bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract B103: Time for a change in breast cancer screening? A survey of female physicians’ perception of 2009 USPSTF guidelines on breast cancer screening
Authors: Liu Hui , Sloan Susan , Nasreen Fahima , Krishnamurthy Mahesh 
Published: December 2010

Abstract
Objective: To explore the attitudes and compliance of female physicians to the 2009 USPSTF guidelines and its influencing factors.
Methods: An anonymous cross-sectional survey was conducted on the SurveyMonkey website with a self-designed questionnaire. Email invitations were sent to the presidents of various organizations including American Medical Association (AMA) to explain the purpose of this survey and to recruit participates. Of the 111 female physicians participated in the survey, 109 completed the questionnaire, resulting in an effective response rate of 98.2%.
Results: Mammography (71.7%) and clinical breast examination (67.3%) are the most preferred screening tests of female physicians for women aged 40 to 49 years. Consistent with the results, mammography was considered as “very effective” in reducing breast cancer mortality in women aged 40 to 49 years by 66.7% of respondents, compared with breast self examination (23.4%) and clinical breast examination (24.8%) (P &lt; 0.0001). Logistic regression analysis results showed that the following items “Recommend not to begin routine screening mammography in women aged 40 to 49 years”, “Recommend biennial screening mammography in women aged 50 to 74 years”, and the female physicians’ age would significantly influence the female physicians’ decision on whether or not to follow the 2009 USPSTF guidelines.
Conclusion: Our survey reveals that most female physician's unwillingness to follow the 2009 USPSTF guidelines is primarily associated with their opposition to the 2009 USPSTF guidelines not to begin routine screening mammography in women aged 40 to 49 years and to start biennial screening mammography in women aged 50 to 74 years. The concerns about the false positive rate and the cost-effectiveness of breast cancer screening, particularly the routine screening mammography for women aged 40 to 49 years, did not significantly influence the female physicians to follow the 2009 USPSTF guidelines. Based on these findings, we propose the following: 1. Inform women about the harms and benefits of mammography as a component of informed decision making and continue annual screening mammography starting at age 40; 2. Educate the public about breast cancer and the importance of early screening remains a high priority. Personalized risk assessment and screening tailored to risks are our future goals. Although there remains some debate about the optimal age at which to begin screening and the optimal frequency of screening, as more robust evidence and improved technical advances are more readily available, the USPSTF guidelines will be updated. The art and science of medicine continue to be intertwined as physicians attempt to balance their current knowledge with the needs and concerns of their individual patients.
Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):B103.
Abstract B113: Regional differences in barriers to breast cancer screening among low-income African American women in Nashville, Chattanooga, and Memphis Tennessee
Authors: Kenerson Donna M. , Patel Kushal , Liu Jianguo , Hargreaves Margaret K. 
Published: December 2010

Abstract
Background: African American women are more likely to have advanced breast cancer at the time of diagnosis and experience worse outcomes than Caucasian women. National surveys have shown that African American women obtain less breast cancer screening than Caucasian women. However, the degree to which psychosocial and economic barriers contribute to racial differences in breast cancer screening remains unclear.
Objectives: The purpose of this study was to examine regional predictors of breast cancer screening among African American women residing in Nashville, Chattanooga, and Memphis. In addition to regional predictors of breast cancer screening, obstacles to screening were also examined. The aim of this study was to incorporate this information into programs aimed at improving breast cancer screening rates at the three Tennessee cities.
Methods: As part of the Meharry Community Networks Program (CNP) needs assessment, a community survey was administered to assess demographic characteristics, breast cancer screening practices, health care access and utilization, and lifestyle behaviors of low-income African American women. Participants were recruited from predominantly African American communities in Nashville, Chattanooga, and Memphis. Only women 40 years and older were included in this study. The final sample size was 286.
Results: The screening rates for mammograms within the past two years among African American women, 40 years and older in Nashville, Chattanooga, and Memphis were 65%, 67% and 62% respectively. There were no regional differences in the screening rates. The predictors of mammograms in the three regions included having made at least one medical visit in the past year, annual household income, employment status, and health insurance status. Although geographically, there were similar predictors of breast cancer screening, there were differences in barriers to screening among the three cities. For example, Memphis participants were more likely to report transportation issues and child/elderly care as obstacles to screening compared to participants in Nashville and Chattanooga (p&lt;.05). In addition, Nashville and Memphis were more likely to report fear of a positive cancer diagnosis than Chattanooga (p&lt;.05).
Discussion: Understanding regional similarities and differences in breast cancer screening behaviors among African American women is important for addressing psychosocial and economic barriers that may contribute to low screening rates.
Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):B113.
Abstract B18: Impact of Nueva Vida's model on self-efficacy in Latinas with breast cancer
Authors: Caicedo Larisa , BrintzenhofeSzoc Karlynn , Zabora James R. 
Published: December 2010

