Building a community cancer registry: An effective call to clinical and policy intervention for reducing racial disparity in breast cancer mortality in Memphis, TN

Background

Funds from the Avon Foundation were provided in support of research into the black-white breast cancer mortality disparity in Memphis, TN. 

Objective/Purpose

The primary goal of this Avon planning grant was to determine the key issues and barriers to enabling women of color to access timely screening and care.  A cancer registry designed to provide the baseline data needed to perform analytics regarding the disparity and its reduction was created.

Methods

The Avon planning grant funded the creation of a community cancer registry.  The registry was developed in conjunction with the University of Tennessee Health Science Center’s Office of Biomedical Informatics.   The effort provided a secure and web-accessible analytics environment linked to encrypted databases. This HIPAA compliant data management system allowed the creation of a registry of 165 variables containing approximately 7 million data points representing more than 500,000 patients.

Results

The time between diagnosis to initial treatment in days by race was analyzed and indicated the difference, in terms of days between diagnosis and treatment, between Non-Hispanic Black (NHB) and Non-Hispanic White (NHW) women is significant at the 95% confidence level (p-value = .0142).  A secondary finding was that the proportion of NHB women under 40 with stage III or IV cancer is significantly higher than the respective proportion of NHW women (p-value = .006). However, screening guidelines do not promote early detection among women under 40 years of age.

Discussion/Conclusions

With the development of a robust registry, we are now in a position to answer process improvement questions and develop interventions that may reduce disparity in breast cancer mortality within the Methodist Healthcare system and our service area within Memphis and Shelby County, Tennessee.