Focus Area 3: Cancer: Objectives and Subobjectives

As a result of the Healthy People 2010 Midcourse Review, changes were made to the Healthy People 2010 objectives and subobjectives. These changes are specific to the following situations:

Changes in the wording of an objective to more accurately describe what is being measured.
Changes to reflect a different data source or new science.
Changes resulting from the establishment of a baseline and a target (that is, when a formerly developmental objective or subobjective became measurable).
Deletion of an objective or subobjective that lacked a data source.
Correction of errors and omissions in Healthy People 2010.

Revised baselines and targets for measurable objectives and subobjectives do not fall into any of the above categories and, thus, are not considered a midcourse review change.¹

When changes were made to an objective, three sections are displayed:

In the Original Objective section, the objective as published in Healthy People 2010 in 2000 is shown.
In the Objective With Revisions section, strikethrough indicates text deleted, and underlining is used to show new text.
In the Revised Objective section, the objective appears as revised as a result of the midcourse review.

Details of the objectives and subobjectives in this focus area, including any changes made at the midcourse, appear on the following pages.

¹See Technical Appendix for more information on baseline and target revisions.

NO CHANGE IN OBJECTIVE
(Data updated and footnoted)

3-1.

Reduce the overall cancer death rate.

Target: 158.6¹ deaths per 100,000 population.

Baseline: 200.8² cancer deaths per 100,000 population occurred in 1999² (age adjusted to the year 2000 standard population).

Target setting method: 21 percent improvement.

Data source: National Vital Statistics System (NVSS), CDC, NCHS.

¹ Target revised from 159.9 because of baseline revision after November 2000 publication.
² Baseline and baseline year revised from 202.4 and 1998 after November 2000 publication.

NO CHANGE IN OBJECTIVE
(Data updated and footnoted)

3-2.

Reduce the lung cancer death rate.

Target: 43.3¹ deaths per 100,000 population.

Baseline: 55.5² lung cancer deaths per 100,000 population occurred in 1999² (age adjusted to the year 2000 standard population).

Target setting method: 22 percent improvement.

Data source: National Vital Statistics System (NVSS), CDC, NCHS.

¹ Target revised from 44.9 because of baseline revision after November 2000 publication.
² Baseline and baseline year revised from 57.6 and 1998 after November 2000 publication.

NO CHANGE IN OBJECTIVE
(Data updated and footnoted)

3-3.

Reduce the breast cancer death rate.

Target: 21.3¹ deaths per 100,000 females.

Baseline: 26.6² breast cancer deaths per 100,000 females occurred in 1999² (age adjusted to the year 2000 standard population).

Target setting method: 20 percent improvement.

Data source: National Vital Statistics System (NVSS), CDC, NCHS.

¹ Target revised from 22.3 because of baseline revision after November 2000 publication.
² Baseline and baseline year revised from 27.9 and 1998 after November 2000 publication.

NO CHANGE IN OBJECTIVE
(Data updated and footnoted)

3-4.

Reduce the death rate from cancer of the uterine cervix.

Target: 2.0¹ deaths per 100,000 females.

Baseline: 2.8² cervical cancer deaths per 100,000 females occurred in 1999² (age adjusted to the year 2000 standard population).

Target setting method: Better than the best.

Data source: National Vital Statistics System (NVSS), CDC, NCHS.

¹ Target revised from 2.0 because of baseline revision after November 2000 publication.
² Baseline and baseline year revised from 3.0 and 1998 after November 2000 publication.

NO CHANGE IN OBJECTIVE
(Data updated and footnoted)

3-5.

Reduce the colorectal cancer death rate.

Target: 13.7¹ deaths per 100,000 population.

Baseline: 20.9² colorectal cancer deaths per 100,000 population occurred in 1999² (age adjusted to the year 2000 standard population).

Target setting method: 34 percent improvement.

Data source: National Vital Statistics System (NVSS), CDC, NCHS.

¹ Target revised from 13.9 because of baseline revision after November 2000 publication.
² Baseline and baseline year revised from 21.2 and 1998 after November 2000 publication.

