Survey Text

2010
2005
2000
top
2010
Survey form view entire document:  text  image

Question ID: NAH.020_00.001

Instrument Variable Name: FHFTYP_1
QuestionText:
What kind of cancer did your father have?
* Enter code for the first kind of cancer.
01 Bladder
02 Blood
03 Bone
04 Brain
05 Breast
06 Cervix
07 Colon
08 Esophagus
09 Gallbladder
10 Kidney
11 Larynx-windpipe
12 Leukemia
13 Liver
14 Lung
15 Lymphoma
16 Melanoma
17 Mouth/tongue/lip
18 Ovary
19 Pancreas
20 Prostate
21 Rectum
22 Skin(non melanoma)
23 Skin (DK what kind)
24 Soft tissue (muscle or fat)
25 Stomach
26 Testis
27 Throat-pharynx
28 Thyroid
29 Uterus
30 Other
97 Refused
99 Don't know
UniverseText: Sample adults 18+ whose father ever had cancer
SkipInstructions:
(1-5,7-17,19-28,30,RF,DK) goto FHFAGE1
(6,18,29) goto ERR_FHFTYP_1
Question ID: NAH.020_00.002

Instrument Variable Name: FHFTYP_2
QuestionText:
* Enter code for the second kind of cancer.
* Enter '96' for no more.
01 Bladder
02 Blood
03 Bone
04 Brain
05 Breast
06 Cervix
07 Colon
08 Esophagus
09 Gallbladder
10 Kidney
11 Larynx-windpipe
12 Leukemia
13 Liver
14 Lung
15 Lymphoma
16 Melanoma
17 Mouth/tongue/lip
18 Ovary
19 Pancreas
20 Prostate
21 Rectum
22 Skin(non melanoma)
23 Skin (DK what kind)
24 Soft tissue (muscle or fat)
25 Stomach
26 Testis
27 Throat-pharynx
28 Thyroid
29 Uterus
30 Other
96 No more
97 Refused
99 Don't know
UniverseText: Sample adults 18+ who either provided an age range for a first kind of cancer or didn't know how old father was
when first diagnosed with that kind of cancer or else refused to provide an age range and had not refused to give
first kind of cancer
SkipInstructions:
(1-5,7-17,19-28,30,RF,DK) if FHFTYP_2 = FHFTYP_1 goto ERR2_FHFTYP_2
else goto FHFAGE2
(96) goto FHMCAN
(6,18,29) goto ERR1_FHFTYP_2
Question ID: NAH.020_00.003

Instrument Variable Name: FHFTYP_3
QuestionText:
* Enter code for the third kind of cancer.
* Enter '96' for no more.
01 Bladder
02 Blood
03 Bone
04 Brain
05 Breast
06 Cervix
07 Colon
08 Esophagus
09 Gallbladder
10 Kidney
11 Larynx-windpipe
12 Leukemia
13 Liver
14 Lung
15 Lymphoma
16 Melanoma
17 Mouth/tongue/lip
18 Ovary
19 Pancreas
20 Prostate
21 Rectum
22 Skin(non melanoma)
23 Skin (DK what kind)
24 Soft tissue (muscle or fat)
25 Stomach
26 Testis
27 Throat-pharynx
28 Thyroid
29 Uterus
30 Other
96 No more
97 Refused
99 Don't know
UniverseText: Sample adults 18+ who either provided an age range for a second kind of cancer or didn't know how old father was
when first diagnosed with that kind of cancer or else refused to provide an age range and had not refused to give a
second type of cancer
SkipInstructions:
(1-5,7-17,19-28,30,RF,DK) if FHFTYP_3 = FHFTYP_1 or FHFTYP_2
goto ERR2_FHFTYP_3
else goto FHFAGE3
(96) goto FHMCAN
(6,18,29) goto ERR1_FHFTYP_3

top
2005
Survey form view entire document:  text  image

NAH.020_00.001

Instrument Variable Name: FHFTYP_1
Question Text:
What kind of cancer did your father have?
*Enter code for the first kind of cancer.
01 Bladder
02 Blood
03 Bone
04 Brain
05 Breast
06 Cervix
07 Colon
08 Esophagus
09 Gallbladder
10 Kidney
11 Larynx-windpipe
12 Leukemia
13 Liver
14 Lung
15 Lymphoma
16 Melanoma
17 Mouth/tongue/lip
18 Ovary
19 Pancreas
20 Prostate
21 Rectum
22 Skin(non melanoma)
23 Skin (DK what kind)
24 Soft tissue (muscle or fat)
25 Stomach
26 Testis
27 Throat-pharynx
28 Thyroid
29 Uterus
30 Other
97 Refused
99 Don't know
Universe Text: Sample adults 18+ whose father ever had cancer
Skip Instructions:
(1-5,7-17,19-28,30,RF,DK) goto FHFAGE1
(6,18,29) goto ERR_FHFTYP_1

