Breast Cancer in Colorado


The Breast Cancer Data – Who it affects?



Incidence – A cancer incidence rate is the number of new cancers of a specific site/type occurring in a specified population during a year, usually expressed as the number of cancers per 100,000 population at risk. That is,

Incidence rate = (New cancers / Population) × 100,000
The numerator of the incidence rate is the number of new cancers; the denominator is the size of the population.


Mortality – A cancer mortality rate is the number of deaths, with cancer as the underlying cause of death, occurring in a specified population during a year. Cancer mortality is usually expressed as the number of deaths due to cancer per 100,000 population. That is,

Mortality Rate = (Cancer Deaths / Population) × 100,000

The numerator of the mortality rate is the number of deaths; the denominator is the size of the population.

Family History Tool: My Family Health Portrait –

Find a Genetic Counselor:


Breast Cancer – The Symptoms



Breast Cancer the Colorado Cancer Plan


5.1 Strategies:

  1. Educate primary care providers on the importance of a provider recommendation and adhering to nationally recognized, evidence based cancer screening guidelines such as the United States Preventive Services Task Force (USPSTF), the National Comprehensive Cancer Network (NCCN), the American Cancer Society (ACS) and the American College of Radiology (ACR).
  2. Promote informed decision-making at both the provider and individual level regarding breast cancer screening guidelines. Discussions should include the advantages and disadvantages related to the variations in how often and when to begin and end screening based on individual risk.
  3.  Implement client reminder systems (e.g., print or phone) to advise individuals in need of a cancer screening; messages may be tailored or general.
  4. Implement provider-oriented strategies, including provider reminders and recalls to identify when an individual is in need of, or overdue for, a cancer screening test based on individual or family history risk, and provider assessment and feedback interventions that present information about screening provision, in particular through use of an electronic health record system.
  5. Deliver one-on-one or group education conducted by health professionals or trained lay people to motivate individuals to seek screenings by addressing indications for and benefits of screening, and what to expect during screening services. Use small media to support this education (e.g., brochures or newsletters).
  6. Implement workplace policies to provide paid time off for individuals to complete recommended cancer screenings.
  7. Collaborate with health plans to achieve increased cancer screening compliance rates, for example through the use of National Committee for Quality Assurance (NCQA) Healthcare Effectiveness Data and Information Set (HEDIS) cancer screening measures.
  8. Implement evidence-based practices through engagement of patient navigators in cancer screening processes.



5.2 Strategies:

  1. Increase access to cancer screening services, including colonoscopy, mammography and low dose lung CT screening, in rural areas by implementing mobile services, traveling providers, upgraded equipment or increased Health First Colorado reimbursement.
  2. Partner with community-based organizations to reduce barriers (financial, cultural, structural or regional) to obtaining cancer screening services through engagement of community health workers and patient navigators.
  3. Provide culturally relevant screening services for medically underserved communities and promote culturally sensitive informed decision-making about screening through engagement of community health workers and patient navigators.
  4. Facilitate enrollment in public and private health insurance.
  5. Educate Health First Colorado-eligible Coloradans about their cancer screening coverage, including locations that accept Health First Colorado.
  6. Address limited local provider access for individuals due to insurance coverage, insurance plans accepted by providers, or provider capacity.
  7. Educate employers on the importance of providing paid leave for cancer screenings (especially for hourly employees).


3.1 Strategies

  1. Support efforts seeking to standardize family history data collection in electronic health records to allow providers to identify individuals whose family history meets the clinical criteria for a hereditary cancer syndrome and those who should be referred to a genetic counselor.
  2. Educate providers on guidelines for family history collection and referral for genetic counseling and testing, including potential BRCA1/2 mutations or Lynch Syndrome.
  3. Conduct demonstration projects that implement family history screening tools in primary or specialty care settings to identify patients at risk for hereditary cancer.
  4. Develop referral and communication systems to facilitate on-site or referred cancer risk assessment, genetic counseling, including tele-counseling, and testing services by a qualified genetics professional.
  5. Promote access to genetic counseling based on risk assessment prior to genetic testing to review potential risks and benefits, including post-test risk and benefits when prophylactic options are under consideration.
  6. Identify funding sources for genetic counseling and testing for at-risk individuals who are unable to pay.
  7. Promote appropriate insurance coverage, especially Medicaid coverage, of genetic counseling, testing and ensuing clinical services for high-risk individuals.