Grant Number:	1R01CA134722-01A1 Interpret this number
Primary Investigator:	Oeffinger, Kevin
Organization:	Sloan-Kettering Inst Can Research
Project Title:	Empower Study: Promoting Bc Screening in Women Who Survived Childhood Cancer
Fiscal Year:	2009

DESCRIPTION (provided by applicant): Women who have been treated with chest radiation for a childhood cancer frequently have multiple health problems and have a significantly increased risk of developing breast cancer at a young age (prior to their forties). Although breast cancer surveillance with annual mammography and adjunct breast MRI is recommended starting at age 25, most young women are not obtaining screening. We have conducted preliminary studies to identify important predictors of screening and successfully piloted an intervention leading to increased rates of breast cancer screening among this high risk population. To reduce the breast cancer related morbidity and mortality faced by women who survived childhood cancer, it is imperative to formally test behaviorally-based intervention studies intended to promote breast cancer surveillance. In the proposed 12-month intervention trial, among 330 women who are 25 to 39 years of age and who have not had a mammogram (or similar screening imaging study) in the preceding two years, we will test the efficacy of an intervention aimed at increasing the likelihood of successfully completing the recommended surveillance. The intervention, theoretically founded upon the Transtheoretical Model and the Health Belief Model, consists of a mailed tailored education intervention followed by a stage-based brief motivational interview delivered by telephone. The primary outcome is obtaining a mammogram during the 12-month study period, confirmed by medical record. We hypothesize that women randomized to the intervention group will have a 20% higher rate of screening mammography than women randomized to the attention control group. Secondary aims will include exploring moderating and mediating factors that predict mammogram completion and timing of the obtained surveillance, determining the percent of women who obtain an adjunct breast MRI and explore barriers to completing this imaging test (e.g., insurance/cost, physician authorization), and estimating the intervention replication costs and costs resulting from the intervention. The proposed EMPOWER (Encouraging Mammography/MRI and Preventive Opportunities for Women Exposed to Radiation) study brings together a research team with the necessary expertise and experience in both survivorship research and telephone delivered motivational interviewing with the unique resource of the 26-institution Childhood Cancer Survivor Study (CCSS). Notably, the CCSS represents the single largest cohort of women in the target population and the infrastructure to conduct the proposed study. This study will represent the first randomized controlled trial aimed at promoting breast cancer surveillance among women who are treated with chest radiation for a childhood cancer and will advance our understanding of this vulnerable group.




Association of Changes in Cancer Therapy Over 3 Decades With Risk of Subsequent Breast Cancer Among Female Childhood Cancer Survivors: A Report From the Childhood Cancer Survivor Study (CCSS).
Authors: Henderson T.O. , Liu Q. , Turcotte L.M. , Neglia J.P. , Leisenring W. , Hodgson D. , Diller L. , Kenney L. , Morton L. , Berrington de Gonzalez A. , et al. .
Source: Jama Oncology, 2022-10-13 00:00:00.0; , .
EPub date: 2022-10-13 00:00:00.0.
PMID: 36227603
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Long-term care for people treated for cancer during childhood and adolescence.
Authors: Tonorezos E.S. , Cohn R.J. , Glaser A.W. , Lewin J. , Poon E. , Wakefield C.E. , Oeffinger K.C. .
Source: Lancet (london, England), 2022-04-16 00:00:00.0; 399(10334), p. 1561-1572.
PMID: 35430023
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Development and Validation of a Breast Cancer Risk Prediction Model for Childhood Cancer Survivors Treated With Chest Radiation: A Report From the Childhood Cancer Survivor Study and the Dutch Hodgkin Late Effects and LATER Cohorts.
Authors: Moskowitz C.S. , Ronckers C.M. , Chou J.F. , Smith S.A. , Friedman D.N. , Barnea D. , Kok J.L. , de Vries S. , Wolden S.L. , Henderson T.O. , et al. .
Source: Journal Of Clinical Oncology : Official Journal Of The American Society Of Clinical Oncology, 2021-09-20 00:00:00.0; 39(27), p. 3012-3021.
EPub date: 2021-05-28 00:00:00.0.
PMID: 34048292
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Hodgkin Lymphoma Survivors: We Need to Do Better.
