Survey Text

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

Question ID: NAH.050_00.004

Instrument Variable Name: FHMTYP_4
QuestionText:
* Enter '95' if respondent offers more than 3 kinds of cancer.
* Enter '96' for no more.
95 More than 3 kinds
96 No more
UniverseText: Sample adults 18+ who either provided an age range for a third kind of cancer or didn't know how old mother was
when first diagnosed with that kind of cancer or else refused to provide an age range but had not refused to answer
a third kind of cancer
SkipInstructions:
(95,96) goto FHBNUM
(1-30) ERR_FHMTYP_4

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2005
Survey form view entire document:  text  image

NAH.050_00.001

Instrument Variable Name: FHMTYP_1
Question Text:
What kind of cancer did your mother 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

NAH.050_00.002

Instrument Variable Name: FHMTYP_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

NAH.050_00.003

Instrument Variable Name: FHMTYP_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

NAH.050_00.004

Instrument Variable Name: FHMTYP_4
Question Text:
*Enter '95' if respondent offers more than 3 kinds of cancer.
*Enter '96' for no more.
95 More than 3 kinds
96 No more
Universe Text: Sample adults 18+ who either provided an age range for a third kind of cancer or didn't know how old mother was when first diagnosed with that kind of cancer or else refused to provide an age range but had not refused to answer a third kind of cancer
Skip Instructions:
(95,96) [goto FHBNUM]
(1-30) [goto ERR_FHMTYP_4]

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2000
Survey form view entire document:  text  image

NAH.050

What kind of cancer did your mother 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.
FHMTYP
(1) Bladder
(2) Blood
(3) Bone
(4) Brain
(5) Breast
(6) Cervix
(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
(18) Ovary
(19) Pancreas
(21) Rectum
(22) Skin (non-melanoma)
(23) Skin (Don't Know what kind)
(24) Soft Tissue (muscle/fat)
(25) Stomach
(27) Throat -pharynx
(28) Thyroid
(29) Uterus
(30) Other
(96) More than 3 kinds
(97) Refused
(99) Don't know

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