National Cancer Institute
Cancer Control & Population Sciences Home - NCI's Bridge to Public Health Research, Practice and Policy

Grant Details

Grant Number: 5U01CA088283-07 Interpret this number
Primary Investigator: Mandelblatt, Jeanne
Organization: Georgetown University
Project Title: CISNET: the "Spectrum" of Breast Cancer Disparities
Fiscal Year: 2007
Back to top


Abstract

DESCRIPTION (provided by applicant): Breast cancer remains the second most common cancer in women, and is one of the few cancer sites for which incidence rates continue to rise. In addition, despite improvements in breast cancer survival, racial disparities in mortality remain pervasive. These mortality disparities have been widening over the last two decades, with the odds of dying from breast cancer for Black vs. White women increasing from 1.27 in 1984 to 1.85 in 1999. This racial inequality in breast cancer outcomes is cast on the backdrop of an obesity epidemic. We have assembled an experienced multidisciplinary team from Georgetown University, Einstein College of Medicine, Erasmus University, and RAND to use two established models (SPECTRUM and MISCAN) to develop a mini "base case" with common parameters to simulate how obesity (defined as BMI >30) interacts with risk, screening outcomes, and treatment effectiveness to effect trends in overall and race specific US breast cancer incidence and mortality from 1975 to 2015. We will also project results to 2025 to capture the lag time in effects of obesity (and screening). We have selected obesity as a key modifiable risk factor to be examined since it has been identified as a proximate target for change to achieve the Healthy People 2010 targets, disproportionately effects Black women, and impacts breast cancer incidence and mortality through several mechanisms with potentially competing effects. As secondary goals, we will also examine how screening policies and treatment improvements are likely to impact future differences in rates of breast cancer between Black and White women. Our objectives will be accomplished in three phases: In the first phase, we will focus on developing the common data inputs needed to address our research questions. In phase 2, we will use the models to synthesize the data and conduct analyses. Finally, in Phase 3, we will use the results to inform policy and practice relevant discussions and make the models available to others to address emerging research questions. Throughout, we will also collaborate with other CISNET modeling groups. By working together with 2 models, we can achieve important economies of scale, test the impact of model structure on results, provide a range of plausible projections, and contribute to a better understanding of the science of modeling. Overall, the information generated by these models will provide a framework to inform policy debates about equity in care and how to best achieve targeted reductions in breast cancer morbidity and mortality for all US women.

Back to top


Publications

Evaluating the cost-effectiveness of cancer patient navigation programs: conceptual and practical issues.
Authors: Ramsey S, Whitley E, Mears VW, McKoy JM, Everhart RM, Caswell RJ, Fiscella K, Hurd TC, Battaglia T, Mandelblatt J, Patient Navigation Research Program Group
Source: Cancer, 2009 Dec 1;115(23), p. 5394-403.
PMID: 19685528
Related Citations

Grant Numbers:
PHS HHS - HHSN261200700048U NCI NIH HHS - U01 CA116875-04 NCI NIH HHS - U01 CA116885
NCI NIH HHS - U01 CA116924-04S1 NCI NIH HHS - U01 CA116903 NCI NIH HHS - U01 CA117281
NCI NIH HHS - U01 CA116925-04 NCI NIH HHS - U01 CA116903-04 PHS HHS - 263-FQ-612391
NCI NIH HHS - K05 CA096940-08 NCI NIH HHS - U01 CA116885-04 NCI NIH HHS - U01 CA116892
NCRR NIH HHS - UL1 RR025755 NCI NIH HHS - U01 CA88283 NCI NIH HHS - U01 CA116875
NCI NIH HHS - U01 CA117281-04 NCI NIH HHS - U01 CA116892-04 NCI NIH HHS - U01 CA116937-04
NCI NIH HHS - U01 CA088283-04 NCI NIH HHS - KO5 CA96940 NCI NIH HHS - U01 CA116925
NCI NIH HHS - U01 CA116937 NCI NIH HHS - U01 CA116924

MeSH Terms:
Neoplasms Humans Cost-Benefit Analysis
Government Programs Program Evaluation Healthcare Disparities
Health Services Accessibility

Back to top


Communication between older women and physicians: preliminary implications for satisfaction and intention to have mammography.
Authors: Liang W, Kasman D, Wang JH, Yuan EH, Mandelblatt JS
Source: Patient Educ Couns, 2006 Dec;64(1-3), p. 387-92.
EPub date: 2006 Jul 26.
PMID: 16872797
Related Citations

Grant Numbers:
NCI NIH HHS - 1K07CA90352-01A1 NCI NIH HHS - 5U01 CA88283-05 NIA NIH HHS - R44 AG15737

MeSH Terms:
Clinical Competence Health Services Needs and Demand Mammography
Attitude of Health Personnel Patient Satisfaction Chi-Square Distribution
Humans Women Medical Staff, Hospital
Communication Internal Medicine Aged
Faculty, Medical Cross-Sectional Studies Hospitals, University
Trust Patient Compliance Intention
Physician-Patient Relations Male Female
Outpatient Clinics, Hospital

Back to top


Effect of screening and adjuvant therapy on mortality from breast cancer.
Authors: Berry DA, Cronin KA, Plevritis SK, Fryback DG, Clarke L, Zelen M, Mandelblatt JS, Yakovlev AY, Habbema JD, Feuer EJ, Cancer Intervention and Surveillance Modeling Network (CISNET) Collaborators
Source: N Engl J Med, 2005 Oct 27;353(17), p. 1784-92.
PMID: 16251534
Related Citations

Grant Numbers:
NCI NIH HHS - U01CA70040 NCI NIH HHS - CA88177 NCI NIH HHS - U01CA63731
NCI NIH HHS - U01CA63740 NCI NIH HHS - CA88278 NCI NIH HHS - CA88248
NCI NIH HHS - CA88283 NCI NIH HHS - U01CA63736 NCI NIH HHS - CA88270
NCI NIH HHS - U01CA86076 NCI NIH HHS - CA88202 NCI NIH HHS - U01CA86082
NCI NIH HHS - CA88211 NCI NIH HHS - U01CA70013 NCI NIH HHS - U01CA69976

MeSH Terms:
United States Mammography Neoplasm Staging
Antineoplastic Agents Humans SEER Program
Aged Breast Neoplasms Models, Statistical
Tamoxifen Mass Screening Adult
Incidence Middle Aged Chemotherapy, Adjuvant
Female Survival Analysis

Back to top




Last Updated: August 24, 2012
NIH - Turning Discovery Into Health
National Cancer InstituteU.S. National Institutes of HealthNational Cancer Institute