Development of Sub-County Cancer Reporting Zones in Delaware and Example Use Case for Targeted Interventions.

Area of Science:

• Cancer surveillance and epidemiology
• Geographic information systems (GIS) in public health
• Population health and disparities research

Background:

• Cancer registries are crucial for tracking disease patterns and informing public health strategies.
• Sub-county level cancer data is essential for identifying localized trends and disparities.
• The National Cancer Institute (NCI)/North American Association of Central Cancer Registries (NAACCR) Zone Design Project aims to standardize geographic units for cancer reporting.

Purpose of the Study:

• To describe the Delaware Cancer Registry's (DCR) involvement in the NCI/NAACCR Zone Design Project.
• To create optimized sub-county geographic areas (zones) for cancer reporting and geospatial analysis in Delaware.
• To facilitate the use of zone-level data for targeted cancer interventions and public health outreach.

Main Methods:

• Reviewed multiple zone configurations using AZTool, optimizing for population size, homogeneity (minority, poverty, urban), and compactness.
• Conducted a stakeholder survey to gather input on preferred zone configurations for each county.
• Utilized selected zones to calculate and map breast cancer incidence rates (overall and late-stage) by quintiles.

Main Results:

• Established 15 zones across Delaware: 3 in Kent, 9 in New Castle, and 3 in Sussex County.
• Zone populations ranged from 54,013 to 67,693.
• Identified areas with higher late-stage breast cancer incidence, including regions near Wilmington, Middletown, and between Milford and Georgetown.

Conclusions:

• Aggregating census tracts into zones enables reliable sub-county cancer rate reporting.
• Zone-level cancer data provides meaningful insights into regional cancer trends for stakeholders and the public.
• Delaware can leverage zone-level cancer information for targeted interventions and outreach initiatives.