In this project, we propose to develop and test a communication strategy to support clinical decision making about a key step in a personalized breast cancer screening paradigm, the age of initiating breast cancer screening. The absolute benefit of mammography screening varies according to risk of developing breast cancer, a risk that depends upon multiple factors and particularly age. Women at lower risk of breast cancer will experience smaller absolute benefits from screening, but are likely to have the same risk of false positives and other adverse effects. This variation in the risk-benefit ratio of a particular screening strategy according to individual characteristics is fundamental to the personalized screening paradigm. However, there is little evidence about how best to communicate this information to women considering screening. The proposed project includes two phases. In Phase 1, we will conduct a series of experimental studies to examine the effect of alternative communication strategies on comprehension and the correlation between screening intentions and the absolute benefit and risk in the scenarios. Based on recent advances in communication theory and our preliminary work, we will focus on the potential impact of exemplars and of information addressing the expertise and motives of the information sources. In Phase 2, we will test a decision aid based upon the results of Phase 1 in an cross-over, clustered randomized controlled trial in a primary care population, examining its effects on knowledge, decision satisfaction and screening.focusing on the correlation between the absolute benefit of screening and screening utilization. PHS

National Institute of Health (NIH)
National Cancer Institute (NCI)
Specialized Center--Cooperative Agreements (U54)
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Special Emphasis Panel (ZCA1-SRLB-R (O1))
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University of Pennsylvania
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Wood, Marie E; Sprague, Brian L; Oustimov, Andrew et al. (2017) Aspirin use is associated with lower mammographic density in a large screening cohort. Breast Cancer Res Treat 162:419-425
Conant, Emily F; Keller, Brad M; Pantalone, Lauren et al. (2017) Agreement between Breast Percentage Density Estimations from Standard-Dose versus Synthetic Digital Mammograms: Results from a Large Screening Cohort Using Automated Measures. Radiology 283:673-680
Balasubramanian, Bijal A; Garcia, Michael P; Corley, Douglas A et al. (2017) Racial/ethnic differences in obesity and comorbidities between safety-net- and non safety-net integrated health systems. Medicine (Baltimore) 96:e6326
Weiss, Julie E; Goodrich, Martha; Harris, Kimberly A et al. (2017) Challenges With Identifying Indication for Examination in Breast Imaging as a Key Clinical Attribute in Practice, Research, and Policy. J Am Coll Radiol 14:198-207.e2
McDonald, Elizabeth S; McCarthy, Anne Marie; Weinstein, Susan P et al. (2017) BI-RADS Category 3 Comparison: Probably Benign Category after Recall from Screening before and after Implementation of Digital Breast Tomosynthesis. Radiology 285:778-787
Haas, Jennifer S; Barlow, William E; Schapira, Marilyn M et al. (2017) Primary Care Providers' Beliefs and Recommendations and Use of Screening Mammography by their Patients. J Gen Intern Med 32:449-457
Chudgar, A V; Conant, E F; Weinstein, S P et al. (2017) Assessment of disease extent on contrast-enhanced MRI in breast cancer detected at digital breast tomosynthesis versus digital mammography alone. Clin Radiol 72:573-579
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
Korhonen, Katrina E; Weinstein, Susan P; McDonald, Elizabeth S et al. (2016) Strategies to Increase Cancer Detection: Review of True-Positive and False-Negative Results at Digital Breast Tomosynthesis Screening. Radiographics 36:1954-1965
Haas, Jennifer S; Sprague, Brian L; Klabunde, Carrie N et al. (2016) Provider Attitudes and Screening Practices Following Changes in Breast and Cervical Cancer Screening Guidelines. J Gen Intern Med 31:52-9

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