Breast Cancer Infographics · BREAST CANCER INFOGRAPHICS . 7 . Introduction . The Minnesota Department of Health (MDH) is pleased to release Breast Cancer Infographics Rates by County

Breast Cancer Infographics PREVENTION AND RATES BY COUNTY 09/25/2019

B R E A S T C A N C E R I N F O G R A P H I C S

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Breast Cancer Infographics

Minnesota Department of Health Minnesota Cancer Reporting System PO Box 64882 St. Paul, MN 55164-0822 651-201-5900 [email protected] www.health.state.mn.us

To obtain this information in a different format, call: 651-201-5900.

mailto:[email protected]

http://www.health.state.mn.us/

http://www.health.state.mn.us/


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Contents Introduction ................................................................................................................................ 7

Minnesota State .......................................................................................................................... 8

Aitkin County ............................................................................................................................. 10

Anoka County ............................................................................................................................ 11

Becker County ........................................................................................................................... 12

Beltrami County ........................................................................................................................ 13

Benton County .......................................................................................................................... 14

Big Stone County ....................................................................................................................... 15

Blue Earth County ..................................................................................................................... 16

Brown County ........................................................................................................................... 17

Carlton County .......................................................................................................................... 18

Carver County ........................................................................................................................... 19

Cass County ............................................................................................................................... 20

Chippewa County ...................................................................................................................... 21

Chicago County ......................................................................................................................... 22

Clay County ............................................................................................................................... 23

Clearwater County .................................................................................................................... 24

Cook County .............................................................................................................................. 25

Cottonwood County .................................................................................................................. 26

Crow Wing County .................................................................................................................... 27

Dakota County .......................................................................................................................... 28

Dodge County ........................................................................................................................... 29

Douglas County ......................................................................................................................... 30

Faribault County ........................................................................................................................ 31

Fillmore County ......................................................................................................................... 32

Freeborn County ....................................................................................................................... 33

Goodhue County ....................................................................................................................... 34

Grant County ............................................................................................................................. 35

Hennepin County ...................................................................................................................... 36

Houston County ........................................................................................................................ 37

Hubbard County ........................................................................................................................ 38


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Isanti County ............................................................................................................................. 39

Itasca County ............................................................................................................................. 40

Jackson County .......................................................................................................................... 41

Kanabec County ........................................................................................................................ 42

Kandiyohi County ...................................................................................................................... 43

Kittson County ........................................................................................................................... 44

Koochiching County .................................................................................................................. 45

Lac qui Parle County.................................................................................................................. 46

Lake County ............................................................................................................................... 47

Lake of the Woods County ........................................................................................................ 48

Le Sueur County ........................................................................................................................ 49

Lincoln County .......................................................................................................................... 50

Lyon County .............................................................................................................................. 51

Mahnomen County ................................................................................................................... 52

Marshall County ........................................................................................................................ 53

Martin County ........................................................................................................................... 54

McLeod County ......................................................................................................................... 55

Meeker County ......................................................................................................................... 56

Mille Lacs County ...................................................................................................................... 57

Morrison County ....................................................................................................................... 58

Mower County .......................................................................................................................... 59

Murray County .......................................................................................................................... 60

Nicollet County .......................................................................................................................... 61

Nobles ....................................................................................................................................... 62

Norman County ......................................................................................................................... 63

Olmsted County ........................................................................................................................ 64

Otter Tail County ....................................................................................................................... 65

Pennington County ................................................................................................................... 66

Pine County ............................................................................................................................... 67

Pipestone County ...................................................................................................................... 68

Polk County ............................................................................................................................... 69

Pope County .............................................................................................................................. 70


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Ramsey County ......................................................................................................................... 71

Red Lake County ....................................................................................................................... 72

Redwood County ....................................................................................................................... 73

Renville County ......................................................................................................................... 74

Rice County ............................................................................................................................... 75

Rock County .............................................................................................................................. 76

Roseau County .......................................................................................................................... 77

Scott County .............................................................................................................................. 78

Sherburne County ..................................................................................................................... 79

Sibley County ............................................................................................................................ 80

St. Louis County ......................................................................................................................... 81

Stearns County .......................................................................................................................... 82

Steele County ............................................................................................................................ 83

Stevens County ......................................................................................................................... 84

Swift County .............................................................................................................................. 85

Todd County .............................................................................................................................. 86

Traverse County ........................................................................................................................ 87

Wabasha County ....................................................................................................................... 88

Wadena County ........................................................................................................................ 89

Waseca County ......................................................................................................................... 90

Washington County .................................................................................................................. 91

