Anne Marie Murphy, PhD, Executive Director, Metropolitan Chicago Breast Cancer Task Force
Over the past 20 years, the advent of improved imaging technology and more effective treatments has led to a significant decrease in the overall death rate from breast cancer in the United States. However, the gains have not been shared equally by all segments of the population. For example, in Chicago in 1980, the difference in breast cancer mortality between black and white women was nonexistent; this difference has grown steadily since the mid-1990s with the advent of better imaging and treatment. Currently the breast cancer mortality rate in Chicago among black women is 62 percent higher than for white women.
Research performed by the Metropolitan Chicago Breast Cancer Task Force showed that black women in Chicago were far less likely to access mammography in an academic medical center, to have their mammograms read by breast imaging specialists, and to have their images taken by a digital machine, all measures which have been found to correlate with better breast health outcomes. Additionally, geographic mapping of approved cancer treatment centers in Chicago showed that with one exception, they were all located outside the high mortality, predominantly minority areas of the city. This research suggests that unequal access to resources that correlate with higher quality health care is a significant driver of health care disparities.
In an effort to begin addressing the Chicago disparity and many of the factors that likely contribute to it, the Chicago Breast Cancer Quality Consortium was formed in 2008 with generous funding from the Susan G. Komen for the Cure Foundation. In 2009, it became the first federally designated Patient Safety Organization dedicated exclusively to breast health. It brings together more than 70 percent of hospital based mammography and treatment providers in Metropolitan Chicago to share breast cancer screening and treatment quality data, with the goal of identifying deficits and implementing solutions that are compatible with the resources of each hospital. This is the largest voluntary collection of breast cancer quality metrics across an entire metropolitan area, and it is unique because participating hospitals cover the entire breadth of facility types (i.e. academic, public, private, and safety-net). One of the reasons we have been able to work with such a diverse group of hospitals is the technical assistance provided directly by staff at the Task Force for hospitals with few resources.
Data-sharing in a confidentiality protected manner is available to Patient Safety Organizations, and has allowed us to compare data across all types of hospitals, gaining a better picture of what is happening throughout Metropolitan Chicago. Furthermore, we believe this approach will actively drive improvement across the area and in particular will provide targeted assistance to providers serving minorities and underserved populations in order to integrate quality improvement more broadly and raise the boat for all.
For more information on this project, please visit our website <www.chicagobreastcancer.org> under quality consortium. All data collection tools are available to the public for replication of this project in other areas.
Anne Marie Murphy, PhD, is executive director of the Metropolitan Chicago Breast Cancer Task Force. She can be reached at Anne_Murphy@rush.edu.