|Grant Number:||5R21CA098594-02 Interpret this number|
|Primary Investigator:||Schootman, Mario|
|Project Title:||Gis and Breast Cancer Screening in Saint Louis|
DESCRIPTION (provided by applicant): Individual-level barriers to breast cancer screening are well documented. Although community factors, such as area deprivation or availability/distribution of medical providers, are independently associated with breast cancer incidence, survival, and with several behaviors (e.g., walking and smoking), their association with screening for breast cancer has received very little attention. The use of geographic information systems (GIS) and multilevel modeling facilitate new and exciting opportunities that could shed new light on potential barriers to screening that could be used to increase breast cancer screening by multilevel interventions. In order to develop effective multilevel interventions to increase screening and to identify where to implement such interventions, it becomes important to investigate the association of community indicators at different geographic levels (zip code, census tract, block group). GIS analyses will be combined with quantitative epidemiological methods to examine the relationship of neighborhood characteristics to breast cancer screening. The goals of the proposed, population-based study are to determine areas where breast cancer screening is underutilized in St. Louis, if women living in neighborhoods characterized by adverse socioeconomic conditions are less likely to be screened for breast cancer, and if this association depends on the geographical classification used to obtain these community indicators. We will collect primary data of 1400 randomly-selected women in the City of St. Louis via telephone interviews (sociodemographics, barriers to screening) and use existing data from the 2000 census (area deprivation and residential segregation), the Food and Drug Administration (mammography location), the Missouri Department of Health and Senior Services (location and distribution of primary care physicians), the City of St. Louis, and the federal Department of Housing and Urban Development. GIS will be used to geographically link the data and construct multiple data layers by respondent address. Advanced multilevel and spatial analyses will be conducted to identify underlying factors for the spatial variation of breast cancer screening and where to target interventions aimed at increasing screening could be implemented.
Geographic variation and effect of area-level poverty rate on colorectal cancer screening.
Authors: Lian M, Schootman M, Yun S
Source: BMC Public Health, 2008 Oct 16;8, p. 358.
EPub date: 2008 Oct 16.
Racial and geographic differences in mammography screening in St. Louis City: a multilevel study.
Authors: Lian M, Jeffe DB, Schootman M
Source: J Urban Health, 2008 Sep;85(5), p. 677-92.
EPub date: 2008 Jul 12.
Geographic clustering of adequate diagnostic follow-up after abnormal screening results for breast cancer among low-income women in Missouri.
Authors: Schootman M, Jeff DB, Gillanders WE, Yan Y, Jenkins B, Aft R
Source: Ann Epidemiol, 2007 Sep;17(9), p. 704-12.
EPub date: 2007 Jun 18.
The effects of radiotherapy for the treatment of contralateral breast cancer.
Authors: Schootman M, Jeffe DB, Gillanders WE, Yan Y, Aft R
Source: Breast Cancer Res Treat, 2007 May;103(1), p. 77-83.
EPub date: 2006 Oct 11.
Prognosis of metachronous contralateral breast cancer according to stage at diagnosis: the importance of early detection.
Authors: Schootman M, Fuortes L, Aft R
Source: Breast Cancer Res Treat, 2006 Sep;99(1), p. 91-5.
EPub date: 2006 Mar 23.
Effect of area poverty rate on cancer screening across US communities.
Authors: Schootman M, Jeffe DB, Baker EA, Walker MS
Source: J Epidemiol Community Health, 2006 Mar;60(3), p. 202-7.
A Bayesian semi-parametric model for colorectal cancer incidences.
Authors: Zhang S, Sun D, He CZ, Schootman M
Source: Stat Med, 2006 Jan 30;25(2), p. 285-309.
Evaluating the utility and accuracy of a reverse telephone directory to identify the location of survey respondents.
Authors: Schootman M, Jeffe D, Kinman E, Higgs G, Jackson-Thompson J
Source: Ann Epidemiol, 2005 Feb;15(2), p. 160-6.
The full potential of breast cancer screening use to reduce mortality has not yet been realized in the United States.
Authors: Schootman M, Jeffe D, Reschke A, Aft R
Source: Breast Cancer Res Treat, 2004 Jun;85(3), p. 219-22.