Totally Joined for Achieving Collaborative Techniques, Atlanta, GA 30303, USA.
Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA 30303, USA.
Int J Environ Res Public Health. 2024 Feb 7;21(2):188. doi: 10.3390/ijerph21020188.
Alignment of National Breast and Cervical Cancer Early Detection Program (NBCCEDP) clinical services with the spatial distribution of breast and cervical cancer burden is essential to maximizing programmatic impact and addressing cancer disparities. This study identified spatial clustering of breast and cervical cancer burden scores and assessed whether and to what extent NBCCEDP clinical services were associated with clusters for the 5-year period, 2015-2019.
We examined burden scores for spatial clustering using Local Indicators of Spatial Association (LISA) tests in GeoDA. We then used -tests to compare the NBCCEDP 5-year average percentage of eligible women served clinical breast and cervical cancer services between hotspot (high burden) and coolspot clusters.
There was statistically significant spatial clustering in the pattern of breast and cervical cancer burden scores across counties, with hotspot clusters mostly observed in the Southern region, Idaho and Nevada. For both breast and cervical cancer, higher percentages of eligible women received breast and cervical cancer clinical services in coolspot clusters compared to hotspot clusters during each year from 2015-2019.
NBCCEDP clinical services can help reduce breast and cervical cancer burden. Yet, during 2015-2019, increased service delivery was not aligned with the spatial distribution of counties with greater breast and cervical cancer burdens. NBCCEDP recipients may improve their impact on breast and cervical cancer burden by prioritizing and consistently increasing service delivery in cancer burden hotspot clusters if they have not already maximized their resources in these areas.
使国家乳腺癌和宫颈癌早期检测计划（NBCCEDP）的临床服务与乳腺癌和宫颈癌负担的空间分布保持一致，对于最大限度地发挥项目影响和解决癌症差异至关重要。本研究确定了乳腺癌和宫颈癌负担评分的空间聚类，并评估了在 2015-2019 年的 5 年期间，NBCCEDP 临床服务是否以及在何种程度上与聚类相关。
我们使用 GeoDA 中的局部空间关联指标（LISA）检验来检查负担评分的空间聚类。然后，我们使用 t 检验比较了在热点（高负担）和冷点聚类中，NBCCEDP 在 5 年内为符合条件的女性提供的服务的临床乳腺癌和宫颈癌服务的百分比。
在各县的乳腺癌和宫颈癌负担评分模式中存在统计学上显著的空间聚类，热点聚类主要分布在南部地区、爱达荷州和内华达州。对于乳腺癌和宫颈癌，在 2015-2019 年的每一年，冷点聚类中符合条件的女性接受乳腺癌和宫颈癌临床服务的比例均高于热点聚类。
NBCCEDP 临床服务可以帮助减轻乳腺癌和宫颈癌的负担。然而，在 2015-2019 年期间，服务提供的增加并没有与乳腺癌和宫颈癌负担较大的县的空间分布保持一致。如果 NBCCEDP 受助人尚未在这些地区充分利用其资源，则通过优先考虑和持续增加在癌症负担热点聚类中的服务提供，他们可以提高其对乳腺癌和宫颈癌负担的影响。
