Abstract
Background and Aims: California is home to an engaged network of breast cancer stakeholders that need sub-county data to identify and support at-risk communities. Cancer registries are requested to produce maps depicting sub-county breast cancer incidence data, but reliance on traditional statistical tools confines them to producing county-level maps. The California Breast Cancer Mapping Project was formed to develop a protocol for mapping breast cancer rates in a manner that is useful to breast cancer stakeholders. Methods: We convened an Advisory Group (AG) of breast cancer stakeholders to elicit priorities, and characteristics for a proactive sub-county breast cancer mapping protocol. Strategies for facilitating transparent, informed, and productive decision-making included trainings to establish common vocabulary; web tools for hands-on demonstration of statistical methods; discussions to translate AG priorities into a mapping protocol and communication products; flexibility to redirect project goals; and staff commitment to prioritize and incorporate AG input. Results and Conclusions: The AG identified a protocol which was applied to nine years of data describing invasive breast cancer in California. Priorities included avoiding false positive findings, maintaining scientific credibility, and including demographic and clinical characteristics. The resulting protocol successfully identified unknown areas with elevated breast cancer risk in California irrespective of county boundaries. With AG guidance, we developed and disseminated communication materials describing the mapping results. The results and communication products will aid stakeholders to identify vulnerable communities, target resources and services, and ground discussions about social and environmental contributions to breast cancer with reliable geographic data.
Published Version
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