Survey Text

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

Question ID: NAH.090_00.001

Instrument Variable Name: FHBTYP_1
QuestionText:
What kinds of cancer did your [Fill1: brother/Fill2: brothers] 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 brother(s) ever had cancer
SkipInstructions:
(1-5,7-17,19-28,30,RF,DK) if FHBCAN = '1' goto FHBAGE1
else goto FHBMAN1
(6,18,29) goto ERR_FHBTYP_1
Question ID: NAH.090_00.002

Instrument Variable Name: FHBTYP_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 provided age range for brother(s) diagnosed with the first kind of cancer or didn't know
how old brother(s) was/were when first diagnosed with that kind of cancer or else refused to provide an age range
and had not refused to answer the first kind of cancer
SkipInstructions:
(1-5,7-17,19-28,30,RF,DK) if FHBTYP_2 = FHBTYP_1 goto ERR2_FHBTYP_2
elseif FHBCAN = '1' goto FHBAGE2
else goto FHBMAN2
(96) goto FHSNUM
(6,18,29) goto ERR1_FHBTYP_2
Question ID: NAH.090_00.003

Instrument Variable Name: FHBTYP_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 provided age range for brother(s) diagnosed with the second kind of cancer or didn't know
how old brother(s) was/were when first diagnosed with that kind of cancer or else refused to provide an age range
and had not refused to answer the second kind of cancer
SkipInstructions:
(1-5,7-17,19-28,30,RF,DK) if FHBTYP_3 = FHBTYP_1 or FHBTYP_2 goto ERR2_FHBTYP_3
elseif FHBCAN = '1' goto FHBAGE3
else goto FHBMAN3
(96) goto FHSNUM
(6,18,29) goto ERR1_FHBTYP_3

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2005
Survey form view entire document:  text  image

NAH.090_00.001

Instrument Variable Name: FHBTYP_1
Question Text:
What kinds of cancer did your [Fill1: brother/Fill2: brothers] 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 brother(s) ever had cancer
Skip Instructions:
(1-5,7-17,19-28,30,R,D) if FHBCAN = 1 [goto FHBAGE1]; else [goto FHBMAN1]
(6,18,29) [goto ERR_FHBTYP_1]

NAH.090_00.002

Instrument Variable Name: FHBTYP_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 provided age range for brother(s) diagnosed with the first kind of cancer or didn't know how old brother(s) was/were when first diagnosed with that kind of cancer or else refused to provide an age range and had not refused to answer the first kind of cancer
Skip Instructions:
(1-5,7-17,19-28,30,R,D) if FHBTYP_2 = FHBTYP_1 [goto ERR2_FHBTYP_2]; elseif FHBCAN = '1' [goto FHBAGE2]; else [goto FHBMAN2]
(96) [goto FHSNUM]
(6,18,29) [goto ERR1_FHBTYP_2]

NAH.090_00.003

Instrument Variable Name: FHBTYP_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 provided age range for brother(s) diagnosed with the second kind of cancer or didn't know how old brother(s) was/were when first diagnosed with that kind of cancer or else refused to provide an age range and had not refused to answer the second kind of cancer
Skip Instructions:
(1-5,7-17,19-28,30,R,D) if FHBTYP_3 = FHBTYP_1 or FHBTYP_2 [goto ERR2_FHBTYP_3]; elseif FHBCAN = '1' [goto FHBAGE3]; else [goto FHBMAN3]
(96) [goto FHSNUM]
(6,18,29) [goto ERR1_FHBTYP_3]

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2000
Survey form view entire document:  text  image

NAH.090

What kinds of cancer did your brother(s) 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.
FHBTYP
(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

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