A Novel Approach for Conducting a Catchment Area Analysis of Breast Cancer by Age and Stage for a Community Cancer Center.

Abstract

The U.S. Preventive Services Task Force recently issued an updated draft recommendation statement to initiate breast cancer (BC) screening at age 40, reflecting well-documented disparities in BC mortality that disproportionately impact younger Black women. This study applied a novel approach to identify hotspots of BC diagnosed before age 50 and/or at an advanced stage to improve BC detection within these communities. Cancer registry data for 3,497 women with invasive BC diagnosed or treated between 2012 and 2020 at the Helen F. Graham Cancer Center & Research Institute (HFGCCRI) and who resided in the HFGCCRI catchment area, defined as New Castly County, Delaware, were geocoded and analyzed with spatial intensity. Standardized incidence ratios stratified by age and race were calculated for each hotspot. Four hotspots were identified, two for BC diagnosed before age 50, one for advanced BC, and one for advanced BC diagnosed before age 50. Younger Black women were overrepresented in these hotspots relative to the full catchment area. The novel use of spatial methods to analyze a community cancer center catchment area identified geographic areas with higher rates of BC with poor prognostic factors and evidence that these areas made an outsized contribution to racial disparities in BC. Identifiying and prioritizing hotspot BC communities for community outreach and engagement activities designed to improve BC detection has the potential to reduce the overall burden of BC and narrow racial disparities in BC.