  • Ethnicity.
  • Family income.

Data Source

ACS, CoC, NCDB.

Denominator

Number of adults 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 the denominator with 12 or more regional lymph nodes pathologically examined.

Comments

Includes only patients who received their first course of surgery at a facility with a CoC-approved cancer program.

This measure and its tables are also presented in other relevant sections of the National Healthcare Disparities Report.

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Colorectal Cancer

Measure Title

Colorectal cancer deaths per 100,000 population per year.

Measure Source

Healthy People 2010.

National Tables

1_3_6.1 Colorectal cancer deaths per 100,000 population per year, United States, 1999 and 2005.

1_3_6.2 Colorectal cancer deaths per 100,000 population per year, United States, 2005, by:

  • Race.
  • Ethnicity.
  • Education.

National Data Source

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

National Denominator

U.S. resident population.

National Numerator

Number of deaths per year due to colorectal cancer (International Classification of Diseases, Tenth Revision, Clinical Modification [ICD-10-CM] codes C18-C21).

State Tables

1_3_6.3 Colorectal cancer deaths per 100,000 population per year, by State, 1999 and 2005.

State Data Source

CDC, NCHS, NVSS-M.

State Denominator

Population, by State.

State Numerator

Same as national.

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 3-5 in Healthy People 2010 documentation.

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Other Cancers

Measure Title

Cancer deaths per 100,000 population per year.

Measure Source

Healthy People 2010.

National Tables

1_4_1.1 All cancer deaths per 100,000 population per year, United States, 1999 and 2005.

1_4_1.2 All cancer deaths per 100,000 population per year, United States, 2005, by:

  • Race.
  • Ethnicity.
  • Education.

National Data Source

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

National Denominator

U.S. resident population.

National Numerator

Number of deaths per year due to cancer (International Classification of Diseases, Tenth Revision, Clinical Modification [ICD-10-CM] codes C00-C97).

State Tables

1_4_1.3 All cancer deaths per 100,000 population per year, by State, 1999 and 2005.

State Data Source

CDC, NCHS, NVSS-M.

State Denominator

Population, by State.

State Numerator

Same as national.

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 3-1 in Healthy People 2010 documentation.

Education data are for people ages 25–64 years only.

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Other Cancers

Measure Title

Prostate cancer deaths per 100,000 male population per year.

Measure Source

Healthy People 2010.

National Tables

1_4_2.1 Prostate cancer deaths per 100,000 male population per year, United States, 1999 and 2005.

1_4_2.2 Prostate cancer deaths per 100,000 male population per year, United States, 2005, by:

  • Race.
  • Ethnicity.
  • Education.

National Data Source

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

National Denominator

U.S. male resident population.

National Numerator

Number of male deaths per year due to prostate cancer (International Classification of Diseases, Tenth Revision, Clinical Modification [ICD-10-CM] code C61).

State Tables

1_4_2.3 Prostate cancer deaths per 100,000 male population per year, by State, 1999 and 2005.

State Data Source

CDC, NCHS, NVSS-M.

State Denominator

Population, by State.

State Numerator

Same as national.

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 3-7 in Healthy People 2010 documentation.

Education data are for people ages 25–64 years only.

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Other Cancers

Measure Title

Lung cancer deaths per 100,000 population per year.

Measure Source

Healthy People 2010.

National Tables

1_4_3.1 Lung cancer deaths per 100,000 population per year, United States, 1999 and 2005.

1_4_3.2 Lung cancer deaths per 100,000 population per year, United States, 2005, by:

  • Race.
  • Ethnicity.
  • Education.

National Data Source

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

National Denominator

U.S. resident population.

National Numerator

Number of deaths per year due to lung cancer (International Classification of Diseases, Tenth Revision, Clinical Modification [ICD-10-CM] codes C33-C34).

State Tables

1_4_3.3 Lung cancer deaths per 100,000 population per year, by State, 1999 and 2005.

State Data Source

CDC, NCHS, NVSS-M.

State Denominator

Population, by State.

State Numerator

Same as national.

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 3-2 in Healthy People 2010 documentation.

Return to Measure Specifications

Current as of September 2009
Internet Citation: Effectiveness of Care: Cancer: 2008 National Healthcare Quality and Disparities Reports. September 2009. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/findings/nhqrdr/nhqrdr08/measurespec/cancer.html