Abstract
Purpose: Cancer is the second leading cause of death in the Latino population in the United States and for Latina's the most common cancer diagnosis is breast cancer. Latina's diagnosed with breast cancer have a higher mortality rate than their white non-Hispanic counterparts (American Cancer Society, 2009). Based on this data and the lived experiences of Latina's with breast cancer in the Washington, DC area Nueva Vida (NV) came to be. NV was founded in 1996 by Latina breast cancer survivors and health professionals to address the lack of culturally sensitive cancer support services for Latinas in the Washington, DC, area. The goal of this community based organization-academic partnership project that will be presented is to evaluate the impact of Nueva Vida's model on levels of self-efficacy, psychological distress, and quality of life. The NV model provides a variety of services that include patient navigation, support groups, individual counseling, peer support, and resources and information. This study is looking at the impact of this model for one year.
Methods: This study is a time-series design with time 1 data collection on the day of initial contact with NV, time 2 within 3-10 days of initial contact, time 3 at 4 months, and time 4 at 12 months. The instruments used in this study include: Cancer Behavior Inventory -Version 2.0 (CBI) measuring self-efficacy (Merluzzi et al, 2001), the Brief Symptom Inventory-18 (BSI-18) measuring psychological distress (Zabora et al., 2001), and the Satisfaction with Life Domains Scale-Breast Cancer (SLDS-BC) measuring quality of life (Spagnola et al., 2003). The sample will include between 60 and 90 Latina women diagnosed with breast cancer who contacted NV and agreed to participate in the study. The interventions offered over the course of the twelve months include, individual counseling, various support group participation, patient navigation, and peer support.
Results: Data collection for this study took place between March 2008 to December 2009. The findings will be presented in regards to the self-efficacy, psychological distress, and quality of life over time. The results will guide the development of a problem-solving intervention which will be implemented in the third year of the grant.
Conclusions: Participants will have an increased awareness of the impact of breast cancer on Latinas and the impact of a targeted program for Latinas has on the study participants. Further, participants will learn the ups and downs of a collaboration between a community based organization and a university in developing and undertaking a research project.
Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):B18.
Abstract B20: Community bridges to cancer clinical trials: Evaluating community education modules
Authors: Green Melissa A. , Michaels Margo , Blakeney Natasha , Richmond Alan , Long Debra , Robinson William , Elliott-Bynum Sharon , Corbie-Smith Giselle 
Published: December 2010

Abstract
Cancer clinical trials are a source for high-quality cancer care. However, they are often perceived as an option of last resort. Raising consciousness about cancer clinical trials in community settings may lead to informed decision-making about cancer clinical trials.
Objective: To modify and pilot training materials for a community organization intervention to positively impact knowledge, attitudes, beliefs, and behaviors regarding cancer research in African American communities in North Carolina.
Methodology: The Education Network to Advance Cancer Clinical Trials, University of North Carolina at Chapel Hill, and four community-based organizations collaborated using CBPR methods to revise cancer clinical trials education materials for Southern African American communities. Three cancer clinical trials education modules were developed and piloted in African American Communities with 128 participatnts. Modules include: 1) a workshop about cancer clinical trials and what they mean for communities; 2) a storytelling discussion describing one person's experience with cancer clinical trials; and 3) a discussion session that reviews the myths and facts about cancer clinical trials.
Results/Impact: This presentation describes the preliminary findings of the intervention. Participants demonstrated understanding of the definition of clinical trials. Preliminary results establish consensus that participants desire equal access to cancer clinical trials, improved community education, and personal interest in learning more about clinical trials.
Conclusions: Culturally sensitive community education sessions about cancer clinical trials improve favorable attitudes towards clinical trials. Actively engaging African American communities in dialogue about cancer research is necessary to create community awareness of the role of cancer research in reducing health disparities. Engaging community partners in cancer clinical trials education is synergistic with their mission of equal access to care.
Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):B20.
Abstract B35: Working to close the gap: Identifying predictors of HPV vaccine initiation among young African American women
Authors: Bynum Shalanda A. , Brandt Heather M. , Sharpe Patricia A. , Williams Michelle S. , Kerr Jelani C. 
Published: December 2010

