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Grant Details

Grant Number: 5R03CA150007-02 Interpret this number
Primary Investigator: Hubbard, Rebecca
Organization: Kaiser Foundation Health Plan Of Washington
Project Title: Estimating the Cumulative Risk of a False-Positive Screening Mammogram.
Fiscal Year: 2011
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Abstract

DESCRIPTION (provided by applicant): Abstract/Project Summary. The goal of cancer screening is to reduce morbidity and mortality through the early detection of disease; but the benefits of screening must be weighed against potential harms, such as false-positive (FP) results, which may lead to increased healthcare costs, patient anxiety, and other adverse outcomes associated with diagnostic follow-up procedures. The overall goal of this research is to develop statistical methods for estimating the cumulative risk of a false-positive (FP) result after multiple rounds of screening in order to facilitate comparative effectiveness research for a variety of screening regimens. Our work will address three specific aims: (1) To describe operating characteristics of existing statistical methods for estimating the cumulative FP risk under scenarios likely to occur in screening mammography; (2) To develop new statistical methods for estimation of the FP risk under dependence of the history of FP results and the screening regimen while incorporating time-varying covariates and allowing for variability among radiologists; (3) To apply new statistical methods to analysis of the FP risk using 13 years of data from the Breast Cancer Surveillance Consortium (BCSC). Under this aim we will analyze data from the BCSC using statistical methods developed under Aim 2 and will carry out comparative effectiveness analyses of the cumulative FP risk after 10 years of annual versus biennial screening, for women beginning screening at age 40 versus 50. This work will allow us to compare the potential harms of proposed breast cancer screening regimens. By contributing information about the potential harms of screening mammography, this work will inform policy-makers and facilitate communication between patients and providers about the risks and benefits of various screening regimens. This will aid both individual decision makers and development of evidence-based guidelines. PUBLIC HEALTH RELEVANCE: Title: Estimating the cumulative risk of a false-positive screening mammogram Project narrative: We propose new statistical methods for estimating the cumulative risk of a false-positive screening mammogram. By contributing information about the potential harms of screening mammography, this work will inform policy-makers and facilitate communication between patients and providers about the risks and benefits of various screening regimens. This will aid both individual decision makers and development of evidence-based guidelines.

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Publications

Impact of mammography screening interval on breast cancer diagnosis by menopausal status and BMI.
Authors: Dittus K. , Geller B. , Weaver D.L. , Kerlikowske K. , Zhu W. , Hubbard R. , Braithwaite D. , O'Meara E.S. , Miglioretti D.L. , Breast Cancer Surveillance Consortium .
Source: Journal of general internal medicine, 2013 Nov; 28(11), p. 1454-62.
EPub date: 2013-06-13.
PMID: 23760741
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The cumulative risk of false-positive fecal occult blood test after 10 years of colorectal cancer screening.
Authors: Hubbard R.A. , Johnson E. , Hsia R. , Rutter C.M. .
Source: Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 2013 Sep; 22(9), p. 1612-9.
EPub date: 2013-07-18.
PMID: 23868091
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Outcomes of screening mammography by frequency, breast density, and postmenopausal hormone therapy.
Authors: Kerlikowske K. , Zhu W. , Hubbard R.A. , Geller B. , Dittus K. , Braithwaite D. , Wernli K.J. , Miglioretti D.L. , O'Meara E.S. , Breast Cancer Surveillance Consortium .
Source: JAMA internal medicine, 2013-05-13; 173(9), p. 807-16.
PMID: 23552817
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Screening outcomes in older US women undergoing multiple mammograms in community practice: does interval, age, or comorbidity score affect tumor characteristics or false positive rates?
Authors: Braithwaite D. , Zhu W. , Hubbard R.A. , O'Meara E.S. , Miglioretti D.L. , Geller B. , Dittus K. , Moore D. , Wernli K.J. , Mandelblatt J. , et al. .
Source: Journal of the National Cancer Institute, 2013-03-06; 105(5), p. 334-41.
EPub date: 2013-02-05.
PMID: 23385442
Related Citations

A semiparametric censoring bias model for estimating the cumulative risk of a false-positive screening test under dependent censoring.
Authors: Hubbard R.A. , Miglioretti D.L. .
Source: Biometrics, 2013 Mar; 69(1), p. 245-53.
EPub date: 2013-02-05.
PMID: 23383717
Related Citations

Comparative effectiveness of digital versus film-screen mammography in community practice in the United States: a cohort study.
Authors: Kerlikowske K. , Hubbard R.A. , Miglioretti D.L. , Geller B.M. , Yankaskas B.C. , Lehman C.D. , Taplin S.H. , Sickles E.A. , Breast Cancer Surveillance Consortium .
Source: Annals of internal medicine, 2011-10-18; 155(8), p. 493-502.
PMID: 22007043
Related Citations

Cumulative probability of false-positive recall or biopsy recommendation after 10 years of screening mammography: a cohort study.
Authors: Hubbard R.A. , Kerlikowske K. , Flowers C.I. , Yankaskas B.C. , Zhu W. , Miglioretti D.L. .
Source: Annals of internal medicine, 2011-10-18; 155(8), p. 481-92.
PMID: 22007042
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