Identifying Breast and Cervical Cancer Burden by County

Pennsylvania Cancer Registry

The Healthy Woman Program approached statistical analysts in the Bureau of Health Statistics and Research, where the cancer registry resides, and asked our staff to create a better way to identify the breast and cervical cancer burden in our state by county. These burden measurements could be used to drive program decisions.

A major component of this burden index uses cancer incidence, late stage, and mortality data from the Pennsylvania Cancer Registry. They chose these components because the cancer prevention and control program logically identified death by cancer as the largest public health problem for their program. Also, since cancer is much more treatable if found in early stages, late stage was identified as the second most important factor. These two variables received the largest weights of any of the data in the burden index calculations. Incidence data was included because even if the program could have an effect on cancer deaths and late stage, they still need to address areas with a greater rate of cancer incidence.

As the saying goes, "good data lead to good decisions." We are fortunate to have high-quality data that are complete, timely, and constantly improving. Without the cancer registry data, the program would have to make decisions based on general population counts or general demographics that are only suspected of having a larger cancer burden. With the cancer registry data, we can prove where, and with whom, the cancer burden lies.

In the past, the Healthy Woman Program's screening and funding allocations were driven partially by politics and a dated methodology that focused on population demographics instead of cancer registry data. Quality cancer registry data and a sound statistical methodology allow the program to target the areas of our state that have the greatest breast and cervical cancer burden, giving the program more leverage against political influence. The methodology allows funds to be distributed logically and equitably to address cancer problems in areas with the greatest need.

In the future, the cancer prevention and control program plans to require vendors to use the Department's calculated county screening allotments based on the breast and cervical cancer burden index, which uses Pennsylvania Cancer Registry data as a major component.