Donna Jeffe, Ph.D.
Project Overview:
Early diagnosis and treatment of breast cancer reduces mortality, and delay in presentation of symptomatic disease is associated with poorer survival. Development of strategies to encourage women to promptly seek evaluation of breast symptoms requires better understanding of factors that are associated with patient delays. Although a few informative literature reviews have been published on studies that looked at demographic factors associated with delay in patient presentation with breast disease, little research has been published about women’s own reasons for delay in diagnosis. Therefore, we plan to submit a grant application (R01) to the National Cancer Institute on or before June 1, 2003 for a population-based study of reasons for delay in diagnosis among women with locally advanced breast cancer (LABC) using data from the Iowa Surveillance, Epidemiology and End Results (SEER) program. The proposed R01 also will assess differences in psychosocial and demographic variables between LABC (stages IIB, III, and IV) and non-LABC (stages I and IIA) patients, because we expect these two groups of patients to differ on many of the variables of interest. Results from the R01 should be helpful in developing interventions to encourage earlier detection.
Collaborating with Dr. Donna Jeffe (PI) on the future R01 and proposed pilot study are Drs. Rebecca Aft, Mario Schootman, and Anat Reschke, all currently co-investigators on several funded studies. The members of this collaborative group have experience pertinent to the planned R01, including 1) using the rapid case ascertainment process of the Iowa SEER program, which reports cancer cases identified 3-6 months after diagnosis, 2) using a Computer-assisted Telephone Interview (CaTI) system to interview breast cancer patients, and 3) recruiting cancer patients diagnosed at all stages of disease.
We are requesting funding from the Longer Life Foundation to conduct a necessary pilot study to strengthen our R01 application. The Specific Aims of the pilot study are to: 1) test for differences in response rates between LABC and non-LABC patients and between two recruitment strategies, 2) pilot the interview measures, and 3) test for recall bias by evaluating differences between the two recruitment strategies in the correct reporting of mode of detection (abnormal mammogram vs. palpable mass or other breast symptoms), type of surgery (if any), and receipt of radiation therapy.
Final Report:
Early diagnosis and treatment of breast cancer reduces mortality, and delay in presentation of symptomatic disease is associated with poorer survival. Development of strategies to encourage women to promptly seek evaluation of breast symptoms requires better understanding of factors that are associated with patient delays. Although informative literature reviews have been published on studies that looked at demographic factors associated with delay in patient presentation with breast disease, little research has been published about women’s own reasons for delay in diagnosis. To address this issue, we plan to submit a grant application to the National Cancer Institute for a population-based study of reasons for delay in diagnosis among women with locally advanced breast cancer using data from the Iowa Surveillance, Epidemiology and End Results (SEER) program. The proposed R01 also will assess differences in psychosocial and demographic variables between LABC (stages IIB, III, and IV) and non-LABC (stages I and IIA) patients, because we expect these two groups of patients to differ on many of the variables of interest. Results from the R01 should be helpful in developing interventions to encourage earlier detection among women at higher risk for presenting with late-stage breast cancer.
