California Health Maps is an interactive mapping tool of health data for geographies beyond the county level in California. You can map cancer incidence for 12 of the most common invasive cancer sites and filter by sex, race, and ethnicity. Visit Learn to review methodology, data sources, and more.
According to California Department of Public Health guidelines, cancer incidence rates cannot be reported if based on <15 cancer cases and/or a population of <10,000 to ensure confidentiality and stable statistical rates.
California
Health Maps
California
Demographics
Selected Area
Statewide
Population
% Hispanic
% Non-Hispanic Asian/Pacific Islander
% Non-Hispanic Black
% Non-Hispanic White
% Foreign Born
% Rural
% Over Age 65
Socioeconomic Status
Healthcare Access and Use
Selected Area
Statewide
% Uninsured
% Annual Checkups
% Colorectal Cancer Screening
% Mammograms
% Cervical Cancer Screening
% Preventive Care (Men, 65+ years)
% Preventive Care (Women, 65+ years)
Health and Well-Being
Selected Area
Statewide
% Obesity
% Smoking
Data Sources
California Cancer Registry, 2012-2021
PLACES Project. Centers for Disease Control and Prevention, 2023
American Community Survey, 2015-2019 and 2018-2022
US Census, 2010 and 2020
SEER census tract estimates by race/origin, Vintage 2020
The California Health Maps project aims to provide data for geographies beyond the county level to better serve cancer control, public health, and policy efforts. California Health Maps allows users to interactively map health data for California at different geographic levels: census tract aggregation zones, medical service study areas (MSSAs), and counties (see Methodology section for definitions).
California Health Maps include 5-year and 10-year cancer incidence rates based on the most current data for 12 of the most common invasive cancer sites by sex, race, and ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic, and non-Hispanic Asian/Pacific Islander). Cancer incidence rates are calculated from California Cancer Registry data and are updated regularly.
California Health Maps also includes selected population sociodemographic data based on American Community Survey 2015-2019 and 2018-2022, Census 2010 and 2020, and SEER census tract estimates by race/origin, Vintage 2020. Health and well-being, and health care access and use data from CDC PLACES Project 2023 Release.
On this website, data are shown by cancer reporting zone. These zones have been designed so that they have a minimum population, have similar demographic and socioeconomic characteristics, and are geographically compact (they minimize the distance between different parts of the zone). The minimum population for each zone is 50,000 people.
Counties with larger populations (more than 100,000 people) were divided into multiple zones by combining adjacent census tracts. For the rest of the state, adjacent counties and parts of counties were combined to form zones. Three demographic and socioeconomic characteristics were used to determine similarity: the percent of the population who are not non-Hispanic White, percent of the population with incomes below poverty, and the proportion of the population living in urban and rural areas.
We used population data from Census 2010 and Census 2010 tract geographies to construct the zones. Poverty data came from the American Community Survey 2012-2016 5-year data. We used a software zone design program called AZTool to identify aggregations of adjacent tracts and counties that optimize the three objectives: a target population of 50,000, geographic compactness, and similarity in terms of minority population, poverty, and urbanicity characteristics.
Medical Service Study Areas (MSSAs)
As defined by California's Office of Statewide Health Planning and Development (OSHPD) in 2013, "MSSAs are sub-city and sub-county geographical units used to organize and display population, demographic and physician data." Each census tract in CA is assigned to a given MSSA. The most recent MSSA dataset (2014) was used. Spatial data are available via OSHPD at the California Open Data Portal.
Census Places
Census places are bounded areas designating cities, towns, unincorporated populations, and other "settled concentrations of populations" (more information at the Census website). As detailed population denominators for Census 2020 geographies are not yet available, updated incidence rates for Census places cannot be generated. An archived version of California Health Maps including Census places can be found at archive.californiahealthmaps.org.
Congressional Districts
Congressional districts define the boundaries around areas which are represented by the U.S. House of Representatives (more information at the Census website). District boundaries are based on the 2020 U.S. Census.
