Targeting Breast Cancer Screening Initiatives Geographically
Minnesota Cancer Surveillance System
The Minnesota affiliate of Susan G. Komen for the Cure asked for help identifying geographic areas in the state to be the focus of their 2011 Community Profile, and to receive funds to improve breast cancer screening. The Minnesota Cancer Surveillance System (MCSS) was invited to join the advisory committee for the project and attended monthly meetings over the six-month period.
MCSS provided age-adjusted county-specific rates for in situ breast cancer, controlling for the age-adjusted invasive rate and the age-adjusted late-stage breast cancer rate. The data were well received and generated lively discussion. Mapping the data was particularly helpful in the decision-making process. MCSS data resulted in the selection of counties for the Community Profile and the adoption of a regional rather than county-based approach for this and future funding rounds.
Decision makers can use complex registry data when registry epidemiologists are involved in the process. Conversely, a dialogue between epidemiologists and decision makers helps make sure that data are analyzed in the most meaningful way. We found that breast cancer mortality rates often did not correlate with late-stage breast cancer rates from the same time period, as one might expect. In addition, the average age of county populations in Minnesota varies considerably, so simply using county stage distributions to assess need did not provide an accurate picture.