Information Collection Request

Colorectal Cancer Screening Program

ICR 201304-0920-004 · OMB 0920-0745 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
0920-0745_SS Part B_2 25 2013.docx Supporting Statement B Uploaded 2013-03-14 Available
Attachment 6. Data Consultants.doc Supplementary Document Uploaded 2013-03-14 Available
Attachment 4abc. Sample Feedback.doc Supplementary Document Uploaded 2013-03-14 Repair queued
Attachment 2b. Summary of Public Comments.pdf Supplementary Document Uploaded 2013-03-14 Available
Attachment 2a. Federal Register Notice.pdf Supplementary Document Uploaded 2013-03-14 Repair queued
Attachment 1. Authorizing Legislation.docx Supplementary Document Uploaded 2013-03-14 Available
Attachment 3c. CCDE Data Users Manual.docx Supplementary Document Uploaded 2013-03-14 Available
0920-0745_SS Part A_2 25 2013.docx Supporting Statement A Uploaded 2013-03-14 Available
IC Document Collections
IC IDCollectionTypeStatusForm
179138 Cost Assessment Tool Other-Cost Assessment Tool Modified
179134 Clinical Data Elements (CCDE) Other-Data Definition Table Modified
ICR Details
0920-0745 201304-0920-004
Historical Active 201004-0920-014
HHS/CDC 19143
Colorectal Cancer Screening Program
Extension without change of a currently approved collection   No
Regular
Approved without change 04/29/2013
Retrieve Notice of Action (NOA) 04/04/2013
  Inventory as of this Action Requested Previously Approved
04/30/2016 36 Months From Approved 06/30/2013
10,904 0 9,776
3,357 0 3,010
0 0 0

CDC funds 29 cooperative agreement awardees to increase population-based colorectal cancer (CRC) screening and to reduce health disparities in CRC screening, incidence and mortality. CDC collects programmatic-level activity cost data and de-identified patient-level demographic, screening, diagnostic, treatment and outcome data. An Extension for three years is requested.

US Code: 42 USC 301 Name of Law: Public Health Service Act
  
None

Not associated with rulemaking

  78 FR 3430 01/16/2013
78 FR 18595 03/27/2013
Yes

2
IC Title Form No. Form Name
Clinical Data Elements (CCDE)
Cost Assessment Tool

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 10,904 9,776 0 0 1,128 0
Annual Time Burden (Hours) 3,357 3,010 0 0 347 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
This extension request shows an increase in burden due to an increase in the number of grantees.

$829,385
Yes Part B of Supporting Statement
No
No
No
No
Uncollected
Carol Walker 4046394773

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
04/04/2013