Inclusion of Evidence-Based Breast Cancer Control Recommendations and Guidelines in State Comprehensive Cancer Control Plans

Abstract

Introduction Each US state, territory, and tribe/tribal organization is supported by the Centers for Disease Control and Prevention to develop and implement a comprehensive cancer control (CCC) plan. The objective of this study was to inform areas for improvement of those plans. Methods To show how CCC plans can be improved, we used the example of breast cancer, which has a long public health history and an established, broad spectrum of prevention and control activities. We evaluated the inclusion of evidence-based breast cancer prevention topics as provided by guidelines from the Centers for Disease Control and Prevention (CDC) and recommendations of the US Preventive Services Task Force (USPSTF) in each state’s CCC plan. From January through March 2019, we downloaded CCC plans from each state and the District of Columbia and abstracted and quantified the content of plans for 1) discussion of data on breast cancer mortality, breast cancer incidence, uptake of mammography; 2) statement of objective to reduce the burden of breast cancer; and 3) review of CDC guidelines and USPSTF recommendations. Results The discussion of breast cancer–relevant topics and specification of objectives was incomplete. Of 51 plans, data on breast cancer mortality and incidence and uptake of mammography were reported in 53% (n = 27) to 76% (n = 39) of plans. CDC and USPSTF recommendations for breast cancer–specific interventions were discussed in only 6% (n = 3) to 37% (n = 19) of plans. Discussion of general cancer prevention topics relevant to breast cancer ranged from 10% (n = 5) to 61% (n = 31) of plans. Conclusion Our findings inform areas for quality improvement of state CCC plans and may contribute to other areas of public health planning.

Inclusion of the US Preventive Services Task Force Recommendation for Mammography in State Comprehensive Cancer Control Plans in the US

“…The CDC expects state CCC plans to stay up to date with current recommendations, 2 although, in practice, the periodicity of plan updates may preclude inclusion of the most current recommendations. 14 …”

Success Rates for the Objectives of US State Cancer Control Plans: A First Look

“… 13 The second was a study that found that breast cancer objectives that had a measurable baseline and target in US state plans for incidence, mortality, and mammogram prevalence were at 2%, 21%, and 79%, respectively. 14 The third was a study that found that South Carolina’s cancer control plan had 33% of objectives that were clear and measurable, 38% that were not met, 38% that were partially met, and 24% that were met fully. 15 Apart from those three articles, I was unable to locate any further research on cancer control objective success rates.…”

Cancer Screening Prevalence and Associated Factors Among US Adults

“…Haverkamp and colleagues mailed a fecal immunochemical test (FIT) to the eligible population served by 3 health care facilities in Arizona operated by American Indian tribes. They found that direct mail to eligible tribe members with instructions and a follow-up telephone call and/or home visit improved the screening compliance rate significantly (32) (31). The inclusion of evidence-based interventions in cancer control plans is an area for improvement.…”