Although the benefits of screening mammography are well established among white women, very little is known about the efficacy of mammography among black women. This is the starting point for the proposed project which is a direct outgrowth of an earlier study, supported by an AHCPR dissertation research grant, Race Differences in Stage at Diagnosis of Breast Cancer. The results of this earlier study suggested a race difference in efficacy of screening mammography: a positive history of screening mammography was protective against later stage at diagnosis in white women, but not in black women. Given the importance of ensuring that the benefits of screening mammography be the same for women of both races, this finding calls for further exploration. The general aims of this investigation are to: 1) assess variability in the quality of the screening mammography process in the state of Connecticut, and 2) examine how this variability is distributed between black and white women. A strategy of surveying mammography facilities in Connecticut to collect facility-based data (e.g., technical data on equipment, personnel, and techniques) will be combined with assembling a cohort of 1000 (minimum) black and white women, in approximately equal numbers, who have presented for a screening mammogram in selected facilities in urban centers. These women will be interviewed one month after the screening exam, and again two years later. The first interview will provide data on individual characteristics as well as the subject's encounter with the health care setting (e.g., did she receive notification of results and recommendations for future screening). These data will be used to evaluate race differences in various aspects of the mammography process and to predict subsequent screening behavior. The follow-up interview at 24 months will provide outcome data on repeat screening, interval of screening, and resolution of any breast problem which occurred since the index exam. A third component is a pilot study to review the mammographic films of a subset of study subjects to determine if there are differences in the quality of the film itself which may be related to underlying biologic processes. Together, these sources of data will be used to address the hypothesis that, in practice, there are barriers to the full promise of mammography for some women, and these women are more likely to be black than white.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project (R01)
Project #
5R01CA070731-04
Application #
2733228
Study Section
Special Emphasis Panel (HCT)
Program Officer
Meissner, Helen I
Project Start
1995-09-26
Project End
2000-06-30
Budget Start
1998-07-15
Budget End
2000-06-30
Support Year
4
Fiscal Year
1998
Total Cost
Indirect Cost
Name
Yale University
Department
Public Health & Prev Medicine
Type
Schools of Medicine
DUNS #
082359691
City
New Haven
State
CT
Country
United States
Zip Code
06520
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Dailey, Amy B; Kasl, Stanislav V; Holford, Theodore R et al. (2007) Perceived racial discrimination and nonadherence to screening mammography guidelines: results from the race differences in the screening mammography process study. Am J Epidemiol 165:1287-95
Jones, Beth A; Reams, Kam; Calvocoressi, Lisa et al. (2007) Adequacy of communicating results from screening mammograms to African American and White women. Am J Public Health 97:531-8
Dailey, Amy B; Kasl, Stanislav V; Holford, Theodore R et al. (2007) Neighborhood-level socioeconomic predictors of nonadherence to mammography screening guidelines. Cancer Epidemiol Biomarkers Prev 16:2293-303
Jones, Beth A; Dailey, Amy; Calvocoressi, Lisa et al. (2005) Inadequate follow-up of abnormal screening mammograms: findings from the race differences in screening mammography process study (United States). Cancer Causes Control 16:809-21
Calvocoressi, Lisa; Stolar, Marilyn; Kasl, Stanislav V et al. (2005) Applying recursive partitioning to a prospective study of factors associated with adherence to mammography screening guidelines. Am J Epidemiol 162:1215-24
Calvocoressi, Lisa; Kasl, Stanislav V; Lee, Carol H et al. (2004) A prospective study of perceived susceptibility to breast cancer and nonadherence to mammography screening guidelines in African American and White women ages 40 to 79 years. Cancer Epidemiol Biomarkers Prev 13:2096-105
Habelhah, H; Shah, K; Huang, L et al. (2001) Identification of new JNK substrate using ATP pocket mutant JNK and a corresponding ATP analogue. J Biol Chem 276:18090-5

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