State Senate Districts
California State Senate districts define the boundaries of areas represented in the CA state senate (more information at the Census website). As detailed population denominators for Census 2020 geographies are not yet available, updated incidence rates for State Senate districts cannot be generated. An archived version of California Health Maps including State Senate districts can be found at archive.californiahealthmaps.org.
State Assembly Districts
California State Assembly districts define the boundaries of areas represented in the CA state assembly (more information at the Census website). As detailed population denominators for Census 2020 geographies are not yet available, updated incidence rates for State Assembly districts cannot be generated. An archived version of California Health Maps including State Assembly districts can be found at archive.californiahealthmaps.org.
Counties
California Counties define the boundaries of the 58 California Counties. Spatial data are available from NHGIS (IPUMS NHGIS, University of Minnesota, www.nhgis.org).
Cancer incidence rates
Incidence rates for zones and MSSAs were calculated using case counts from the California Cancer Registry. Population data from SEER census tract estimates by race/origin, Vintage 2020, were used to estimate population denominators. State and county rates were computed based on data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program, to take advantage of annual population data from the National Center for Health Statistics. Cancer case numerator data in SEER are equivalent to cancer case numerator data from the California Cancer Registry.
The California Cancer Registry (CCR) is California's statewide population-based cancer surveillance system. It collects information about almost all cancers diagnosed in California. The CCR is recognized as one of the leading cancer registries in the world, and has been the cornerstone of a substantial amount of research on cancer in the California population. To date the CCR has collected detailed information on over 7 million cases of cancer among Californians diagnosed from 1988 forward, and more than 175,000 new cases are added annually.
The California Cancer Registry is established in accordance with California Health and Safety (HSC) code, sections 103875-103885, requiring that cancer information be reported by law. HSC code section 100330 is also passed, requiring that all information collected remains confidential, patient identities kept anonymous, and patients informed, in accordance with California Code of Regulations, Title 17, Section 2593. Under this authority, all health care providers and facilities providing diagnostic or treatment services to cancer patients in California are required to report information about such patients to the state cancer registry, via the regional registries. The Department has designated the three regional cancer registries in California, the Cancer Registry of Greater California, the Los Angeles Cancer Surveillance System, and the Greater Bay Area Cancer Registry as its agents for the purpose of collecting such data on behalf of this registry. The three California registries are part of the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) Program.
As we are reporting cancer incidence rates for small areas, the minimum reporting requirements allow us to report rates for the top 12 cancer sites.
We plan to update California Health Maps to include the most current 5-year and 10-year cancer incidence data cancer counts and population denominators become available.
It takes several years for cancer incidence data for an entire population to be considered “complete,” that is, when a cancer registry is confident that all new cases of cancer have been reported. Selected population sociodemographic data and population estimates for calculating cancer incidence rates are from the SEER census tract estimates by race/origin, Vintage 2020. Additional sociodemographic data are from the Census 2010 and American Community Survey 2015-2019 for zones and MSSAs, and Census 2020 and American Community Survey 2018-2022 for counties and CA.
Census tract aggregation zones are developed based on combining adjacent census tracts on the basis of similarity in population sociodemographic characteristics: poverty, rurality, and non-Hispanic White composition. Zones are required to have a minimum population of 50,000. In total, there are 578 zones for California. Zones vary in population size from 51,229 to 98,764 with the number of census tracts ranging from 5 to 25. These areas are generally smaller than a county, but larger than census tract to help provide additional options for understanding disease burden and better facilitate public health and policy planning.
The census tract aggregation zones were developed by the California Health Maps team including partners at Westat and the National Cancer Institute as part of a collaborative effort to provide cancer data at small (generally smaller than county) area levels. Stakeholder input was gathered and incorporated in the development process.
