Data Types - Screening and Risk Factors Data Types
Direct Estimates are the usual estimates reported from a survey-directly estimated from the survey data using appropriate weighting. Most of these direct estimates are based on data from the Behavioral Risk Factor Surveillance System (BRFSS), a large annual telephone survey of U.S. households designed to measure at the state level.
County-Level Modeled Estimates combine results from BRFSS and the National Health Interview Survey (NHIS), a smaller, in-person survey, using a statistical model that takes advantage of the strengths of each survey. These estimates:
- use the strength of the NHIS (better response rate and reaches houses without land-line telephones) to adjust BRFSS estimates.
- smooth the results by applying data from demographically similar areas across the country.
- enable estimates for counties with few or no BRFSS respondents by using data from similar areas, albeit at the loss of specificity to that particular small area.
- pool data from multiple years to obtain more responses for small areas.
- can only be used when both surveys ask identical questions, so the number of statistics that can be modeled this way is limited.
For each outcome, the state level modeled estimates are controlled to the direct regional estimates and the county level modeled estimates are controlled to the controlled state level modeled estimates so the aggregated county level estimates equal to the corresponding state level estimates and the aggregated state level estimates equal to the corresponding regional level direct estimates.
These county estimates were updated August 23, 2023, using a new methodology. See https://sae.cancer.gov
for more details.
Summary of Available Statistics by Data Type
| Direct Estimates | Bias-Adjusted Modeled Estimates | |
|---|---|---|
| Areas | States US |
Counties States US |
| Time Period | Most current single year | Pooled years |
| Survey(s) | BRFSS (or CPS, ANR, YRBSS, or NIS*) | BRFSS and NHIS combined |
| Topics Available | Colorectal Screening Fecal occult blood test (FOBT) FOBT or Sigmoidoscopy or Colonoscopy Home Blood Stool Test Sigmoidoscopy or Colonoscopy Diet & Exercise Fruit/Vegetable Servings Overweight or Obese Physical Activity Youth Overweight or Obese (not based on BRFSS*) Women's Health HPV Vaccination (not based on BRFSS*) Mammogram Pap Smear Smoking Smokers Smoking Not Allowed and Smoking Laws (not based on BRFSS*) |
Colorectal Screening Fecal occult blood test (FOBT) Guidance Sufficient CRC Had Colonoscopy in Past 10 Years Women's Health Mammogram Pap Smear Smoking Current Smokers Former Smoker Prevalence Former Smoker Prevalence (Quit 1 year) Daily Smokers Who Stopped Smoking Percent of Workers in Non-Smoking Environment Percent of People Not Allowed to Smoke Anywhere Inside Their Home |
| Limitations | Telephone-only survey method introduces bias and inaccuracies (greater for some statistics than for others) | Depending on the local sample rate, estimates for small areas may not reflect local factors (such as a media campaign to promote mammograms) |
* Smoking Not Allowed measures are direct estimates and are from the Current Population Survey (CPS) Tobacco Use Supplement. The data for Smoking Laws come from Americans for Nonsmokers' Rights (ANR) and are based on analysis of laws across the country. HPV vaccination data come from National Immunization Survey - Teen. Youth obesity data are estimates from YRBS.
References
- County-Level Modeled Estimates (Small Area Estimates), National Cancer Institute
- Behavioral Risk Factor Surveillance System, Centers for Disease Control and Prevention
- National Health Interview Survey, Centers for Disease Control and Prevention
- Current Population Survey Tobacco Use Supplement, National Cancer Institute and U.S. Census Bureau
- U.S. Tobacco Control Laws Database©, Americans for Nonsmokers' Rights Foundation
- YRBSS Survey Data
- The National Immunization Survey - Teen, Hyattsville, MD: Centers for Disease Control and Prevention