NAH.020_00.002

Instrument Variable Name: FHFTYP_2
Question Text:
*Enter code for the second kind of cancer.
*Enter '96' for no more.
01 Bladder
02 Blood
03 Bone
04 Brain
05 Breast
06 Cervix
07 Colon
08 Esophagus
09 Gallbladder
10 Kidney
11 Larynx-windpipe
12 Leukemia
13 Liver
14 Lung
15 Lymphoma
16 Melanoma
17 Mouth/tongue/lip
18 Ovary
19 Pancreas
20 Prostate
21 Rectum
22 Skin(non melanoma)
23 Skin (DK what kind)
24 Soft tissue (muscle or fat)
25 Stomach
26 Testis
27 Throat-pharynx
28 Thyroid
29 Uterus
30 Other
96 No more
97 Refused
99 Don't know
Universe Text: Sample adults 18+ who either provided an age range for a first kind of cancer or didn't know how old father was when first diagnosed with that kind of cancer or else refused to provide an age range and had not refused to give first kind of cancer
Skip Instructions:
(1-5,7-17,19-28,30,R,D) if FHFTYP_2 = FHFTYP_1 [goto ERR2_FHFTYP_2]; else [goto FHFAGE2]
(96) [goto FHMCAN]
(6,18,29) [goto ERR1_FHFTYP_2]

NAH.020_00.003

Instrument Variable Name: FHFTYP_3
Question Text:
*Enter code for the third kind of cancer.
*Enter '96' for no more.
01 Bladder
02 Blood
03 Bone
04 Brain
05 Breast
06 Cervix
07 Colon
08 Esophagus
09 Gallbladder
10 Kidney
11 Larynx-windpipe
12 Leukemia
13 Liver
14 Lung
15 Lymphoma
16 Melanoma
17 Mouth/tongue/lip
18 Ovary
19 Pancreas
20 Prostate
21 Rectum
22 Skin(non melanoma)
23 Skin (DK what kind)
24 Soft tissue (muscle or fat)
25 Stomach
26 Testis
27 Throat-pharynx
28 Thyroid
29 Uterus
30 Other
96 No more
97 Refused
99 Don't know
Universe Text: Sample adults 18+ who either provided an age range for a second kind of cancer or didn't know how old father was when first diagnosed with that kind of cancer or else refused to provide an age range and had not refused to give a second type of cancer
Skip Instructions:
(1-5,7-17,19-28,30,R,D) if FHFTYP_3 = FHFTYP_1 or FHFTYP_2 [goto ERR2_FHFTYP_3]; else [goto FHFAGE3]
(96) [goto FHMCAN]
(6,18,29) [goto ERR1_FHFTYP_3]

top
2000
Survey form view entire document:  text  image

NAH.020

What kind of cancer did your father have?

FR: ENTER UP TO 3 KINDS. IF RESPONDENT OFFERS MORE THAN 3 KINDS, ENTER "96" IN THE FOURTH ANSWER SPACE. ENTER (N) FOR NO MORE.
FHFTYP
(1) Bladder
(2) Blood
(3) Bone
(4) Brain
(5) Breast
(7) Colon
(8) Esophagus
(9) Gallbladder
(10) Kidney
(11) Larynx-windpipe
(12) Leukemia
(13) Liver
(14) Lung
(15) Lymphoma
(16) Melanoma
(17) Mouth/tongue/lip
(19) Pancreas
(20) Prostate
(21) Rectum
(22) Skin (non-melanoma)
(23) Skin (Don't Know what kind)
(24) Soft Tissue (muscle/fat)
(25) Stomach
(26) Testis
(27) Throat -pharynx
(28) Thyroid
(30) Other
(96) More than 3 kinds
(97) Refused
(99) Don't know

____ (Father Cancer Type 1)
____ (Father Cancer Type 2)
____ (Father Cancer Type 3)
____ (N or 96)