Counties in California can span up to hundreds of miles and include large and diverse populations. Surveillance of cancer burden at these large geographic scales may not be meaningful nor adequate for identifying areas with higher disease rates. This information can be used by cancer centers, healthcare organizations, community organizations, and policy makers better serve cancer control, public health, and policy efforts.
For the purposes of determining voting districts and congressional Representation, the U.S. Census is required by the Constitution to count everyone in the country every 10 years, but they do a lot more than that. The American Community Survey has been conducted by the U.S. Census Bureau since 2005 and provides detailed population and housing information replacing data previously collected on the Census long form.
According to California Department of Public Health guidelines, cancer incidence rates cannot be reported if based on <15 cancer cases and/or a population <10,000 to ensure confidentiality and stable statistical rates.
We have not reported small-area level cancer incidence data for smaller racial and ethnic groups or non-binary genders due to small cancer case counts and population estimates at the zone levels to ensure confidentiality and stable statistical rates. In addition, at this time, some of these data are not consistently collected within the California Cancer Registry nor available in population estimate data.
Studies have shown that where we live (and work and learn) affect our opportunities for physical activity, social engagement and support, access to healthy and affordable food, and exposure to stress and harmful chemicals. These factors can influence opportunities for health promotion and disease prevention.
Cancer is a group of diseases with many possible causes including genetic and clinical factors as well as social determinants of health. Common risk factors for cancer include smoking and tobacco use, diet and physical activity, sun and other types of radiation, viruses (e.g., HPV, Hepatitis B and C), chronic inflammation, and environmental exposures. Neighborhoods may influence cancer through multiple pathways including material deprivation, psychosocial mechanisms, health behaviors, and access to resources.
Place-based data are provided to characterize the geographies based on several key social and built environment attributes. These are cross-sectional data on neighborhoods and cancer incidence so inferences regarding causes of cancer cannot be made. We have provided these data for the zones to help provide additional context for the observed cancer incidence rates. For example, a zone may have high colorectal cancer incidence rates; understanding the population-level characteristics of that zone can help community organizations and healthcare facilities target their screening and prevention programs toward the predominant populations within the zone.
Place-based measures were developed using data from census tracts. For Census/ACS measures, we calculated a population weighted average of the values across census tracts for each geography. For CDC PLACES Project measures, we averaged the values across census tracts for each geography.
The CDC PLACES project is a collaboration between CDC, the Robert Wood Johnson Foundation, and the CDC Foundation. PLACES is an extension of the original 500 Cities Project that provided city and census tract estimates for chronic disease risk factors, health outcomes, and clinical preventive services use for the 500 largest US cities. Estimates for all census tracts across the U.S. were modeled using data from Behavioral Risk Factor Surveillance System (BRFSS), Census Bureau, and American Community Survey (ACS).
Age-Adjusted Incidence Rate (AAIR): Age-adjustment is a statistical method that allows comparisons of incidence rates to be made between populations with different age distributions. This is important since the incidence of most cancers increases with age. An age-adjusted cancer incidence (or death) rate is defined as the number of new cancers (or deaths) per 100,000 population that would occur in a certain period of time if that population had a 'standard' age distribution. In the California Health Maps, incidence rates are age-adjusted using the U.S. 2000 Standard Population.
Aggregation: Collections of smaller units grouped together for the purposes of statistical reporting. See Methodology for more information.
Annual Checkups: Visits to doctor for routine checkup within the past year among adults aged 18+ years. Source: PLACES Project. Centers for Disease Control and Prevention, 2023.
Cervical Cancer Screening: Cervical cancer screening among adult women aged 21-65 years. Source: PLACES Project. Centers for Disease Control and Prevention, 2023.
Colorectal Cancer Screening: Colorectal cancer screening among adults aged 50-75 years. Source: PLACES Project. Centers for Disease Control and Prevention, 2023.
Confidence Interval: A statistical measure of the precision of the observed incidence rate. The lower confidence interval (LCI) and upper confidence interval (UCI) provide a range within which the true rate is thought to be with 95% confidence. Rates based on larger numbers are subject to less variation.