Watonwan County .................................................................................................................... 92

Wilkin County ............................................................................................................................ 93

Winona County ......................................................................................................................... 94

Wright County ........................................................................................................................... 95

Yellow Medicine County ........................................................................................................... 96

Technical Notes ......................................................................................................................... 97

Breast Cancer Prevention ..................................................................................................... 97

The Burden of Breast Cancer ................................................................................................ 99

Cancer Prevention Resource Section ...................................................................................... 101

Comprehensive Cancer Control Program ........................................................................... 101

Minnesota Cancer Alliance ................................................................................................. 101


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Sage Screening Programs .................................................................................................... 101

Healthy Minnesota Partnership .......................................................................................... 101

Center for Health Equity ..................................................................................................... 101

Statewide Health Improvement Partnership ...................................................................... 102

Alternate Format of Infographic Materials ................................................................................... 102


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Introduction The Minnesota Department of Health (MDH) is pleased to release Breast Cancer Infographics Rates by County. This report was developed and written as a collaboration among staff in the Division of Health Promotion & Chronic Disease, including researchers, epidemiologists and support staff working in the Minnesota Cancer Reporting System (MCRS) and the Sage Programs.

MDH developed this report to support breast cancer prevention and control efforts throughout Minnesota. For each county as well as for the state, the report provides user-friendly infographic summaries of selected rates for breast cancer in Minnesota women. Statistics displayed in the report include: breast cancer incidence (newly diagnosed) and mortality (death) rates of breast cancer; the distribution of breast cancers that were diagnosed early versus late; and the estimated number of breast cancer survivors living as of 2016, among other statistics. There is also cancer prevention page for the entire state that includes estimates of the prevalence of several life-style factors that have been linked to increased risks of breast cancer, and factors such as being uninsured that pose as barriers to obtaining care. A separate section of technical notes provides details on data sources and methods. For a text-only version of the data used to create the breast cancer infographics, visit Breast Cancer Infographics Data Tables (https://www.health.state.mn.us/data/mcrs/docs/bcafinfogtable.html).

In the U.S., one-in-eight women will be diagnosed with breast cancer at some point in their lifetimes. In Minnesota, breast cancer is the most common malignant cancer diagnosed in women. It is also one of the top five cancer causes of death among Minnesota women regardless of their race or ethnicity. Breast cancers are easier to treat and outcomes are often better when they are detected and treated early. Breast cancer screening can identify cancers early and is a vital approach in the control of this cancer. Breast Cancer Awareness Month is held annually in October to increase the awareness of breast cancer screening. This report will serve as a timely and valuable resource to professionals throughout Minnesota who are planning, developing or evaluating screening programs, patient navigation services, or policy to prevent and control this cancer.

For cancer prevention resources and programs at MDH, please see the Cancer Prevention Resource Section at the end of this report. For additional information about breast cancer, see the American Cancer Society breast cancer webpage (https://www.cancer.org/cancer/breast-cancer.html).

