Abstract
Despite available demographic data on the factors that contribute to breast cancer mortality in large population datasets, local patterns are often overlooked. Such local information could provide a valuable metric by which regional community health resources can be allocated to reduce breast cancer mortality. We used national and statewide datasets to assess geographical distribution of breast cancer mortality rates and known risk factors influencing breast cancer mortality in middle Tennessee. Each county in middle Tennessee, and each ZIP code within metropolitan Davidson County, was scored for risk factor prevalence and assigned quartile scores that were used as a metric to identify geographic areas of need. While breast cancer mortality often correlated with age and incidence, geographic areas were identified in which breast cancer mortality rates did not correlate with age and incidence, but correlated with additional risk factors, such as mammography screening and socioeconomic status. Geographical variability in specific risk factors was evident, demonstrating the utility of this approach to identify local areas of risk. This method revealed local patterns in breast cancer mortality that might otherwise be overlooked in a more broadly based analysis. Our data suggest that understanding the geographic distribution of breast cancer mortality, and the distribution of risk factors that contribute to breast cancer mortality, will not only identify communities with the greatest need of support, but will identify the types of resources that would provide the most benefit to reduce breast cancer mortality in the community.
Highlights
Despite advances in breast cancer prevention, early detection, and treatment, not all segments of the population benefit from these gains
We demonstrate through our study that analyses of known risk factors can be undertaken with existing data to map potential targets for intervention, which could serve as a model for community health resource allocation
Because a primary focus of this study was to define a method with which to identify communities that will benefit from additional resources, we examined breast cancer incidence rates for each county, ranking each county into quartiles based on the breast cancer incidence per 100,000 women
Summary
Despite advances in breast cancer prevention, early detection, and treatment, not all segments of the population benefit from these gains. Patients lacking health insurance have higher breast cancer mortality rates than other populations [1,2,3]. To reduce breast cancer mortality in all segments of the population, it is necessary to define the populations in greatest need of additional interventions and to characterize disparities in underlying risk factors within that population that contribute to increased mortality. Once this information is in place, specific resources can be targeted toward the modifiable risk and mortality factors in a community-specific fashion, thereby increasing the likelihood of a beneficial outcome for the population as a whole
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