Data Suppression: According to California Department of Public Health guidelines, cancer incidence rates cannot be reported if based on fewer than 15 cancer cases and/or 10,000 population counts. Incidence rates with fewer than 15 cases and/or 10,000 population-at-risk for a given cancer site/sex/racial or ethnic group are not shown to ensure confidentiality and stable statistical rates.
Demographics: Statistical data relating to the population and particular groups within it.
Foreign Born: Percent of residents who were born outside the United States. Source: American Community Survey, 2015-2019 and 2018-2022.
Incidence: The number of new cases of cancer diagnosed over a specified period of time (per population).
Mammograms: Mammography use among women aged 50-74 years. Source: PLACES Project. Centers for Disease Control and Prevention, 2023.
Obesity: Obesity among adults aged 18+ years. Source: PLACES Project. Centers for Disease Control and Prevention, 2023.
Over 65: Percent of residents age 65 years and older. Source: SEER census tract estimates by race/origin, Vintage 2020.
Population: Total population, based on SEER census tract estimates. Source: SEER census tract estimates by race/origin, Vintage 2020. Note: state and county cancer incidence rates are calculated using population data from the National Center for Health Statistics to match published rates.
Preventive Care (Men, 65+ years)
Older adult men aged 65 years or older who are up to date on a core set of clinical preventive services: Flu shot past year, Pneumococcal vaccination (PPV) shot ever, Colorectal cancer screening.
Source: PLACES Project. Centers for Disease Control and Prevention, 2023.
Preventive Care (Women, 65+ years)
Older adult women aged 65 years or older who are up to date on a core set of clinical preventive services: Flu shot past year, Pneumococcal vaccination (PPV) shot ever, Colorectal cancer screening, and Mammogram past 2 years.
Source: PLACES Project. Centers for Disease Control and Prevention, 2023.
Race and Ethnicity: Race and ethnicity is categorized as: Non-Hispanic (NH) White, NH Black, NH Asian/Pacific Islander, or Hispanic. "All races and ethnicities" includes all of the above, as well as other and unknown race or ethnicity and American Indian/Alaska Native. The latter two groups are not reported separately due to small numbers for many cancer sites.
Racial and Ethnic Composition: Distribution of residents' race and ethnicity (e.g., % Hispanic, % non-Hispanic White, % non-Hispanic Black, % non-Hispanic Asian/Pacific Islander). Source: SEER census tract estimates by race/origin, Vintage 2020.
Rural: Percent of residents who reside in blocks that are designated as rural. Source: US Census, 2010 and 2020.
Sex: California Cancer Registry defines this field as the sex or gender of the cancer patient, and codes available are male, female, intersex, transsexual, and transgender (natal male, natal female, or not specified). However, categories beyond male and female are not consistently coded by medical reporting facilities, and population estimates for gender categories beyond male and female are not available. Thus, cancer incidence data are reported for only male and female sex at this time. Source: PLACES Project. Centers for Disease Control and Prevention, 2023.
Smoking: Current smoking among adults aged 18+ years. Source: PLACES Project. Centers for Disease Control and Prevention, 2023.
Socioeconomic Status (Neighborhood Level): A composite measure of seven indicator variables created by principal component analysis; indicators include: education, blue collar job, unemployment, household income, poverty, rent, and house value. Quintiles based on state distribution, with quintile 1 being the lowest SES and 5 being the highest. Source: American Community Survey, 2015-2019 and 2018-2022.
Uninsured: Percent of residents who did not have health insurance. Source: American Community Survey, 2015-2019 and 2018-2022.
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The number of new cases of cancer diagnosed in the selected time period.
Age-adjustment is a statistical method that allows comparisons of incidence rates to be made between populations with different age distributions. This is important since the incidence of most cancers increases with age. An age-adjusted cancer incidence (or death) rate is defined as the number of new cancers (or deaths) per 100,000 population that would occur in a certain period of time if that population had a 'standard' age distribution. In the California Health Maps, incidence rates are age-adjusted using the U.S. 2000 Standard Population.
