Cancer Mapping: Making Spatial Models Work for Communities
| Institution: | Public Health Institute | ||
| Investigator(s): |
Eric Roberts , M.D., Ph.D. -
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| Award Cycle: | 2009 (Cycle 15) | Grant #: 15UB-8405 | Award: $349,225 |
| Award Type: | SRI Request for Proposal (RFP) | ||
| Research Priorities | |||
| Prevention & Risk Reduction>The intersection of environment and disparities | |||
Initial Award Abstract (2009)
Diseases such as breast cancer do not strike all members of society equally; for many illnesses, the burdens of disease fall disproportionately on those with the fewest resources. Disease mapping is an effective way to communicate disparities, providing vital information for health and environmental advocates and practitioners. Although public demand is acute for cancer mapping that shows rates for small areas (e.g. census tracts), state and local governments have been unable to meet this need due to statistical issues and confidentiality problems.
Recent developments in statistics and computer power have made possible census tract-level disease maps that provide useful information for communities. In general, methods have been developed by statisticians who have little contact with clinicians, communities, local governments, or advocates. However, input from these stakeholders is essential to adapting these methods for practical use. To create a protocol for mapping breast cancer in a large, diverse state such as California, we will convene an Advisory Group (AG) of collaborators with diverse backgrounds and a multi-disciplinary project team to develop and refine a broadly applicable mapping protocol to help locate vulnerable communities, understand demographic risk factors, target prevention/intervention efforts, and generate hypotheses about breast cancer.
Questions: The research questions for this project fall into three overlapping areas.
1. THE GEOGRAPHY OF INVASIVE BREAST CANCER IN CALIFORNIA: Can we geographically define communities that face heightened vulnerability to invasive breast cancer? Is risk related to issues of social class or segregation?
2. IMPLEMENTATION OF STATISTICAL METHODS: How can we adapt the work of statistical researchers to the needs delineated by our AG in order to carry out mapping?
3. COMMUNICATION AND UTILITY FOR TRANSLATION: How do stakeholders work through issues related to the uncertainty around detecting “clusters” of disease? How should results be communicated? How to use maps in communication, advocacy, and public health action?
Methods: The technical staff will begin by working with “simulated data” to determine what kinds of disease patterns (in terms of geographic size, shape, and degree of risk) the methods can locate. This information will be crucial for the AG to make decisions about how the methods should be used. During this time, the health educator will work with the AG to identify group learning objectives and capacity building necessary for decision-making. Key technical decisions regarding the mapping protocol must be directly informed by AG values and preferences. The AG will also help staff to develop supporting material so that advocates, communities, government, and other stakeholders can interpret breast cancer maps. Finally, we will produce statewide, annualized maps showing areas of California with elevated risk of breast cancer.
Community Involvement and Advocacy Concerns: This project takes advantage of the interdisciplinary teams of the California Environmental Health Tracking Program and the California Cancer Registry to engage scientific, advocacy and other stakeholders together to maximize the potential utility of breast cancer mapping. The AG will be engaged in determining key decisions in developing the maps, interpreting results, and communicating and disseminating the maps and related findings. This process ensures that diverse issues of concern and ideas of breast cancer advocates and a variety of other stakeholders are well represented and guide the project.
