The California Breast Cancer Mapping Project (CBCMP) was initiated to explore the feasibility and utility of mapping areas in the state with elevated cancer rates without being limited to county boundaries. To do this, Tracking California recruited an advisory group of breast cancer advocates, clinicians, and public health practitioners to develop a mapping protocol that would identify geographic areas most impacted by breast cancer.
The analysis conducted using this mapping protocol yielded new information, identifying four areas of concern where invasive breast cancer was 10-20% higher than the state average during the time period of 2000-2008. The mapping protocol and results are outlined a report entitled California Breast Cancer Mapping Project: Identifying Areas of Concern in California.
Traditionally, reporting of breast cancer incidence rates is confined to the county level. The CBCMP was established to evaluate the utility of sub-county breast cancer mapping and to articulate guidelines for its implementation by convening an advisory group of breast cancer advocates, clinicians, and public health practitioners. Together with the advisory group, Tracking California aimed to develop a protocol to map invasive breast cancer rates that:
The CBCMP mapping protocol uses the Scan Statistic, a method developed during the mid-1990s by Martin Kulldorff and colleagues. The Scan Statistic is one of the most reviewed and analyzed statistical methods for depicting cancer geography. It was chosen as the cornerstone of the mapping protocol by the advisory group because of its ability to find true cancer elevations and exclude results due to random chance. The CBCMP protocol describes specific ways to implement the Scan Statistic, along with additional steps for screening out unreliable findings.
The CBCMP analysis was conducted using data from the California Cancer Registry describing the numbers of cases of invasive breast cancer among women by age, year of diagnosis, and census tract of residence at the time of diagnosis for the years 2000-2008. Population data (or denominators) and information about the populations in the Areas of Concern were taken from the 2000 and 2010 U.S. Census.
For more details on statistical methods, view the report and FAQs. For more details on the process to engaged the advisory group in the development of the mapping protocol, analysis, and results dissemination, view the manuscript.
This mapping protocol yielded new and intriguing information by identifying areas- no longer restricted by county boundaries- with elevated rates of invasive breast cancer. We identified four areas of concern where invasive breast cancer rates were 10-20% higher than the state average (and higher than most county rates) from 2000-2008, These areas included portions of counties previously unknown to have elevated breast cancer rates. The areas of concern were:
The CBCMP mapping protocol is a valuable supplement to other breast cancer surveillance methods currently used by public agencies. It can:
The CBCMP protocol maintains widely accepted standards of scientific rigor and protects patient confidentiality.
Tracking California convened an advisory group representing breast cancer advocates, clinicians, and public health agencies. Members are listed below. The advisory group was tasked with addressing the following questions:
The CBCMP advisory group played a vital role throughout the entire study process, from assessing and selecting the statistical approach used in the study to guiding the development of the report. To learn more about the thoughts on the project, view the report preface written by the CBCMP advisory group.
||American Cancer Society, California Division|
||UCSF Helen Diller Family Comprehensive Cancer Center|
||Zero Breast Cancer|
||Breast Cancer Action|
||Breast Cancer Fund|
||California Health Collaborative|
||National Disease Clusters Alliance and Concerned Residents Initiative|
||Latinas Contra Cancer|
||Alameda County Department of Public Health|
||Los Angeles County Public Health Department|
||Bayview Hunters Point Community Advocates and San Francisco Department of Public Health|
||Cancer Prevention Institute of California|
|Sora Park Tanjasiri
||California State University, Fullerton|
Many government programs collect or provide breast cancer data. Additional public resources include the following:
The CBCMP was funded by the California Breast Cancer Research Program of the University of California.