Incorporating Multiple Evidence Sources for the Assessment of Breast Cancer Policies and Practices

1. Incorporating Multiple Evidence Sources for the Assessment of Breast Cancer Policies and Practices J. Jackson-Thompson, Gentry White, Missouri Cancer Registry, University of Missouri-Columbia; M.J. King, Missouri Department of Health and Senior Services • Background: • Breast cancer accounts for c. 1/3 of cancers among U.S. women. • Early detection and timely, appropriate treatment increase 5-year survival. • Black women with breast cancer are less likely than white women to survive 5 years. • Lack of health insurance and low income are other factors associated with lower survival. • Purpose: • To evaluate efforts to reduce breast cancer incidence and mortality. • To examine effectiveness of screening policies and practices. • Methods: • We examined trends for breast cancer incidence, stage at diagnosis and mortality by race for 1996 – 2002. • We also examined prevalence of mammography screening using Behavioral Risk Factor Surveillance System (BRFSS) data for 1996-2000 and 2002. • Results: • Incidence rates for white women decreased significantly from 1996 to 2002. • Incidence rates for black women declined slightly from 1996 to 2002. • Percentage of early-stage diagnosis was slightly higher for white women than black women throughout the period. • Mortality rates for black and white women were relatively stable throughout the period. • Mortality rates for black women were significantly higher than for white women throughout the period. • There were no differences by race in the percentage of women who reported ever having had a mammogram. • Black women were more likely to report having had a mammogram in the past two years than white women. * Rates are per 100,000 persons and are age-adjusted to the 2000 U.S. standard population. * Rates are per 100,000 persons and are age-adjusted to the 2000 U.S. standard population. ** Incidence rates for white female breast cancer show a statistically significant decrease in the time period 1996-2001. Weighted Responses to BRFSS Questions, Missouri 1996-2002+ • Conclusion: • Efforts to reduce breast cancer incidence and mortality and effectiveness of screening policies cannot be evaluated adequately using only statewide data. • . + Responses not available for 2001 as questions were not asked that year. ^ Denominator is all women 18 years of age and older. ^^ Denominator is all women who responded “yes” to first question. § Early-stage diagnosis includes In situ and Localized stages. This project was supported in part by a cooperative agreement between the Centers for Disease Control and Prevention (CDC) and the Missouri Department of Health and Senior Services (DHSS) (#U55/CCU721904-04) and a SurveillanceContract between DHSS and the University of Missouri. Data Source: MICA (Missouri Information for Community Assessment) http://www.dhss.mo.gov/mica • Recommendations: • Efforts to increase screening, including targeting low-income, underserved and uninsured women, should continue.