A statistical measure of the precision of the observed incidence rate. The lower confidence interval (LCI) and upper confidence interval (UCI) provide a range within which the true rate is thought to be with 95% confidence. Rates based on larger numbers are subject to less variation.
Percent of residents who did not have health insurance. Source: American Community Survey, 2015-2019 and 2018-2022.
Total population, based on SEER census tract estimates. Source: SEER census tract estimates by race/origin, Vintage 2020. Note: state and county cancer incidence rates are calculated using population data from the National Center for Health Statistics to match published rates.
Percent of residents who are non-Hispanic White. Source: SEER census tract estimates by race/origin, Vintage 2020.
Percent of residents who are non-Hispanic Black. Source: SEER census tract estimates by race/origin, Vintage 2020.
Percent of residents who are Hispanic. Source: SEER census tract estimates by race/origin, Vintage 2020.
Percent of residents who are non-Hispanic Asian/Pacific Islander. Source: SEER census tract estimates by race/origin, Vintage 2020.
Percent of residents who were born outside the United States. Source: American Community Survey, 2015-2019 and 2018-2022.
Percent of residents who reside in blocks that are designated as rural. Source: US Census, 2010 and 2020.
A composite measure of seven indicator variables created by principal component analysis; indicators include: education, blue collar job, unemployment, household income, poverty, rent, and house value. Quintiles based on state distribution, with quintile 1 being the lowest SES and 5 being the highest. Source: American Community Survey, 2015-2019 and 2018-2022.
Race and ethnicity is categorized as: Non-Hispanic (NH) White, NH Black, NH Asian/Pacific Islander, or Hispanic. "All races and ethnicities" includes all of the above, as well as other and unknown race or ethnicity and American Indian/Alaska Native. The latter two groups are not reported separately due to small numbers for many cancer sites.
California Cancer Registry defines this field as the sex or gender of the cancer patient, and codes available are male, female, intersex, transsexual, and transgender (natal male, natal female, or not specified). However, categories beyond male and female are not consistently coded by medical reporting facilities, and population estimates for gender categories beyond male and female are not available. Thus, cancer incidence data are reported for only male and female sex at this time. Source: PLACES Project. Centers for Disease Control and Prevention, 2023.
All incidence rates are for invasive cancers except for urinary bladder which include both in situ and invasive cancer cases.
Colorectal cancer screening among adults aged 50-75 years. Source: PLACES Project. Centers for Disease Control and Prevention, 2023.
Mammography use among women aged 50-74 years. Source: PLACES Project. Centers for Disease Control and Prevention, 2023.
Percent of residents age 65 years and older. Source: SEER census tract estimates by race/origin, Vintage 2020.
Older adult men aged 65 years or older who are up to date on a core set of clinical preventive services: Flu shot past year, Pneumococcal vaccination (PPV) shot ever, Colorectal cancer screening. Source: PLACES Project. Centers for Disease Control and Prevention, 2023.
Older adult women aged 65 years or older who are up to date on a core set of clinical preventive services: Flu shot past year, Pneumococcal vaccination (PPV) shot ever, Colorectal cancer screening, and Mammogram past 2 years. Source: PLACES Project. Centers for Disease Control and Prevention, 2023.
Visits to doctor for routine checkup within the past year among adults aged 18+ years. Source: PLACES Project. Centers for Disease Control and Prevention, 2023.
Cervical cancer screening among adult women aged 21-65 years. Source: PLACES Project. Centers for Disease Control and Prevention, 2023.
Current smoking among adults aged 18+ years. Source: PLACES Project. Centers for Disease Control and Prevention, 2023.
Obesity among adults aged 18+ years. Source: PLACES Project. Centers for Disease Control and Prevention, 2023.
Non-cancer metrics are not available by sex or race and ethnicity.
