Online Program

Linkage of the 1986-2009 National Health Interview Survey (NHIS) with the 1981-2010 Florida Cancer Data System (FCDS): Examining the Health Status of Florida Cancer Survivors

Monday, November 2, 2015

David J. Lee, PhD, Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL
William G. Le Blanc, PhD, Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL
Laura A. McClure, MSPH, Sylvester Comprehensive Cancer Center, University of Miami, Miller School of Medicine, Miami, FL
Stacey L. Tannenbaum, PhD, RD, LD/N, Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL
Background: To examine the health status of cancer survivors, we linked the National Health Interview Survey (NHIS) of the National Center for Health Statistics and the Florida Cancer Data System (FCDS).

Methods: Employing a probabilistic algorithm in LinkPlus v2, we linked 1986-2009 NHIS data and 1981-2010 FCDS data using social security number, name, date of birth, address and sex. NHIS participants aged ≥18y with complete information on sociodemographics, body mass index, and activity limitation were included in the analysis (n=41,486). Logistic regression was used to model the probability of reporting excellent/very good/good health compared to fair/poor health with adjustment for covariates, sample year, and the complex sample design. A subset analysis was completed on those with available smoking status (n=19,123).

Results: Relative to those with a late-stage cancer diagnosis, participants without a registry-confirmed cancer were significantly more likely to report excellent/very good/good health (Odds ratio=2.96 [95% confidence interval=1.06-8.28]); those with early versus late-stage cancer were also more likely to report excellent/very good/good health (2.06 [0.62-6.83]) although this difference failed to reach statistical significance. These associations did not change appreciably when further adjusted for smoking status: (3.01 [1.04-8.76] no cancer vs. late-stage; and 2.06 [0.59-7.14] early vs. late-stage).

Conclusions: Cancer-free Florida adults and those diagnosed at early-stage have a higher self-reported health status relative to adults with late-stage cancer. Similar linkages conducted by all U.S. cancer registries would represent an unparalleled data resource to evaluate the nation's health and other outcomes, such as mental health, healthcare access, and healthcare utilization.

Learning Areas:

Chronic disease management and prevention
Public health or related research

Learning Objectives:
Describe the unique linkage of NHIS and FCDS data. Explain the self-reported health status of Florida cancer survivors compared to those without a confirmed cancer diagnosis. Discuss the value of combining similar large datasets through linkages with other US cancer registries.

Keyword(s): Cancer, Epidemiology

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an chronic disease expert with extensive and productive research experience in analysis of large datasets such as the National Health Interview Survey. Since 2005, I have been the Research/Data Dissemination Director of the Florida Cancer Data System (FCDS). As part of this effort I have co-produced cancer monographs focusing on cancer health disparities. As of 2014, I became the Project Director/Principal Investigator of the FCDS and continue to conduct hypothesis-driven surveillance research .
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.