Priority-Setting Data: California Specific Program Goal 06/20/14 - PowerPoint PPT Presentation

Priority-Setting Data: California Specific Program Goal 06/20/14

Overview of 2015 Priority-Setting Process 1. Review the CBCRP mission statement and reaffirm the program’s foundation of long-term outcomes. 2. Review and revise the priority criteria and generate data collection questions. 3. Gather and analyze pertinent data as indicated by the priority criteria and data collection questions. 4. Identify and make decisions on long-term (5 years) priorities through a data-driven, group decision-making process. 5. Incorporate priority decisions into CBCRP operational plans and award cycles.

Timeline for the 2015 Priority-Setting Process 6/13 10/13 1/14 4/14 6/14 9/14 12/14 3/15 Responsive X Translation X Capacity Building X X Public Health Outcomes X Disparities California Specific X Innovation X Collaboration X Non-Duplicative X Policy X Decision-making Retreat X

Program Goal • Program Goal for California Specific: fund research that utilizes resources particular to California and/or addresses a breast cancer need that is specific but not necessarily unique to the burden of breast cancer in California

What do we Mean by California Specific? • Investigates populations that are rare in other parts of the country or take advantage of the diversity of California; • Addresses policies specific to California and/or health care systems in California; • Addresses topics of particular interest to Californians; and/or • Utilizes unique CA resources (e.g. cohorts)

Information Questions Question 1. What is the current burden of breast cancer in California? Question 2. What are the current gaps and opportunities in disparities research, prevention research, and environmental links to breast cancer, with a particular emphasis on CA specific research and opportunities? Question 3. What investment has the Program made in CA specific research? Question 4 Specifically, what role has the SRI/CBCPI set aside had in CBCRP's investment in California-specific research?

Question 1: BURDEN OF BREAST CANCER IN CA

CCR Basic Statistics • Incidence & Mortality Rates Female Breast Cancer – Statewide w/ considerat ions • Race/Ethnicity – Non Hispanic White [NHW] – Non Hispanic Black [Black] – Hispanic [HISP] – Asian/Pacific Islander [API] – American Indian/Alaskan Native [AI/AN] [*Misclassifcation] • County of residence at time of diagnosis • Stage at time of diagnosis (SEER Summary Stage) • Urban/Rural categorization (County Level)

CCR Basic Statistics • Population Data Sources: – California Cancer Registry (CCR) published reports varying years – NCI SEERStat TM Data Files • SEER 18 Registry File 2000-2011, November 2013 Submission • American Community Health Survey 2010 (County Level Attributes) • Rural Urban Commuter Codes 2013 (County Level) • NCHS Mortality Data, Aggregated by NCI into 3-5 Yr Periods – CCR on-line Query System (2007-2011, October 2013) • Age-Adjusted Rates (AAR) per 100,000 – Calculated 2000 Std U.S. Population • Descriptive statistics – Females only, malignant cases (except as stated) – Majority rates presented for 2007-2011 (except as stated) – Stage (SEER Summary Stage 2000)

Overall CA Breast Cancer Incidence Rates, 2007-2011 160 Invasive 141.5 140 Age Adjusted Incidence Rate per 100000 In Situ 127.7 122.4 120 100 93.2 91.8 80 60 40 33.3 29.1 28.7 28.7 19.8 20 0 Non Hispanic Non Hispanic Hispanic Asian Pacific All Races White Black Islander Combined Calculated from NCI SEERStat SEER 18 Registries w/ Katrina Correction, November 2013 Submission

Overall CA Incidence & Mortality Age Adjusted Rate, 2007-2011: Age & Race/Ethnicity < Age 50 Age 50+ Total Incidence Incidence Incidence Mortality NH White 47.2 388.5 141.5 23.4 Black 127.7 33.2 43.3 348.5 Hispanic 33.3 250.1 93.2 17.0 Asian/PI 91.8 13.2 39.4 229.1 AI/AN* 9.9 112.6 38.3 * All Races 122.4 21.4 40.8 335.9 Combined Age adjusted incidence rate per 100,000 (2000 U.S. Std Population) *AI/AN identification via medical record considered misreported (no other AI/AN rates reported in following slides). Calculated from NCI SEERStat, SEER 18 Registry File w/ Katrina Correction, November 2013 Submission

Overall CA Incidence Age Adjusted Rate, 1988-2010: Trends by Race/Ethnicity 160.0 140.0 AAR per 100,000 NHW 120.0 Black Hispanic API 100.0 80.0 60.0 Extracted from CCR annual rate data at http://www.ccrcal.org/pdf/AnnualReport/1988-2010_BREAST.pdf

Overall CA Mortality Age Adjusted Rate, 1988-2010: Trends by Race/Ethnicity 45.0 40.0 35.0 30.0 AAR per 100,000 25.0 20.0 15.0 10.0 NHW Black 5.0 Hispanic API 0.0 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Extracted from CCR annual rate data at http://www.ccrcal.org/pdf/AnnualReport/1988-2010_BREAST.pdf

Overall CA Invasive Incidence 2007-2011: Geography (County), All Races Combined

Overall CA Mortality AAR 2007-2011: Geography (County), All Races Combined

Overall CA Invasive Incidence AAR 2007-2011: Geography (County), by Race/Ethnicity: NHW

