Geographically-based cancer control: Methods for targeting and evaluating the impact of screening interventions on defined populations Journal Article
| Authors: | Kerner, J. F.; Andrews, H.; Zauber, A.; Struening, E. |
| Article Title: | Geographically-based cancer control: Methods for targeting and evaluating the impact of screening interventions on defined populations |
| Abstract: | Successful implementation of cancer control programs depends on efficient targeting to those at highest risk of developing and dying from the disease. This study presents a methodology for targeting cancer screening on the basis of population and disease variation among small geographic areas. Techniques for quantifying the impact of targeting on the predictive value of a positive test are demonstrated, using 329 New York City health areas. Age-truncated crude incidence, late-stage incidence and mortality rates for breast, cervix, and colorectal cancer are used, using site-specific truncation points relevant to the age groups appropriate for screening. Coefficient alpha was used to determine rate stability with 2, 3, 5 and 7 years of data. The stability of most small area rates was found to reach acceptable levels only with 5 and 7 years of data. Targeting into areas where breast cancer prevalence was high increased the expected predictive value of a positive test by as much as 50% when compared with areas of average prevalence. Geographic targeting will be most useful where between-area variability in prevalence is large and within-area variability is small. The implications of these results are discussed and future studies are suggested. © 1988. |
| Keywords: | adult; major clinical study; comparative study; cancer incidence; organization and management; neoplasms; colorectal cancer; breast cancer; statistics; colonic neoplasms; risk factors; cancer screening; age factors; breast neoplasms; cancer mortality; time factors; uterine cervix cancer; epidemiologic methods; predictive value of tests; new york city; cancer control; evaluation studies; rectal neoplasms; economic aspect; middle age; community health services; cervix neoplasms; human; male; female; priority journal; support, non-u.s. gov't; support, u.s. gov't, p.h.s.; small area variation |
| Journal Title: | Journal of Clinical Epidemiology |
| Volume: | 41 |
| Issue: | 6 |
| ISSN: | 0895-4356 |
| Publisher: | Elsevier Inc. |
| Date Published: | 1988-01-01 |
| Start Page: | 543 |
| End Page: | 553 |
| Language: | English |
| DOI: | 10.1016/0895-4356(88)90058-3 |
| PUBMED: | 3385456 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Source: Scopus |
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