Purpose To determine the proportional distribution of early- and late-stage breast cancers diagnosed in years 2004–2009 among women enrolled in the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) and to compare this distribution to that of geographically comparable non-enrolled women diagnosed with breast cancer. Methods Using data from the National Program of Cancer Registries, we compared the demographic characteristics and cancer stage distribution of women enrollees and non-enrollees by use of conditional logistic regression using the odds ratio as a measure of association. Results NBCCEDP enrollees were slightly younger and more likely to identify as African-American, API and AIAN than were non-enrollees. The proportion of late-stage breast cancer (regional and distant) decreased slightly over the study period. NBCCEDP enrollees generally were diagnosed at a later stage of breast cancer than were those not enrolled in the NBCCEDP. Conclusions The NBCCEDP has been effective in achieving its goal of enrolling racial and ethnic populations; however, enrollees had a poorer stage distribution of breast cancer than did non-enrollees underscoring the need to expand breast cancer control efforts among low-income, underserved populations.

Objectives: To provide a population-based description of the anatomic distribution of melanoma among non-Hispanic black patients and to explore how characteristics of this distribution relate to the etiologies previously reported for both white and black patients.

Cancer cluster investigations rarely receive significant public health resource allocations due to numerous inherent challenges and the limited success of past efforts. In 2008, a cluster of polycythemia vera, a rare blood cancer with unknown etiology, was identified in northeast Pennsylvania. A multidisciplinary group of federal and state agencies, academic institutions, and local healthcare providers subsequently developed a multifaceted research portfolio designed to better understand the cause of the cluster. This research agenda represents a unique and important opportunity to demonstrate that cancer cluster investigations can produce desirable public health and scientific outcomes when necessary resources are available.

Context The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides cancer screening to low income, un- and underinsured women through over 11,000 primary care clinics. The program is well-positioned to work with health systems to implement evidence-based interventions (EBIs) to increase screening among all women. Objective To collect baseline data on EBI use, evaluation of EBIs, and related training needs among NBCCEDP grantees. Design CDC conducted a web-based survey in late 2013 among NBCCEDP grantees for the period July 2012-June 2013. This was the first systematic assessment of EBIs among NBCCEDP grantees. Setting CDC’s National Breast and Cervical Cancer Early Detection Program Participants Primarily program directors/coordinators for all 67 NBCCEDP grantees. Main Outcome Measures Data captured were used to assess implementation of five EBIs, their evaluation, and related training needs. Frequencies and proportions were determined. Cluster analysis identified grantees with similar patterns of EBI use for NBCCEDP clients and providers. Results On average, 4.1 of 5 EBIs were implemented per grantee for NBCCEDP clients and providers. Four clusters were identified including “high overall EBI users,” “high provider EBI users,” “high EBI users with no provider assessment and feedback,” and “high client EBI users.” Only 1.8 EBIs were implemented, on average, with non-NBCCEDP clients and providers. Fewer than half (n= 32, 47.8%) of grantees conducted process or outcome evaluation of one or more EBIs. Overall, 47.6% of grantees reported high or medium training needs for client-oriented EBIs and 54.3% for provider-oriented EBIs. Conclusions NBCCEDP grantees are implementing EBIs extensively with clients and providers. Increased EBI use among non-NBCCEDP clients/providers is needed to extend the NBCCEDP’s reach and impact. Grantee training and technical assistance is necessary across EBIs. Additionally, grantees’ use of process and outcome evaluation of EBI implementation must be increased to inform effective program implementation.