Overall CA Invasive Incidence AAR 2007-2010: Geography (County), by Race/Ethnicity, NH Black

Overall CA Invasive Incidence AAR 2007-2010: Geography (County), by Race/Ethnicity, Hispanic

Overall CA Invasive Incidence AAR 2007-2010: Geography (County), by Race/Ethnicity, API

Percent of CA Cancer Cases, 2007-2011: by Summary Stage & Age Group 0% 20% 40% 60% 80% 100% 65+ 45-64 20-44 In Situ Local Reg Distant Unk Calculated from NCI SEERStat SEER 18 Registries w/ Katrina Correction, November 2013 Submission

Percent of CA Cancer Cases, 2007-2011: by Summary Stage & Race/Ethnicity 0% 20% 40% 60% 80% 100% NHW Black Hispanic API In Situ Local Reg Distant Unk Calculated from NCI SEERStat SEER 18 Registries w/ Katrina Correction, November 2013 Submission

Overall CA Incidence AAR 2007-2011: Summary Stage at Dx & Race/Ethnicity 100 90 Age Adjusted Incidence Rate per 100,000 80 70 60 50 40 30 20 10 0 NH White Black Hispanic Asian/PI Total In Situ Localized Regional (Ext +/or LN) Distant Unstaged Calculated from NCI SEERStat SEER 18 Registries w/ Katrina Correction, November 2013 Submission

Overall CA Incidence AAR 2007-2011: Summary Stage at Dx & Race/Ethnicity Regional In Situ Localized (Ext +/or Distant Unstaged LN) NH White 33.3 91.2 41.5 6.6 2.2 Black 28.7 71.3 44.0 9.9 2.9 Hispanic 19.8 53.6 32.3 5.6 2.0 Asian/PI 28.7 27.2 4.2 1.5 59.2 All Races 29.1 76.8 37.2 6.2 2.3 Combined Calculated from NCI SEERStat SEER 18 Registries w/ Katrina Correction, November 2013 Submission

Overall CA Incidence Age Adjusted Rate, 2000-2011: Trends by Race/Ethnicity, Advanced Stage, Ages 50+ 160 140 AAR per 100,000 120 100 80 60 NHW Black Hispanic API 40 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 NCI SEERStat data available statewide for California with cases diagnosed as of 1/1/2000 Calculated from NCI SEERStat SEER 18 Registries w/ Katrina Correction, November 2013 Submission

Overall Incidence AAR 2005-2009: Age 20+ Years Advanced Stage at Dx & Geography (MSSA) “Late Stage” : Summary Stage Regional/Distant MSSA = Medical Service Study Area Morris CR, et al. Cancer Stage at Diagnosis, 2013. Sacramento, CA: California Department of Public Health, California Cancer Registry, June 2013.

Overall CA Incidence AAR 2007-2011: Urban/Rural (County) 130 125.7 124.1 125 122.6 121 120.8 120.7 120 AAR per 100,000 115 110 108.1 105 100 95 Metro >1M Metro>250K Metro <250K Urban 2.5- Urban 2.5- Rural <2.5K Urban>20K 20K Adj 20K Calculated from NCI SEERStat SEER 18 Registry w/ Katrina Correction, November 2013 Urban/Rural: Counties aggregated per 2013 RUCA codes w/ ‘Adj’ = adjacent to ‘Metro’ area

Overall CA Incidence AAR 2007-2011: Summary Stage at Dx & Urban/Rural (County) 90 Metro >1M 80 Metro>250K 70 Metro <250K 60 AAR per 100,000 Urban>20K Urban 2.5-20K Adj 50 Urban 2.5-20K 40 Rural <2.5K 30 20 10 * 0 In Situ Local Reg Distant Unk Calculated from NCI SEERStat SEER 18 Registry w/ Katrina Correction, November 2013 Urban/Rural: Counties aggregated per 2013 RUCA codes w/ ‘Adj’ = adjacent to ‘Metro’ area

Overall CA Incidence AAR 2007-2011: Race/Ethnicity & Urban/Rural (County) 60 53.9 53.8 NHW Hisp 49.3 50 46.8 46.3 45.5 45.0 41.1 41.4 39.4 39.2 40 37.3 37.6 AAR per 100,000 30 20 10 * 0 Metro >1M Metro>250K Metro <250K Urban 2.5-20K Adj Rural <2.5K Urban>20K Urban 2.5-20K Calculated from NCI SEERStat SEER 18 Registries w/ Katrina Correction, November 2013 Submission Urban/Rural: Counties aggregated per RUCA codes w/ ‘Adj’ = adjacent to ‘Metro’ area

Overall CA Incidence AAR 2007-2011: Socioeconomic Status (County: Household Median) 180 162.5 160 147.3 139.1 134.7 140 AAR per 100,000 120 100 80 60 40 20 0 <$44,000 $44-$50,099 $50.1-$64,000 >$64,000 Calculated from NCI SEERStat SEER 18 Registries w/ Katrina Correction, November 2013 Submission SES: Median Household Income at County Level, Quartiles derived from NCI SEERStat County Attributes File, American Community Health Survey 2010