Authors: Henderson T.O. , Oeffinger K.C. .
Source: Journal Of The National Cancer Institute, 2021-06-01 00:00:00.0; 113(6), p. 654-655.
PMID: 33351151
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Updated Breast Cancer Surveillance Recommendations for Female Survivors of Childhood, Adolescent, and Young Adult Cancer From the International Guideline Harmonization Group.
Authors: Mulder R.L. , Hudson M.M. , Bhatia S. , Landier W. , Levitt G. , Constine L.S. , Wallace W.H. , van Leeuwen F.E. , Ronckers C.M. , Henderson T.O. , et al. .
Source: Journal Of Clinical Oncology : Official Journal Of The American Society Of Clinical Oncology, 2020-12-10 00:00:00.0; 38(35), p. 4194-4207.
EPub date: 2020-09-29 00:00:00.0.
PMID: 33078972
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Clinical Benefits, Harms, and Cost-Effectiveness of Breast Cancer Screening for Survivors of Childhood Cancer Treated With Chest Radiation: A Comparative Modeling Study.
Authors: Yeh J.M. , Lowry K.P. , Schechter C.B. , Diller L.R. , Alagoz O. , Armstrong G.T. , Hampton J.M. , Leisenring W. , Liu Q. , Mandelblatt J.S. , et al. .
Source: Annals Of Internal Medicine, 2020-07-07 00:00:00.0; , .
EPub date: 2020-07-07 00:00:00.0.
PMID: 32628531
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Promoting Breast Cancer Surveillance: The EMPOWER Study, a Randomized Clinical Trial in the Childhood Cancer Survivor Study.
Authors: Oeffinger K.C. , Ford J.S. , Moskowitz C.S. , Chou J.F. , Henderson T.O. , Hudson M.M. , Diller L. , McDonald A. , Ford J. , Mubdi N.Z. , et al. .
Source: Journal Of Clinical Oncology : Official Journal Of The American Society Of Clinical Oncology, 2019-08-20 00:00:00.0; 37(24), p. 2131-2140.
EPub date: 2019-07-01 00:00:00.0.
PMID: 31260642
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Mortality After Breast Cancer Among Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study.
Authors: Moskowitz C.S. , Chou J.F. , Neglia J.P. , Partridge A.H. , Howell R.M. , Diller L.R. , Novetsky Friedman D. , Barnea D. , Morton L.M. , Turcotte L.M. , et al. .
Source: Journal Of Clinical Oncology : Official Journal Of The American Society Of Clinical Oncology, 2019-08-20 00:00:00.0; 37(24), p. 2120-2130.
EPub date: 2019-07-01 00:00:00.0.
PMID: 31260644
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Radiation-associated breast cancer and gonadal hormone exposure: a report from the Childhood Cancer Survivor Study.
Authors: Moskowitz C.S. , Chou J.F. , Sklar C.A. , Barnea D. , Ronckers C.M. , Friedman D.N. , Neglia J.P. , Turcotte L. , Howell R.M. , Henderson T.O. , et al. .
Source: British Journal Of Cancer, 2017-07-11 00:00:00.0; 117(2), p. 290-299.
EPub date: 2017-06-20 00:00:00.0.
PMID: 28632729
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Breast Cancer Risk In Childhood Cancer Survivors Without A History Of Chest Radiotherapy: A Report From The Childhood Cancer Survivor Study
Authors: Henderson T.O. , Moskowitz C.S. , Chou J.F. , Bradbury A.R. , Neglia J.P. , Dang C.T. , Onel K. , Novetsky Friedman D. , Bhatia S. , Strong L.C. , et al. .
Source: Journal Of Clinical Oncology : Official Journal Of The American Society Of Clinical Oncology, 2016-03-20 00:00:00.0; 34(9), p. 910-8.
PMID: 26700127
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Specialty care for adult survivors of childhood cancer.
Authors: Tonorezos E.S. , Oeffinger K.C. .
Source: Cancer, 2015-12-15 00:00:00.0; 121(24), p. 4279-81.
EPub date: 2015-12-15 00:00:00.0.
PMID: 26407076
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Enhancing Health Care Of Survivors Of Childhood Cancer With Tailored Education
Authors: Henderson T.O. , Oeffinger K.C. .
