This proposal outlines the implementation and expansion of the Colorado BC screening surveillance system to include all facilities throughout the state that are involved in the provision of MM services to women. Specifically, this proposal requests support for activities to track the results of all MM completed for women in Colorado as well as conduct diagnostic and treatment follow-up for all cases with screen-detected abnormalities. This will include an estimated 300,000 MM and 45,000 women requiring diagnostic follow-up during the first year of the project. Funding currently received from the CDC will be used to continue the rescreening reminder component of CMAP as well as support tracking and follow-up for women who receive subsidized BC screening services from CPCP under the Colorado Women's Cancer Control Initiative. The proposed expansion will be guided by the phased addition of MC located in five specific regions in Colorado with the full expansion completed by Project Year 05. Proposed surveillance activities will include data collection for all completed MMs and characterization of screening results for all women. In addition, diagnostic follow-up will be conducted for all women with screen-detected abnormalities to determine the nature and results of diagnostic evaluation. Further follow-up will be conducted for women determined to have BC upon completion of diagnostic follow-up to ensure that comprehensive data are available concerning clinical characteristics of disease, treatment protocols, morbidity and mortality. Biannual matches of the full surveillance system database with all BC cases in the CCCR will be completed in order to identify interval and non-screen-detected BCs. These matches will also permit validation of data collected by the CPCP surveillance system concerning screen-detected BCs. In addition, the CPCP and CCCR will collaborate on the collection of pathobiology reports for all biopsy cases reported to the surveillance system, including both negative and positive biopsies. The CPCP will collaborate with a national Consortium to define and accomplish standardized data collection strategies and content as well as research priorities. In addition, the CPCP will work with an Advisory Board and investigators from a number of Colorado academic and health care to define and accomplish a BC research agenda for Colorado that draws upon specific components of the proposed screening surveillance system database.
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