The purpose of this Preventive Oncology Academic Award is to enable Paul C Schroy III, M.D. to acquire additional training in new disciplines relevant to preventive oncology and to initiate community-based research that addresses critical issues in the area of colorectal cancer prevention and early detection. Dr. Schroy's educational goals are to 1) obtain a master of Public Health degree; 2) acquire multidisciplinary expertise in areas relevant to preventive oncology through frequent interactions with various sponsors, consultants and co-investigators, and 3.) expand participation in ongoing cancer prevention activities at Boston University Medical Center and outside organizations such as the American Cancer Society and Boston's Center for Community Health, Education, Research and Service (CCHERS). Dr. Schroy's first research objective is to develop, implement an evaluate a model for primary care-directed community-based colorectal cancer control. The model employs a two-tiered strategy which consists of 1) an on-site practice-oriented provider education program, which includes both didactic and sigmidoscopy training, to enhance provider compliance, and 2) provisions for on-site primary care directed colorectal screening services. The model's impact on provider attitudes and practice patterns will be evaluated at 10 Neighborhood Health Centers (NHCs), including 5 intervention and 5 control sites, using a quasi-experimental design. Provider attitudes and practice patterns will be monitored and compared using pre-post-educational surveys and sigmoidoscopy appointment schedules, respectively. Dr. Schroy's second research objective is to identify demographic, behavioral, and/or psychosocial determinants of compliance with screening sigmoidoscopy for racially/ethnically-diverse inner city populations. To achieve this goal, the plan is to: 1) arrange focus group interviews at select NHCs. 2) develop a survey instrument utilizing data derived from the focus groups; 3) conduct an expanded survey of patients referred for sigmoidoscopy at select NHCs to assess the validity and generalizability of the focus group data; and 4) compare responses from compliers and noncompliers to identify discriminating factors. Dr. Schroy's third research objective is to further define the clinical role of molecular testing for the p21ras oncoprotein. Specifically, he plans to 1) determine whether the prevalence and/or type of p21ras mutation(s) in colorectal adenomas/carcinomas varies among racially- /ethnically-diverse high-risk groups to justify expanded population testing. 2) continue ongoing correlative studies to define the relationship between p21ras mutational status and clinicopathologic determinants of adenoma progression, 3) establish a database from which to assess the predictive value of p21ras mutational status with respect to patient outcome at a 3-year surveillance colonoscopy.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Academic/Teacher Award (ATA) (K07)
Project #
5K07CA068058-05
Application #
6172781
Study Section
Cancer Research Manpower and Education Review Committee (CRME)
Program Officer
Gorelic, Lester S
Project Start
1996-09-30
Project End
2001-09-29
Budget Start
2000-09-30
Budget End
2001-09-29
Support Year
5
Fiscal Year
2000
Total Cost
$88,398
Indirect Cost
Name
Boston University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
604483045
City
Boston
State
MA
Country
United States
Zip Code
02118
Schroy 3rd, Paul C; Lal, Subodh K; Wilson, Sheila et al. (2005) Deficiencies in knowledge and familial risk communication among colorectal adenoma patients. J Clin Gastroenterol 39:298-302
Lal, Subodh K; Barrison, Adam; Heeren, Timothy et al. (2004) A national survey of flexible sigmoidoscopy training in primary care graduate and postgraduate education programs. Am J Gastroenterol 99:830-6
Barrison, Adam F; Smith, Christopher; Oviedo, Jaime et al. (2003) Colorectal cancer screening and familial risk: a survey of internal medicine residents' knowledge and practice patterns. Am J Gastroenterol 98:1410-6
Schroy 3rd, Paul C; Barrison, Adam F; Ling, Bruce S et al. (2002) Family history and colorectal cancer screening: a survey of physician knowledge and practice patterns. Am J Gastroenterol 97:1031-6
Schroy 3rd, P C; Geller, A C; Crosier Wood, M et al. (2001) Utilization of colorectal cancer screening tests: a 1997 survey of Massachusetts internists. Prev Med 33:381-91
Pho, K; Geller, A; Schroy 3rd, P C (2000) Lack of communication about familial colorectal cancer risk associated with colorectal adenomas (United States). Cancer Causes Control 11:543-6
Schroy, P C; Heeren, T; Bliss, C M et al. (1999) Implementation of on-site screening sigmoidoscopy positively influences utilization by primary care providers. Gastroenterology 117:304-11