Survey Text

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

Question ID: NAH.120_00.001

Instrument Variable Name: FHSTYP_1
QuestionText:
What kind of cancer did your [Fill1: sister/Fill2: sisters] 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 sister(s) ever had cancer
SkipInstructions:
(1-19,21-25,27-30,RF,DK) if FHSCAN = '1'
goto FHSAGE1
else
goto FHSMAN1
(20,26) goto ERR_FHSTYP_1
Question ID: NAH.120_00.002

Instrument Variable Name: FHSTYP_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 sister(s) diagnosed with the first kind of cancer or didn't know how
old sister(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:
(1-19,21-25,27-30,RF,DK) if FHSTYP_2 = FHSTYP_1
goto ERR2_FHSTYP_2
elseif FHSCAN = '1'
goto FHSAGE2
else
goto FHSMAN2
(96) goto FHNNUM
LT (20,26) goto ERR1_FHSTYP_2
Question ID: NAH.120_00.003

Instrument Variable Name: FHSTYP_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 sister(s) diagnosed with the second kind of cancer or didn't know
how old sister(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:
(1-19,21-25,27-30,RF,DK) if FHSTYP_2 = FHSTYP_1 or FHSTYP_2
goto ERR2_FHSTYP_3
elseif FHSCAN = '1'
goto FHSAGE3
else
goto FHSMAN3
(96) goto FHNNUM
(20,26) goto ERR1_FHSTYP_3

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2005
Survey form view entire document:  text  image

NAH.120_00.001

Instrument Variable Name: FHSTYP_1
Question Text:
What kind of cancer did your [Fill1: sister/Fill2: sisters] 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 sister(s) ever had cancer
Skip Instructions:
(1-19,21-25,27-30,R,D) if FHSCAN = 1 [goto FHSAGE1]; else [goto FHSMAN1]
(20,26) [goto ERR_FHSTYP_1]

NAH.120_00.002

Instrument Variable Name: FHSTYP_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)
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 sister(s) diagnosed with the first kind of cancer or didn't know how old sister(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:
(1-19,21-25,27-30,R,D) if FHSTYP_2 = FHSTYP_1 [goto ERR2_FHSTYP_2]; elseif FHSCAN = 1 [goto FHSAGE2]; else [goto FHSMAN2]
(96) [goto FHNNUM]
(20,26) [goto ERR1_FHSTYP_2]

NAH.120_00.003

Instrument Variable Name: FHSTYP_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 sister(s) diagnosed with the second kind of cancer or didn't know how old sister(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:
(1-19,21-25,27-30,R,D) if FHSTYP_2 = FHSTYP_1 or FHSTYP_2 [goto ERR2_FHSTYP_3]; elseif FHSCAN = 1 [goto FHSAGE3]; else [goto FHSMAN3]
(96) [goto FHNNUM]
(20,26) [goto ERR1_FHSTYP_3]

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2000
Survey form view entire document:  text  image

NAH.120

What kinds of cancer did your sister(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.
FHSTYP
(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

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