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California’s Bold New Plan to Prevent Breast Cancer Before It Starts

Today, one in eight women face breast cancer. While all states have “cancer plans,” these generally focus on early detection, treatment, and access to services. That’s why Paths to Prevention (the Plan) is California’s new, first-of-its-kind action plan to prevent breast cancer before it starts.

Breast cancer has both genetic and environmental components. We cannot change our genes, but we can change our environment. In fact, many experts agree that at least 50 percent of all breast cancer cases are preventable by using risk-reduction strategies. This action plan focuses exclusively on primary prevention of this disease: reducing risk rather than early detection.

Developed by Breast Cancer Prevention Partners, Paths to Prevention lays out a strategic agenda to reduce 23 breast cancer risk factors, from chemical exposures to alcohol and tobacco use. For each risk factor, the plan offers actionable systemic interventions rather than individual actions, to stem rising breast cancer rates. For instance, social and built environment can impact access to diet and nutrition. Similarly, placed-based chemical exposures can impact access to physical activity. Breast cancer causation is multifactorial and interconnected, so the recommended interventions are too.

Paths to Prevention also recommends ways to make the healthy choice the easy choice. For example, telling people to get more exercise does not mean much if they do not have safe and accessible green spaces and community-gathering spaces for children and adults to play and move. While it is important for individuals to strive for a healthier lifestyle, we should not shame or blame individuals who do not or cannot make those changes. People need safe spaces for exercise, access to healthy and affordable food, and protection from exposures linked to breast cancer where they live, work, play, and learn.

This bold new plan for how to reduce breast cancer rates in California weaves together science and community wisdom to provide a richness and relevance to those most impacted. For instance, due to historically racist policies, factors like higher exposure to industrial pollution, poor air quality, lack of access to healthy food, and limited opportunities for physical activity are often concentrated in communities where people of color live. And African American women face both disproportionate exposure to breast carcinogens and the highest risk of serious health impacts from the disease. Across racial and ethnic groups, Black women have the highest breast cancer mortality rate, 42 percent higher than the comparable rate for white women, and among women younger than 45, breast cancer incidence is higher among Black women than white women. 

Paths to Prevention’s interventions were crucially developed with leadership from the communities most highly impacted by breast cancer, with the ethos of, “Don’t do anything for me without me.”

To bring Paths to Prevention to life, Breast Cancer Prevention Partners will engage partners from the local to the national levels in these critical interventions to reduce breast cancer rates. The aim will be to provide a breast cancer prevention lens for the environmental justice work already happening in communities, bringing additional resources to advance shared goals and save lives.

This groundbreaking California Plan will serve as a model for the whole country and beyond. And while Paths to Prevention’s primary aim is to reduce rates of breast cancer, when brought to life, this action plan will also help prevent other cancers and life-threatening diseases. The work done now to implement this action plan will have a multi-generational effect.

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