Places Cancer Screening Rates and SDOH

Geospatial analysis and small area estimation (SAE) are valuable tools for cancer prevention and control, as they provide key information at the neighborhood level and facilitate identification of areas with greater need for place-based interventions. The CDC PLACES project provides estimates of cancer screening rates at geographically granular levels including county, census tract, and ZIP Code Tabulation Area (ZCTA), allowing users to identify areas with low screening rates and inform the design of interventions strategies and community-based cancer screening programs. Such public datasets provide opportunities for researchers from various disciplines to investigate small area variation that may be obscured at larger levels of geography. The project demonstrates how geospatial methods and technology can aid and improve the design, visualization and communication of small area estimates such as PLACES in informing place-based interventions. The current PLACES project provides model-based small area estimates of 40 chronic disease and health-related across multiple geographic unites, including counties, places, census tracts, and ZCTA levels in the U.S. The estimates are based on Behavioral Risk Factor Surveillance System (BRFSS) public use data and U.S. census data, using a multilevel regression and poststratification (MRP) approach. The three measures related to cancer screening include breast cancer screening, cervical cancer screening, and colorectal cancer screening. Our R Shiny dashboard will allow the researchers to investigate spatial variation in cancer screening rates at different geographic units, and generate hypotheses on how the Social Determinants of Health (SDoH) may be associated with cancer screening patterns.