accuracy of information reported in claims-based data systems to determine the utility of reimbursement claims for tracking cancer incidence and stage, the use of screening and diagnostic tests, long-term treatment, and cancer-related health care utilization.

Surveys

To address questions regarding health risk behaviors (e.g., diet, health habits, and use of cancer screening), NCI conducts or uses a number of surveys that may identify ethnic group differences related to cancer risk. As indicated above, many of these efforts are conducted in collaboration with other federal agencies or organizations.

NCI has collaborated with the U.S. Bureau of the Census to generate supplemental questions for the Current Population Survey, a monthly survey of approximately 50,000 households used to obtain information about the labor force. NCI questions provide surveillance information on tobacco use and tobacco control attitudes. These data have been used to provide estimates of tobacco use among minority and medically underserved populations and were published in the Journal of the National Cancer Institute in 1996.

NCI also periodically provides supplemental questions to the Centers for Disease Control and Prevention's (CDC's) annual National Health Interview Survey (NHIS), a nationally representative survey administered in person. NCI supplements to NHIS in 1987 and 1992 pertained to cancer risk factors, including tobacco use, diet and nutrition, knowledge and attitudes about cancer, use of cancer screening, and cancer survivorship. The survey has been translated into Spanish and has included a measure of ''acculturation to the Hispanic population" (National Cancer Institute, 1998b, p. 12). NCI's supplemental questions to NHIS in the year 2000 will expand the acculturation section to include questions on health beliefs and health service use and will expand acculturation questions to Asian Americans, as well as Hispanics. NCI has also collaborated with CDC in the prospective National Health and Nutrition Examination Survey (NHANES), which investigated the health and nutrition status of the U.S. population with a particular focus on high-risk populations. Several cohorts have been followed prospectively since the 1970s to obtain data on diet and health. Both NHANES and NHIS are classified by NCI as Category II studies.

As part of the effort to understand dietary patterns and cancer risk, DCCPS staff have also studied data from the U.S. Department of Agriculture's Continuing Surveys of Food Intakes by Individuals to explore ethnic group differences in dietary intake and compliance with recommended daily nutritional guidelines.



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