https://www.health.state.mn.us/data/mcrs/docs/bcafinfogtable.pdf

https://www.health.state.mn.us/data/mcrs/docs/bcafinfogtable


https://www.cancer.org/cancer/breast-cancer.html


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Minnesota State


9

Minnesota State


10

Aitkin County


11

Anoka County


12

Becker County


13

Beltrami County


14

Benton County


15

Big Stone County


16

Blue Earth County


17

Brown County


18

Carlton County


19

Carver County


20

Cass County


21

Chippewa County


22

Chicago County


23

Clay County


24

Clearwater County


25

Cook County


26

Cottonwood County


27

Crow Wing County


28

Dakota County


29

Dodge County


30

Douglas County


31

Faribault County


32

Fillmore County


33

Freeborn County


34

Goodhue County


35

Grant County


36

Hennepin County


37

Houston County


38

Hubbard County


39

Isanti County


40

Itasca County


41

Jackson County


42

Kanabec County


43

Kandiyohi County


44

Kittson County


45

Koochiching County


46

Lac qui Parle County


47

Lake County


48

Lake of the Woods County


49

Le Sueur County


50

Lincoln County


51

Lyon County


52

Mahnomen County


53

Marshall County


54

Martin County


55

McLeod County


56

Meeker County


57

Mille Lacs County


58

Morrison County


59

Mower County


60

Murray County


61

Nicollet County


62

Nobles


63

Norman County


64

Olmsted County


65

Otter Tail County


66

Pennington County


67

Pine County


68

Pipestone County


69

Polk County


70

Pope County


71

Ramsey County


72

Red Lake County


73

Redwood County


74

Renville County


75

Rice County


76

Rock County


77

Roseau County


78

Scott County


79

Sherburne County


80

Sibley County


81

St. Louis County


82

Stearns County


83

Steele County


84

Stevens County


85

Swift County


86

Todd County


87

Traverse County


88

Wabasha County


89

Wadena County


90

Waseca County


91

Washington County


92

Watonwan County


93

Wilkin County


94

Winona County


95

Wright County


96

Yellow Medicine County


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Technical Notes

Breast Cancer Prevention Data Sources

The Surveillance, Epidemiology, and End Results Program (SEER) is a national repository of state and local cancer registry data. For these infographics, information came from SEER Cancer Stat Facts: Female Breast Cancer (https://seer.cancer.gov/statfacts/html/breast.html), retrieved June 2019. SEER data retrieved at that time represent a US national sample, years 2014 to 2016.

The Behavioral Risk Factor Surveillance System (BRFSS) is a nationally representative telephone survey conducted every year, which collects information on health-related behaviors. BRFSS data are adjusted for a number of socio-demographic factors, including age, sex, and race/ethnicity. Data from the 2016 BRFSS survey were used for analysis; these data are publically available online: BRFSS data (https://www.cdc.gov/brfss/index.html).

The Small Area Health Insurance Estimates (SAHIE) Program generates single-year health insurance coverage status estimates from several data collection mechanisms adminstered by the US Census Bureau. SAHIE 2017 estimates, retrieved June 2019, were used for the infographics; these are publically available at the online portal: SAHIE data (https://www.census.gov/programs-surveys/sahie.html).

The American Community Survey (ACS) is a yearly, mail-based, nationally-representative survey collecting information on how Americans live, work, and commute. For these infographics data was taken from 2017 American Community Survey 5-year estimates, data set S1606, retrieved June 2019 through the American FactFinder advanced search online portal: US Census FactFinder (https://factfinder.census.gov/faces/nav/jsf/pages/index.xhtml).

Measure Notes

1. Minnesota women’s lifetime risk of breast cancer Source: SEER 2014 – 2016.

2. Screening rates in Minnesota Source: BRFSS 2016. Definition: Women 45 to 74 years reporting breast cancer screening in the last two years.

3. Population attributable fraction (PAF) of potentially modifiable risk factors of breast cancer Source: Islami, F., Goding Sauer, A., Miller, K. D., Siegel, R. L., Fedewa, S. A., Jacobs, E. J., ... & Flanders, W. D. (2018). Proportion and number of cancer cases and deaths attributable to potentially modifiable risk factors in the United States. CA: a cancer journal for clinicians, 68(1), 31-54.

4. Alcohol consumption measure Source: Statewide: BRFSS 2016 Definition: Drinking alcohol above recommendations was defined for respondents 18 years of age and older who reported heavy drinking or binge drinking. Heavy drinking was defined as consuming more than 1 alcoholic beverage a day over the course of a month. Binge drinking was defined as drinking 4 or more alcoholic beverages in one bout in the course of a month.

https://seer.cancer.gov/statfacts/html/breast.html

https://seer.cancer.gov/statfacts/html/breast.html

https://www.cdc.gov/brfss/index.html

https://www.census.gov/programs-surveys/sahie.html

https://factfinder.census.gov/faces/nav/jsf/pages/index.xhtml

https://factfinder.census.gov/faces/nav/jsf/pages/index.xhtml


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5. Obesity measure Source: Statewide: BRFSS 2016 Definition: Obesity was coded as positive for women 18 years and older with a >=30 body mass index (BMI).

6. Physical inactivity measure Source: Statewide: BRFSS 2016 Definition: A “no” response to the following question was coded as physically inactive for women 18 years and older: “During the past 30 days, other than your regular job, did you participate in any physical activity or exercises such as running, calisthenics, golf, gardening or walking for exercise?”

7. Uninsured rates Source: SAHIE 2017. Definition: State and county small area estimates for percent unisured among women ages 40 to 64.

8. Delayed medical care due to costs measure Source: Statewide: BRFSS 2016 Definition: BRFSS contained a single or two part question concerning medical care delays and associated costs. In the single question format, a “yes” response to the following question would be coded as delaying medical care due to costs: “Was there a time in the past 12 months when you needed to see a doctor but could not because of costs?” In the two-part version of the question, the first question asked, “During the past 12 months, was there a time that you needed medical care but did not get it or delayed getting it?” This question was a followed by a multiple response question asking “Why did you not get or delay getting the medical care you thought you needed?” which included potential cost and expense related responses. Those who marked “yes” to the first question, and indicated a cost or expense related reason in the second question were coded as delaying medical care due to costs. This measure was calculated for women 18 years and older.