Source: Journal Of Clinical Oncology : Official Journal Of The American Society Of Clinical Oncology, 2015-11-20 00:00:00.0; 33(33), p. 3849-50.
PMID: 26460304
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Health care utilization, lifestyle, and emotional factors and mammography practices in the Childhood Cancer Survivor Study.
Authors: Rosenberg S.M. , Moskowitz C.S. , Ford J.S. , Henderson T.O. , Frazier A.L. , Diller L.R. , Hudson M.M. , Stanton A.L. , Chou J.F. , Smith S. , et al. .
Source: Cancer Epidemiology, Biomarkers & Prevention : A Publication Of The American Association For Cancer Research, Cosponsored By The American Society Of Preventive Oncology, 2015 Nov; 24(11), p. 1699-706.
PMID: 26304504
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Breast Cancer Following Spinal Irradiation For A Childhood Cancer: A Report From The Childhood Cancer Survivor Study
Authors: Moskowitz C.S. , Malhotra J. , Chou J.F. , Wolden S.L. , Weathers R.E. , Stovall M. , Armstrong G.T. , Leisenring W.M. , Neglia J.P. , Robison L.L. , et al. .
Source: Radiotherapy And Oncology : Journal Of The European Society For Therapeutic Radiology And Oncology, 2015 Nov; 117(2), p. 213-6.
PMID: 26391961
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Predicting Adverse Health Outcomes In Long-term Survivors Of A Childhood Cancer
Authors: Moskowitz C.S. , Oeffinger K.C. .
Source: Children (basel, Switzerland), 2014 Sep; 1(2), p. 63-73.
PMID: 26236650
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Breast cancer after chest radiation therapy for childhood cancer.
Authors: Moskowitz C.S. , Chou J.F. , Wolden S.L. , Bernstein J.L. , Malhotra J. , Novetsky Friedman D. , Mubdi N.Z. , Leisenring W.M. , Stovall M. , Hammond S. , et al. .
Source: Journal Of Clinical Oncology : Official Journal Of The American Society Of Clinical Oncology, 2014-07-20 00:00:00.0; 32(21), p. 2217-23.
EPub date: 2014-07-20 00:00:00.0.
PMID: 24752044
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Recommendations For Breast Cancer Surveillance For Female Survivors Of Childhood, Adolescent, And Young Adult Cancer Given Chest Radiation: A Report From The International Late Effects Of Childhood Cancer Guideline Harmonization Group
Authors: Mulder R.L. , Kremer L.C. , Hudson M.M. , Bhatia S. , Landier W. , Levitt G. , Constine L.S. , Wallace W.H. , van Leeuwen F.E. , Ronckers C.M. , et al. .
Source: The Lancet. Oncology, 2013 Dec; 14(13), p. e621-9.
PMID: 24275135
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Survivor Profiles Predict Health Behavior Intent: The Childhood Cancer Survivor Study
Authors: Cox,C.L. , Zhu,L. , Finnegan,L. , Steen,B.D. , Hudson,M.M. , Robison,L.L. , Oeffinger,K.C. .
Source: Psycho-oncology, 2012 May; 21(5), p. 469-78.
PMID: 21381147
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Screening And Surveillance For Second Malignant Neoplasms In Adult Survivors Of Childhood Cancer: A Report From The Childhood Cancer Survivor Study
Authors: Nathan,P.C. , Ness,K.K. , Mahoney,M.C. , Li,Z. , Hudson,M.M. , Ford,J.S. , Landier,W. , Stovall,M. , Armstrong,G.T. , Henderson,T.O. , et al. .
Source: Annals Of Internal Medicine, 2010-10-05 00:00:00.0; 153(7), p. 442-51.
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Inconsistent mammography perceptions and practices among women at risk of breast cancer following a pediatric malignancy: a report from the Childhood Cancer Survivor Study.
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Source: Cancer Causes & Control : Ccc, 2010 Oct; 21(10), p. 1585-95.
PMID: 20506037
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Systematic Review: Surveillance For Breast Cancer In Women Treated With Chest Radiation For Childhood, Adolescent, Or Young Adult Cancer
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Source: Annals Of Internal Medicine, 2010-04-06 00:00:00.0; 152(7), p. 444-55; W144-54.
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