Breast cancer screening has led to substantial reductions in breast cancer mortality in the United States over the past 30 years, but not without unintended harms and shortcomings. Comprehensive, population-based, longitudinal data on the entire screening process can evaluate current screening practices and recommend improvements. The Vermont Prosper Research Center (VPRC) proposes to continue and extend the work of the Vermont Breast Cancer Surveillance System (VBCSS), which has 16 years of experience in collecting Integrated patient risk factor, breast imaging, pathology, treatment, cancer outcome and vital status data.
Our first aim i s to document the entire breast cancer screening process In community practice across the state of Vermont. The new data collected will add to our 16 years of longitudinal data, which provide the foundation for our proposed research program, data sharing with the Statistical Coordination Center, and collaborations with other PROSPR sites. Second, we will pursue a research program that improves the screening process by developing prognostic markers that can be used to develop personalized management strategies for ductal carcinoma in situ (DCIS). Using longitudinal data on approximately 1400 DCIS cases from the VBCSS, we will seek to identify novel molecular, morphologic, radiologic, and tumor microenvironment markers that can stratify DCIS patients by risk of progression to invasive disease. Our comparative effectiveness analyses will provide a framework by which new DCIS prognostic markers can be evaluated for their potential impacts on the benefits and harms of screening. Third, we will conduct collaborative research with other PROSPR Research Centers, the PROSPR Statistical Coordination Center, the National Cancer Institute, and the larger research community. Our multidisciplinary team of experienced basic, clinical, and population scientists will lead and participate in trans-Network initiatives and ensure the dissemination of our data and study findings. Accomplishment of these aims will provide a rich source of data for use in evaluating and improving current breast cancer screening processes. Success in our research program will fill an urgent need for identification of DCIS prognostic markers that could enable personalized management strategies.

Public Health Relevance

Breast cancer screening detects many early stage breast cancers (ductal carcinoma in situ or DCIS) that are unlikely to threaten a woman's life. However, aggressive treatment is recommended for all women with DCIS because we cannot currently identify which of these DCIS cases are potentially life threatening. Our research is focused on finding ways to know which DCIS cases are unlikely to progress to invasive cancer so that these women do not have to suffer needlessly from the side effects of aggressive treatment.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Specialized Center--Cooperative Agreements (U54)
Project #
5U54CA163303-04
Application #
8715712
Study Section
Special Emphasis Panel (ZCA1)
Project Start
2014-06-01
Project End
2016-05-31
Budget Start
2014-06-01
Budget End
2015-05-31
Support Year
4
Fiscal Year
2014
Total Cost
Indirect Cost
Name
University of Vermont & St Agric College
Department
Type
DUNS #
City
Burlington
State
VT
Country
United States
Zip Code
05405
Onega, Tracy; Lee, Christoph I; Benkeser, David et al. (2016) Travel Burden to Breast MRI and Utilization: Are Risk and Sociodemographics Related? J Am Coll Radiol 13:611-9
Carney, Patricia A; Allison, Kimberly H; Oster, Natalia V et al. (2016) Identifying and processing the gap between perceived and actual agreement in breast pathology interpretation. Mod Pathol 29:717-26
Corley, Douglas A; Haas, Jennifer S; Kobrin, Sarah (2016) Reducing Variation in the ""Standard of Care"" for Cancer Screening: Recommendations From the PROSPR Consortium. JAMA 315:2067-8
Hubbard, Rebecca A; Ripping, Theodora M; Chubak, Jessica et al. (2016) Statistical Methods for Estimating the Cumulative Risk of Screening Mammography Outcomes. Cancer Epidemiol Biomarkers Prev 25:513-20
Mandelblatt, Jeanne S; Stout, Natasha K; Schechter, Clyde B et al. (2016) Collaborative Modeling of the Benefits and Harms Associated With Different U.S. Breast Cancer Screening Strategies. Ann Intern Med 164:215-25
Schapira, Marilyn M; Sprague, Brian L; Klabunde, Carrie N et al. (2016) Inadequate Systems to Support Breast and Cervical Cancer Screening in Primary Care Practice. J Gen Intern Med 31:1148-55
Sprague, Brian L; Conant, Emily F; Onega, Tracy et al. (2016) Variation in Mammographic Breast Density Assessments Among Radiologists in Clinical Practice: A Multicenter Observational Study. Ann Intern Med 165:457-464
Hubbard, Rebecca A; O'Meara, Ellen S; Henderson, Louise M et al. (2016) Multilevel factors associated with long-term adherence to screening mammography in older women in the U.S. Prev Med 89:169-77
Klabunde, Carrie N; Zheng, Yingye; Quinn, Virginia P et al. (2016) Influence of Age and Comorbidity on Colorectal Cancer Screening in the Elderly. Am J Prev Med 51:e67-75
Valeri, Linda; Chen, Jarvis T; Garcia-Albeniz, Xabier et al. (2016) The Role of Stage at Diagnosis in Colorectal Cancer Black-White Survival Disparities: A Counterfactual Causal Inference Approach. Cancer Epidemiol Biomarkers Prev 25:83-9

Showing the most recent 10 out of 55 publications