9. Speaking a language other than English measure Source: ACS 5-year estimates 2017 Definition: State and county estimates for the percent of individuals 18 years and older in households that speak a language other than English.


99

The Burden of Breast Cancer Data Sources

The Minnesota Cancer Reporting System (MCRS) provided data on new breast cancer diagnoses and deaths from breast cancer for this report. Unless otherwise noted, statistics for this report were based on incident breast cancers including in situ breast cancers diagnosed in Minnesota female residents between 2012 and 2016. The MCRS database contains information on nearly all microscopically confirmed malignant and in site cancers diagnosed in Minnesota residents between 1988 and 2016. After a rule change, starting in 2012, both clinical and microscopically confirmed cancers were reported to the state’s cancer registry. For detailed information about cancer reporting in Minnesota, please visit Minnesota Cancer Reporting System (https://www.health.state.mn.us/data/mcrs/index.html).

Mortality data are obtained from electronic death certificates on Minnesota residents. Only the underlying cause of death is used in calculating cancer mortality rates. Statistics for this report were based on breast cancers deaths in Minnesota female residents that occurred between 2012 and 2016. To learn more about the Office of Vital Records and death certificates, in particular, please visit Minnesota Center for Health Statistics (https://www.health.state.mn.us/data/mchs/index.html) or the Office of Vital Records (https://www.health.state.mn.us/people/vitalrecords/about.html).

The National Cancer Institute’s (NCI) website contains population data used in generating statistics for this report. The U.S. Census Bureau develops annual population estimates. Census population estimation methods and the population estimates used in the calculations. See the National Cancer Institute – U.S. Population Data – 1969-2017 (https://seer.cancer.gov/popdata/) page for more information.

Measure Notes

1. Annual incidence counts Definition: The 5-year annual average count of incident breast cancers diagnosed in females who were residents of Minnesota at the time of diagnosis.

2. Incidence rates Definition: Rates are per 100,000 and age-adjusted to the 2000 US standard population (19 age groups – Census P25 – 1130) standard. Rates with a relative standard error > 30% are considered unstable and are denoted with an asterisk (*).

3. Annual mortality counts Definition: The 5-year annual average count of incident breast cancer deaths in females who were residents of Minnesota at the time of death. The annual average number of breast cancer deaths less than 2 per year is denoted as “< 2”.

4. Mortality rates Definition: Rates are per 100,000 and age-adjusted to the 2000 US standard population (19 age groups – Census P25 – 1130) standard. Rates with a relative standard error > 30% are considered unstable and are denoted with an asterisk (*).

5. Stage at diagnosis by early and late stage Source: MCRS 2009 – 2016

https://www.health.state.mn.us/data/mcrs/index.html

https://www.health.state.mn.us/data/mchs/index.html

https://www.health.state.mn.us/people/vitalrecords/about.html

https://seer.cancer.gov/popdata/


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Definition: In situ cases and local stage cancers were recoded as early stage; regional and distant cases were recoded as late stage. Percent distribution was calculated from the total count of all incidence cancers.

6. Number of breast cancer survivors in counties Source: MCRS 2006-2016 Definition: These counts estimate the number of females in each county who were alive with a history of malignant breast cancer as of January 1st, 2016.

7. 5-year breast cancer survival rate Source: MCRS 2009-2015 Definition: Five-year breast cancer relative survival rate is the percent of women in Minnesota who have survived their breast cancer 5 years after diagnosis. Breast cancer survival does include women with a cause of death unrelated to breast cancer.

Data Notes 1. Race and ethnicity abbreviations ▪ WOC – Women of color, including African American, Asian, Pacific Islander, Hispanic

ethnicity and multiracial women ▪ AI – American Indian ▪ AI/AN – American Indian or Alaska Native ▪ AA – Black or African American ▪ A/PI - Asian or Pacific Islander, including Native Hawaiian ▪ White – White non-Hispanic ▪ Hisp. – Hispanic ethnicity, including all race categories 2. n/a data In some cases, data were not available for certain measures. Lack of available data are indicated by “n/a” abbreviation. Reasons data are not available include: ▪ Survey did not collect data on that measure ▪ Survey collected data on a similar but incompatible measure ▪ No estimate available for that county for that measure or rate ▪ No observed cases in that county for that measure ▪ Fewer than 10 cases in the county for that measure 3. Unstable rates When calculated incidence or mortality rates had a relative standard error greater than 30, rates were flagged as unstable. This indicates that the rate has a wide margin of error and should be interpreted with caution.


