An Expanded Agenda for the Primary Prevention of Breast Cancer: Charting a Course for the Future

Abstract

Advances in breast cancer science, early detection, and treatment have resulted in improvements in breast cancer survival but not in breast cancer incidence. After skin cancer, breast cancer is the most common cancer diagnosis in the United States. Each year, nearly a quarter million U.S. women receive a breast cancer diagnosis, and the number continues to rise each year with the growth in the population of older women. Although much remains to be understood about breast cancer origins and prevention, action can be taken on the existing scientific knowledge to address the systemic factors that drive breast cancer risk at the population level. The California Breast Cancer Research Program funded a team at Breast Cancer Prevention Partners (BCPP) to convene leaders in advocacy, policy, and research related to breast cancer prevention from across the state of California. The objective was the development of a strategic plan to direct collective efforts toward specific and measurable objectives to reduce the incidence of breast cancer. The structured, innovative approach used by BCPP to integrate scientific evidence with community perspectives provides a model for other states to consider, to potentially change the future trajectory of breast cancer incidence in the United States.

Californians Linking Action with Science for Prevention of Breast Cancer (CLASP-BC)—Phase 2

“…Phase 1 has been previously described [4]. Phase 2 will focus on: Addressing one or more of the intervention goals for the 23 risk factors identified in P2P [3]; expanding upon existing primary prevention efforts into two or more California jurisdictions; on disadvantaged, high risk communities with unmet social needs; actively engaging the leadership of local community-based organizations with research scientists, public health and/or community health practitioners, and legislative/executive policy influencers/makers as partners; and rigorously evaluating the impact of these expanded collaborative efforts; including and updating annually a sustainability plan for successful dissemination and implementation approaches; and collaboratively disseminating the results of this D&I research through community, practice, and policy presentations, and policy briefs (e.g., social media, press conferences, town hall/community meetings, press release, policy briefs, newsletters and magazines), as well as peer-reviewed publication.…”

“…Paths to Prevention: The California Breast Cancer Primary Prevention Plan (P2P), whose development has been described elsewhere [3,4], provides an action plan of local, regional, and statewide evidence-informed interventions, both research-based and practice-based, to foster an environment that reduces a community's risk for breast cancer. The plan is unique from other cancer plans in several important ways, including its sole focus on primary prevention, its focus on systemic interventions, the social justice lens through which breast cancer is viewed and the weaving together of scientific and community wisdom.…”

“…Similarly, CLASP-BC is designed to support the dissemination, implementation, and evaluation of evidence-informed intervention (EII) strategies from the Paths to Prevention: The California Breast Cancer Primary Prevention Plan (P2P) [3] by adding value to existing cancer and chronic disease prevention efforts, focusing on identified risk factors for breast cancer. CLASP-BC will also be implemented in two phases.…”

Doing What We Know, Knowing What to Do: Californians Linking Action with Science for Prevention of Breast Cancer (CLASP-BC)

“…The California Breast Cancer Primary Prevention Plan (BCPPP) [ 6 ], was based on a strong foundation of science and input from many stakeholders, including academics, government regulators, non-profit organizations and impacted communities, and developed a policy agenda and action plan, to reduce the incidence of breast cancer in the state. Over the two-year project, BCPPP held a series of webinar-based study groups to: explore the strength of the science behind known and suspected risk factors for breast cancer; explore potential interventions to address these risk factors; identify strengths, weaknesses and gaps in scientific research; and work with the broad array of stakeholders to disseminate and implement the plan.…”

“…Given the lack of progress in breast cancer prevention, the California Breast Cancer Research Program (CBCRP) [ 5 ] applies current scientific knowledge about breast cancer to primary prevention at the population level. To turn the tide of breast cancer in the state, CBCRP supported the development of a Comprehensive Breast Cancer Primary Prevention Plan (BCPPP) for California [ 6 ]. The plan addresses all levels of the health impact pyramid, from education at the top to the bottom rungs of changing the context and socioeconomic factors, where the population impact is greatest [ 7 ].…”