Application) The objectives of the personal plans described in this Preventive Oncology Academic Award application include receiving additional training in the areas of epidemiology, genetics, and to a lesser degree, biostatistics and bioethics. The teaching plans include formal and informal instruction of fellows in the Department of Oncology and graduate students in the Division of Behavioral Sciences and Health Education within the School of Public Health at Johns Hopkins. Long term research plans include studies focusing upon adherence to screening recommendations, training in screening examinations sensitive to examiner proficiency (e.g., breast self exam, clinical breast exam, digital rectal exam), and life style changes to decrease cancer risk. These studies will extend to populations at increased risk of cancer development, particularly those individuals at genetic risk, including individuals of low socioeconomic status. Two of the studies proposed in this application, in addition toaddressing current issues of concern, can be extended to studies targeting individuals at increased risk of cancer development. The third study focuses upon individuals at riskof prostate cancer due to family history of this disease.The specific projects described in this application include: 1) a prospective randomized trial of clinical breast exam proficiency, contrasting two differing training interventions among medical residents; 2) a randomized prospective investigation of BSE sensitivity and specificity among womenages 20-30, initiated due to concerns regarding the effects of false-positive findings on BSE in this age groupand the uncertain efficacy of BSE in decreasing mortality due to breast cancer; 3) a project to increase screening adherence (prostate specific antigen testing; digital rectal exam; trans-rectalultrasonography) among men at increased risk of prostate cancer as afunction of family history. Potential additional projects are also described.