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Cancer Prevention Resource Section

Comprehensive Cancer Control Program The Comprehensive Cancer Control Program (https://www.health.state.mn.us/diseases/cancer/compcancer/index.html) at the Minnesota Department of Health is a CDC funded initiative to strengthen efforts across Minnesota to decrease the impacts of cancer. To achieve this objective, program staff collaborated with the Minnesota Cancer Alliance (below) to develop the Cancer Plan Minnesota 2025: A Framework for Action. (https://mncanceralliance.org/cancer-plan/)

Minnesota Cancer Alliance The Minnesota Cancer Alliance is a coalition of more than 100 organizations from diverse backgrounds and disciplines dedicated toward reducing the burden of cancer in Minnesota. Members are actively working to achieve the objectives of the Cancer Plan Minnesota 2025. For more information, go to Minnesota Cancer Alliance (https://mncanceralliance.org/).

Sage Screening Programs The Minnesota Department of Health’s Sage Screening Programs provide free screening for breast, cervical, and colorectal cancers at participating locations across Minnesota. The program has a wide network of partners working together to reduce the burden of cancer by providing access to and promoting breast, cervical, and colorectal cancer screening services for Minnesota’s uninsured and underinsured populations. For more information, go to MDH Sage Screening Programs (https://www.health.state.mn.us/diseases/cancer/sage/about/index.html).

Healthy Minnesota Partnership The Healthy Minnesota Partnership is a collaboration between community partners and the Minnesota Department of Health to improve the health and quality of life for individuals, families and communities in the state. The Healthy Minnesota 2020 Framework identifies and acts on strategic opportunities to improve health and well-being for all people in Minnesota. The most recent progress report was produced as a collaboration between the Minnesota Department of Health and the Healthy Minnesota Partnership. To access the report, go to Healthy Minnesota 2020 Update (https://www.health.state.mn.us/communities/practice/healthymnpartnership/docs/annualreport2017.pdf).

Center for Health Equity The Center for Health Equity (CHE) was created in 2013 to advance health equity as a practice or approach within the Minnesota Department of Health and across the state. Under CHE’s leadership, Minnesota’s approach addresses health disparities as part of a broad spectrum of public investments in housing, transportation, education, economic opportunity and criminal justice. CHE also carries out specific initiatives and projects, including state funding available to

https://www.health.state.mn.us/diseases/cancer/compcancer/index.html

https://www.health.state.mn.us/diseases/cancer/compcancer/index.html

https://mncanceralliance.org/cancer-plan/

https://mncanceralliance.org/cancer-plan/

https://mncanceralliance.org/

https://www.health.state.mn.us/diseases/cancer/sage/about/index.html

https://www.health.state.mn.us/diseases/cancer/sage/about/index.html

https://www.health.state.mn.us/communities/practice/healthymnpartnership/docs/annualreport2017.pdf


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Tribal Nations to support Eliminating Health Disparities Initiative (EHDI) activities (Minnesota Statute 145.928, subdivision 10). EHDI funding is for various activities in health areas including decreasing morbidity and mortality rates from breast and cervical cancer, diabetes, HIV/AIDS and other health conditions. For more information, go to MDH Center for Health Equity (https://www.health.state.mn.us/communities/equity/about/index.html).

Statewide Health Improvement Partnership SHIP works to create healthier communities across Minnesota by expanding opportunities for active living, healthy eating and tobacco-free living. At its core, SHIP is a locally driven effort, with community partnerships formed to create better health together across Minnesota. Communities choose strategies that are based on the latest science and focused on making long-term, sustainable changes in schools and child care facilities, communities, workplaces and health care settings. SHIP has been instrumental in helping Minnesota keep obesity rates relatively flat, and reducing commercial tobacco use and secondhand smoke exposure. These factors contribute to chronic diseases, rising health care costs, disability and death. For more information about SHIP, go to Statewide Health Improvement Partnership (https://www.health.state.mn.us/communities/ship/).

Alternate Format of Infographic Materials Alternative format for the data found in the infographics is located in the Breast Cancer Infographic Data Table (https://www.health.state.mn.us/data/mcrs/docs/bcafinfogtable).

https://www.health.state.mn.us/communities/equity/about/index.html

https://www.health.state.mn.us/communities/ship/

https://www.health.state.mn.us/data/mcrs/docs/bcafinfogtable.pdf


Documents

Breast Cancer Infographics · BREAST CANCER INFOGRAPHICS . 7 . Introduction . The Minnesota Department of Health (MDH) is pleased to release Breast Cancer Infographics Rates by County