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Table 1: MSSAs With a Significantly Elevated Percentage of Advanced Stage Breast Cancer

MSSA Medical Service Study Area.MSSAs are the defined geographic analysis unit for the California Office of Statewide Health Planning and Development.MSSAs are aggregations of census tracts that make up "rational service areas" for primary health care and are used to identify medically underserved areas.

 

 

MSSA ID

Medical Service Study Area of residence at diagnosis.The MSSA numbers on the tables correspond to numbers on the accompanying maps. A list of census tracts within each MSSA is available from CCR on request.

 

 

MSSA Description

The listing of the community names for the neighborhoods within each MSSA ID.

 

 

% Advanced Stage

The percentage of advanced stage tumors diagnosed in women 40 years old and older in the MSSA during the five-year period 1999-2003.   It is calculated by dividing the observed number of advanced stage breast cancers by the total number of breast cancers, and multiplying by 100.

 

 

Total Cases

The total number of breast cancers (in situ and invasive) diagnosed among women 40 years old and older in the MSSA during the five-year period 1999-2003.

 

 

Advanced Observed

The number of breast cancers which were diagnosed as advanced stage tumors among women 40 years old and older in the MSSA during the five-year period."Advanced stage" tumors are defined as those which have extended beyond the breast itself (i.e., to lymph nodes, surrounding tissues, or to other parts of the body) or for which stage is unknown.

 

 

Advanced Expected

The number of breast cancers one would expect to have been diagnosed as advanced stage tumors if women in this MSSA had the same proportion of advanced stage breast cancers as non-Hispanic white women from the highest quintile for socioeconomic status (SES) in the State during the same five-year period.SES status was ascertained using census indicators of income, employment and education for the block group of residence at diagnosis.The expected number of advanced stage tumors is calculated by multiplying the age-specific (40-49, 50-59, 60-69, 70-79, and 80+ years) proportion of advanced stage tumors in the comparison group by the number of breast cancers diagnosed in the MSSA in each of the same age groups, and summing to obtain the expected number for all age groups combined.

 

 

Excess Advanced

The difference between the observed and expected number of advanced stage tumors.  A positive number indicates the number of tumors that would have been diagnosed as early-stage rather then advanced-stage tumors had the women in this MSSA experienced the same proportion of advanced stage tumors as women in the comparison group. This assumes screening did not increase the overall cancer incidence rate in the 1999-2003 time period.A negative number indicates that fewer advanced stage tumors were diagnosed than one would expect.

 

 

PIR

The proportional incidence ratio, calculated by dividing the observed number of advanced stage breast cancers by the expected number, and multiplying by 100.A PIR which is larger than 100 indicates that a lower proportion of cancer was diagnosed at late stage than in the comparison group.For example, a PIR of 120 can be interpreted as "Examining the cancer of women 40 years old and older, about 20 percent more breast cancers were diagnosed as advanced stage tumors in this MSSA than one would have expected if these breast cancer cases had the same proportion of advanced stage tumors as non-Hispanic white women of the same age living in upper-income neighborhoods throughout the State."Analyses were only conducted if there were at least 15 breast cancers in the MSSA of interest during the five-year period.

 

 

99% C.I.

The 99 percent confidence interval around the PIR.A 99% C.I. which includes 100 (for example, 91.1 - 139.4) indicates that the PIR is not statistically significant; that is, the degree to which the PIR is above or below 100 could have occurred by chance.The confidence interval is influenced by both the total number of cases and the magnitude of the difference; therefore, PIRs with the same value may have different confidence intervals.

 

 

2000 Pop.

The population of the MSSA from the 2000 United States Census.

 

 

POV100

The percent of the population in the MSSA living below the federal poverty level in 2000, from the United States 2000 Census.

 

 

POV200

The percent of the population in the MSSA living below 200 percent of the federal poverty level in 2000, from the United States 2000 Census.

 

 

Race (%) - White

The percent of the population in the MSSA that identifies itself as white in 2000, from the United States 2000 Census.

 

 

Race (%) - Black

The percent of the population in the MSSA that identifies itself as black in 2000, from the United States 2000 Census.

 

 

Race (%) - Asian/PI

The percent of the population in the MSSA that identifies itself as Asian or Pacific Islander in 2000, from the 2000 Census.

 

 

Race (%) - Am. Ind.

The percent of the population in the MSSA that identifies itself as American Indian in 2000, from the 2000 Census.

 

 

Race (%) - Other/Multi

The percent of the population in the MSSA that identifies itself as either being a race other than white, black, Asian, Pacific Islander or American Indian or as being a combination of any of the five race categories in 2000, from the United States 2000 Census.

 

 

Hispanic Ethnicity

The percent of the population in the MSSA that identifies itself as being of Hispanic ethnicity in 2000, from the United States 2000 Census.