NO CHANGE IN OBJECTIVE
(Data updated and footnoted)

3-6.

Reduce the oropharyngeal cancer death rate.

Target: 2.4¹ deaths per 100,000 population.

Baseline: 2.7² oropharyngeal cancer deaths per 100,000 population occurred in 1999² (age adjusted to the year 2000 standard population).

Target setting method: 10 percent improvement.

Data source: National Vital Statistics System (NVSS), CDC, NCHS.

¹ Target revised from 2.7 because of baseline revision after November 2000 publication.
² Baseline and baseline year revised from 3.0 and 1998 after November 2000 publication.

NO CHANGE IN OBJECTIVE
(Data updated and footnoted)

3-7.

Reduce the prostate cancer death rate.

Target: 28.2¹ deaths per 100,000 males.

Baseline: 31.3² prostate cancer deaths per 100,000 males occurred in 1999² (age adjusted to the year 2000 standard population).

Target setting method: 10 percent improvement.

Data source: National Vital Statistics System (NVSS), CDC, NCHS.

¹ Target revised from 28.8 because of baseline revision after November 2000 publication.
² Baseline and baseline year revised from 32.0 and 1998 after November 2000 publication.

NO CHANGE IN OBJECTIVE
(Data updated and footnoted)

3-8.

Reduce the rate of melanoma cancer deaths.

Target: 2.3¹ deaths per 100,000 population.

Baseline: 2.6² melanoma cancer deaths per 100,000 population occurred in 1999² (age adjusted to the year 2000 standard population).

Target setting method: 11 percent improvement.

Data source: National Vital Statistics System (NVSS), CDC, NCHS.

¹ Target revised from 2.5 because of baseline revision after November 2000 publication.
² Baseline and baseline year revised from 2.8 and 1998 after November 2000 publication.

NO CHANGE IN OBJECTIVE
(Data updated and footnoted)

3-9.

Increase the proportion of persons who use at least one of the following protective measures that may reduce the risk of skin cancer: avoid the sun between 10 a.m. and 4 p.m., wear sun-protective clothing when exposed to sunlight, use sunscreen with a sun-protective factor (SPF) of 15 or higher, and avoid artificial sources of ultraviolet light.

3-9a. (Developmental) Increase the proportion of adolescents in grades 9 through 12 who follow protective measures that may reduce the risk of skin cancer.

Potential data source: Youth Risk Behavior Surveillance System (YRBSS), CDC, NCCDPHP.

3-9b. Increase the proportion of adults aged 18 years and older who follow protective measures that may reduce the risk of skin cancer.

Target: 85¹ percent of adults aged 18 years and older use at least one of the identified protective measures.

Baseline: 59² percent of adults aged 18 years and older regularly used at least one protective measure in 2000² (age adjusted to the year 2000 standard population).

Target setting method: Better than the best.

Data source: National Health Interview Survey (NHIS), CDC, NCHS. Data on artificial ultraviolet light source are developmental.

¹ Target revised from 75 percent because of baseline revision after November 2000 publication.
² Baseline and baseline year revised from 47 percent and 1998 after November 2000 publication.

NO CHANGE IN OBJECTIVE
(Data updated and footnoted)

3-10.

Increase the proportion of physicians and dentists who counsel their at-risk patients about tobacco use cessation, physical activity, and cancer screening.

Target and baseline:

Objective	Increase in Counseling About Tobacco Use Cessation, Physical Activity, and Cancer Screening	1988 Baseline (unless noted) Percent	2010 Target Percent
3-10a.	Internists who counsel about smoking cessation	50	85
3-10b.	Family physicians who counsel about smoking cessation	43	85
3-10c.	Dentists who counsel about smoking cessation	59 (1997)	85
3-10d.	Primary care providers who counsel about blood stool tests	56	85
3-10e.	Primary care providers who counsel about proctoscopic examinations	23	85
3-10f.	Primary care providers who counsel about mammograms	37	85
3-10g.	Primary care providers who counsel about Pap tests	55	85
3-10h.	Primary care providers who counsel about physical activity	12 (1998)¹	85

Target setting method: Better than the best.

