Cancer Screening and Risk Factors in Florida: Data from the National Health Interview Survey

Transcription

1 Cancer Screening and Risk Factors in Florida: Data from the National Health Interview Survey David J Lee, PhD Florida Cancer Data System (FCDS), Sylvester Comprehensive Cancer Center, Department of Epidemiology and Public Health, University of Miami Miller School of Medicine Florida Cancer Data System Annual Meeting July 26-27, 2012

2 National Health Interview Survey Nationally representative survey of the civilian noninstitutionalized US population conducted since 1957 Questionnaire Content: Basic socio-demographics Health conditions and utilization Health status, health care services, and behaviors Cancer Supplement Content: Screening & family history Physical activity, diet & nutrition Years collected: 1987, 1992, 2000, 2003, 2005, 2008, 2010

3 Cancer Risk Factors and Screening Behaviors in Florida Source: McClure LA, Clarke TC, Fernandez CA, Arheart KL, LeBlanc WG, Fleming LE, Lee DJ A Report of Florida s Cancer History, Risk Factors, and Screening Behaviors: Data from the National Health Interview Survey Florida Public Health Review, 2012; 9, 67-87

4 Cancer Risk Factors and Screening Behaviors in Florida Source: McClure LA, Clarke TC, Fernandez CA, Arheart KL, LeBlanc WG, Fleming LE, Lee DJ A Report of Florida s Cancer History, Risk Factors, and Screening Behaviors: Data from the National Health Interview Survey Florida Public Health Review, 2012; 9, 67-87

5 Cancer Risk Factors and Screening Behaviors in Florida Cancer history, risk factors, and screening behaviors in Florida vs Rest of the US, NHIS * Cancer History Lifetime Colorectal Screening Lifetime Breast Exam Lifetime Mammography Lifetime Pap Test Past Year Pap Test Lifetime PSA Test Current Smoker Risky Drinker Obese Rest of US Florida Physically Active Concerned with Sun Protection *All prevalence differences significant at p<005 Prevalence

6 Skin Cancer Screening in Florida When compared to the rest of the US and individual regions of the US, Floridians reported significantly higher 12-month skin cancer screening rates, particularly Floridians over 60 years old (110% vs 75%) Source: Fernandez CA, McClure LA, LeBlanc WG, Clarke TC, Kirsner RS, Arheart KL, Lee DJ A Comparison of Florida Skin Cancer Screening Rates to the Rest of the United States Archives of Dermatology, 2012; 148(3):393-5

7 Skin Cancer Screening in Florida Controlling for a variety of demographic factors, Floridians continued to be more likely to report lifetime skin cancer screening compared to the rest of the US (152; ) and all other regions of US ( ) Source: Fernandez CA, McClure LA, LeBlanc WG, Clarke TC, Kirsner RS, Arheart KL, Lee DJ A Comparison of Florida Skin Cancer Screening Rates to the Rest of the United States Archives of Dermatology, 2012; 148(3):393-5

8 Risky Drinking in Florida s Older Population Risky drinking was defined as ten drinks/week in men and seven drinks/week in women; or five drinks at one sitting, once/year Floridians were less likely to report risky drinking compared to the rest of the US (Odds Ratio=075 95% Confidence Interval= ) Among those aged 65, however, Floridians were more likely to report risky drinking than the rest of the US (112; ) Source: McClure LA, Fernandez CA, Clarke TC, Arheart KL, LeBlanc WG, Lee DJ Risky drinking among the elderly: A comparison of Florida to the rest of the US (Under review, Addictive Behaviors)

9 State Variations of Chronic Disease Risk Factors in Older Americans A Call to Action Florida ranked a favorable 12 th lowest smoking prevalence rate Nevada ranked the lowest Source: Tannenbaum S, Kachan D, Fernandez CA, McClure LA, LeBlanc WG, Lee DJ State variations of chronic disease risk factors in older Americans- a call to action (Under review, Preventing Chronic Disease) (179%)

10 National Health Interview Survey (NHIS)-Florida Cancer Data System (FCDS) Data Linkage Project Purpose Evaluate the feasibility and logistics of performing a record linkage between the NHIS of the National Center for Health Statistics (NCHS) and the FCDS database Study will create a highly enriched data source by linking NHIS data on demographics, health conditions, health care access/utilization, and health behaviors with FCDS cancer incidence case data Ultimate Goal: Develop a model for conducting linkages between NCHS population-based surveys and the CDC National Program of Cancer Registries and SEER Cancer Registries

11 National Health Interview Survey (NHIS)-Florida Cancer Data System (FCDS) Data Linkage Project Trial Linkage Linkage between 1987 NHIS and FCDS data designed as test run to evaluate logistics of the linkage process Linkage conducted using probabilistic algorithm through Automatch with name, SSN, date of birth, and sex Result was dataset with 712 linked Florida cancer cases that participated in the 1987 NHIS Dataset deposited at the RDC to be used for approved analyses

12 National Health Interview Survey (NHIS)-Florida Cancer Data System (FCDS) Data Linkage Project Analyses of 1-Year Linked Dataset Application approved by the RDC, currently conducting descriptive and multivariable analyses to test the following hypotheses: H 1-1 : Florida NHIS cancer survivors will have greater work loss and activity limitations relative to FL NHIS non-cancer survivors after adjustment for sociodemographic status H 1-2: The likelihood of being diagnosed with a late-stage vs non-late-stage cancer will be greater among NHIS participants who reported being uninsured in 1987

13 National Health Interview Survey (NHIS)-Florida Cancer Data System (FCDS) Data Linkage Project Full Linkage Linkage complete between 1986, NHIS and FCDS using probabilistic algorithm through LinkPlus with SSN, date of birth, and name Matching scores assigned to identify true, false, and questionable matches ~3,000 questionable matches were reviewed manually Sensitivity analyses determined that the scoring thresholds were accurate

14 National Health Interview Survey (NHIS)-Florida Cancer Data System (FCDS) Data Linkage Project Full Linkage Resulted in preliminary dataset with 10,406 linked Florida cancer cases that participated in the NHIS prior to or subsequent to their diagnosis Dataset being processed by NCHS staff to then be deposited at the RDC for approved analyses

15 National Health Interview Survey (NHIS)-Florida Cancer Data System (FCDS) Data Linkage Project Proposed Analyses: Full Linkage After adjusting for the complex survey design of the NHIS and recalculating survey weights accounting for linkageineligibility, use descriptive analyses and Structural Equation Modeling to evaluate: Cancer screening compliance & cancer diagnosis Socioeconomic factors & late stage cancer diagnosis Activity limitations after cancer diagnosis

16 National Health Interview Survey (NHIS)-Florida Cancer Data System (FCDS) Data Linkage Project Study Collaborators Jill MacKinnon Monique Hernandez Brad Wohler Recinda Sherman Lora Fleming Donna Miller Eric Miller Bill LeBlanc Kris Arheart Cristina Fernandez Tainya Clarke Stacey Tannenbaum Taghrid Asfar Jenelle Lin Dean Judson Anthony D Andrea Hannah Day Jennifer Parker Diana Kachan Laura McClure

17 Thank you for all that you do!