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Statisticians Join in on Fight Against Cancer

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Last month was National Breast Cancer Awareness Month, and many people may not realize the role Census Bureau statistics play in the National Breast and Cervical Cancer Early Detection Program (NBCCEDP).

Created by the Centers for Disease Control and Prevention (CDC) through congressional mandate, the program provides funds to all 50 states and the District of Columbia, five U.S. territories, and 11 tribal organizations to improve access to screening and diagnostic services. The goal of this program is to reduce breast and cervical cancer mortality among low income, uninsured or underinsured women.

In order for the CDC program to effectively implement and evaluate the program, the CDC partially sponsors the Small Area Health Insurance Estimates (SAHIE) program. SAHIE provide county and state statistics on the uninsured by age, sex, income, and race and ethnicity. SAHIE are the only source of single-year health insurance coverage estimates for all U.S. counties.

To provide these estimates, the SAHIE program models health insurance coverage by combining American Community Survey statistics with auxiliary data sources, including administrative records. SAHIE are consistent with the corresponding American Community Survey statistics, but the modeling methods allow for the release of estimates at a finer detail than would be possible with the survey statistics alone.

The map below uses data from the 2014 SAHIE to display the uninsured rate for women ages 40 to 64 living at or below 250 percent of poverty. The areas with darker shades have higher uninsured rates, and the areas with lighter shades have lower uninsured rates.

The SAHIE program provides estimates on the women eligible for the NBCCEDP, which are then combined with data collected by the NBCCEDP grantees on all women participating in the program to form estimated participation rates of cancer screening services. This information is crucial because it provides the CDC and grantee-administrators with the capability to develop resource allocation strategies using data not previously available, and with the ability to monitor screening progress below the state level.

Since 2004, the partnership between the Census Bureau and CDC has been a model of successful interagency collaboration [PDF <1.0 MB]. This collaboration provides a great example for harnessing survey and administrative data to support and improve program operations to better serve the needs of the American public.

The value of the NBCCEDP is measured not only by the number of those screened but also by the potential number of lives extended or saved by early detection. Since the program’s implementation, 4.9 million uninsured or underinsured women have received more than 12 million breast and cervical cancer screenings resulting in the diagnosis of more than 70,997 breast cancers, 3,845 invasive cervical cancers, and 175,688 premalignant cervical lesions.

Further discussion about the use of SAHIE in estimating the number of women eligible for breast and cervical screening through the NBCCEDP is available in a special issue of Cancer Causes and Control published in 2015. Additional information about the SAHIE program can be found at <www.census.gov>.

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