Data sources: Survey of Physicians’ Attitudes and Practices in Early Cancer Detection, NIH, NCI; National Ambulatory Medical Care Survey (NAMCS), CDC, NCHS; Survey of Current Issues in Dentistry, American Dental Association.

¹ Baseline and baseline year revised from 22 percent and 1995 after November 2000 publication.

NO CHANGE IN OBJECTIVE

3-11.

Increase the proportion of women who receive a Pap test.

Target and baseline:

Objective	Increase in Pap Testing	1998 Baseline* Percent	2010 Target Percent
3-11a.	Women aged 18 years and older who have ever received a Pap test	92	97
3-11b.	Women aged 18 years and older who received a Pap test within the preceding 3 years	79	90

* Age adjusted to the year 2000 standard population. Includes women without a uterine cervix.

Target setting method: Better than the best.

Data source: National Health Interview Survey (NHIS), CDC, NCHS.

NO CHANGE IN OBJECTIVE
(Data updated and footnoted)

3-12.

Increase the proportion of adults who receive a colorectal cancer screening examination.

Target and baseline:

Objective		Increase in Colorectal Cancer Screening		2000 Baseline* (unless noted) Percent		2010 Target Percent
3-12a.		Adults aged 50 years and older who have received a fecal occult blood test (FOBT) within the preceding 2 years		24¹		33²
3-12b.		Adults aged 50 years and older who have ever received a sigmoidoscopy		37 (1998)		50

* Age adjusted to the year 2000 standard population.

Target setting method: Better than the best.

Data source: National Health Interview Survey (NHIS), CDC, NCHS.

¹ Baseline and baseline year revised from 35 and 1998 after November 2000 publication.
² Target revised from 50 because of baseline revision after November 2000 publication.

NO CHANGE IN OBJECTIVE
(Data updated and footnoted)

3-13.

Increase the proportion of women aged 40 years and older who have received a mammogram within the preceding 2 years.

Target: 70 percent.

Baseline: 67 percent of women aged 40 years and older received a mammogram within the preceding 2 years in 1998 (age adjusted to the year 2000 standard population).

Target setting method: Better than the best.

Data source: National Health Interview Survey (NHIS), CDC, NCHS.

ORIGINAL OBJECTIVE
3-14.	Increase the number of States that have a statewide population-based cancer registry that captures case information on at least 95 percent of the expected number of reportable cancers. Target: 45. Baseline: 21 States had a statewide population-based cancer registry that captured case information on at least 95 percent of the expected number of reportable cancers in 1999. Target setting method: 114 percent improvement. Data source: National Program of Cancer Registries, CDC.
OBJECTIVE WITH REVISIONS
3-14.	Increase the number of States that have a statewide population-based cancer registry that captures case information on at least 95 percent of the expected number of reportable cancers. Target: 45. Baseline: 2130 States had a statewide population-based cancer registry that captured case information on at least 95 percent of the expected number of reportable cancers in 1999. Target setting method: ~~114~~50 percent improvement. Data source: National Program of Cancer Registries, CDC.
REVISED OBJECTIVE
3-14.	Increase the number of States that have a statewide population-based cancer registry that captures case information on at least 95 percent of the expected number of reportable cancers. Target: 45. Baseline: 30 States had a statewide population-based cancer registry that captured case information on at least 95 percent of the expected number of reportable cancers in 1999. Target setting method: 50 percent improvement. Data source: National Program of Cancer Registries, CDC.

NO CHANGE IN OBJECTIVE
3-15.	Increase the proportion of cancer survivors who are living 5 years or longer after diagnosis. Target: 70 percent. Baseline: 59 percent of persons with invasive cancer of any type were living 5 years or longer after diagnosis in 1989–95. Target setting method: 19 percent improvement. Data source: Surveillance, Epidemiology, and End Results (SEER) Program, NIH, NCI.

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