Abstract
Background: HPV (human papillomavirus) vaccines are recent innovations that have provided a new avenue for cervical cancer prevention. The role of HPV vaccines among groups of women who experience excess cervical cancer incidence and mortality requires further study. The purpose of this study was to assess health beliefs associated with HPV vaccine initiation among young African American (AA) women.
Methods: Three hundred sixty-three African American female college students aged 18-26 were recruited from three Historically Black Colleges/Universities in the southeastern United States. Participants were asked to complete a self-administered, anonymous survey to assess knowledge and beliefs related to HPV and the HPV vaccine.
Results: One-quarter (24%) of participants initiated the HPV vaccine. Women who initiated the HPV vaccine had significantly higher HPV knowledge (p=0.01), lower perceived barriers to vaccination (p&lt;0.01), and were younger (p&lt;0.01) compared to women who had not initiated vaccination. Factors significantly associated with HPV vaccine initiation included: HPV knowledge (OR=1.22), perceived severity of HPV health outcomes, (OR=0.48), perceived barriers to vaccination, (OR=0.49), cues to action (OR=1.94), and age (OR=0.68). The model explained 19% of the variance in HPV vaccine initiation.
Conclusions: Study findings can be used to inform the development of targeted health education and promotion HPV vaccine programs for AA college-aged women to prevent continued disparities in cervical cancer incidence and mortality. Addressing health beliefs will be central to efforts to promote widespread vaccine uptake and future reduction in disease.
Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):B35.
Abstract B38: A summer fellowship designed to engage medical students with demonstrated interest in health disparities: Cancer in the Underprivileged, Indigent or Disadvantaged (CUPID)
Authors: Bunz Fred , Voelker Gail , Zellars Richard 
Published: December 2010

Abstract
Cancer health disparities persist among racial/ethnic minorities and the poor, who historically have been medically underserved. The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins has developed a summer fellowship program that employs a unique approach to address this chronic problem. The Cancer in the Under-Privileged, Indigent or Disadvantaged (CUPID) program is a highly selective 7 week summer fellowship for students who have completed their first year of medical school. Drawn from an applicant pool of over 250 students from 71 US medical schools (2010 data), the 10-11 CUPID fellows accepted each year are selected based on their demonstration of a sustained commitment to serving underserved populations and addressing general health disparities at the level of the individual health care practitioner. Successful CUPID applicants are mature, goal-oriented and dedicated to service. Accepted CUPID fellows have taken an interest in health care disparities and, at an early stage of their careers, have dedicated significant time and energy into addressing these disparities. The strategy is to actively engage these highly motivated students from diverse backgrounds, to instill a sense of excitement about oncology, and to encourage them to consider postgraduate training in medical oncology or one of the oncological subspecialties. To the best of our knowledge, there is no other program in the U.S. like CUPID. The CUPID program provides a structured research experience in oncology laboratories of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins. This laboratory work is accompanied by daily didactic presentations by our diverse faculty that are designed to provide an engaging overview of the molecular basis of cancer, the major areas of modern cancer research, challenges in clinical oncology, and academic approaches to alleviating cancer health disparities. In addition, students are introduced to the efforts of the federal government and a historically black medical college to address cancer health disparities via day programs conducted by partners at the National Cancer Institute in Bethesda and Howard University. The desired outcome is for CUPID fellows to eventually alleviate cancer health disparities as practicing physicians, serving the underprivileged, indigent and/or disadvantaged. By bringing a diverse group of highly motivated students together for an intensive oncology experience early in their training, we expect to instill an enthusiasm for oncology in a group of future caregivers who are most likely to serve the underserved.
Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):B38.
Abstract B78: Is race a prognostic factor for lung cancer?
Authors: Krug Courtney E. , Gress Todd W. , Tirona Maria T. , Mousa Luay , Lark Chris , Sehgal Rajesh , Joan C. 
Published: December 2010

Abstract
Introduction: Lung cancer is the leading cause of cancer related deaths in the United States. Impact of race on prognosis of lung cancer has been controversial. We performed a retrospective study to evaluate if survival differences exist in patients of different races diagnosed with lung cancer and potential causes of these differences, if they exist.
Methods: Data on patients diagnosed with lung cancer from 2003-2008 were collected from the Cancer Information Resource File (CIRF). Of 150,038 patients, complete data on age, gender, stage, histology, radiation therapy, chemotherapy, surgery and survival were available on 130,517 patients. Data were analyzed according to race and grouped into three categories: white, black, and other races (all non-white and non-black patients).
Results: Of 130,517 patients evaluated, 91.4% were white, 6.5% were black, and 2.1% were other races. Within each race category, the percentage of patients less than 70 years of age were 54,67, and 59, and male patients were 55,58, and 56 in white, black, and other races, respectively. Non small cell lung cancer was found in 83.3,87.7, and 86.6%, small cell lung cancer was found in 16.3,12, and 12.9% and mixed histology lung cancer was found in 0.4,0.3, and 0.5% in white, black, and other races, respectively. The percentage of patients with stage I was 23,19, and 21; stage II was 7,6, and 5; stage III was 29,31, and 30; and stage IV was 41,44, and 44 in white, black, and other races, respectively. The percentage of patients receiving chemotherapy was 44, 43, and 45; radiation therapy was 49,52, and 45; and surgery was 28, 21, and 28 in white, black, and other races, respectively. Median overall survival (MOS) in months was 10.3,9.1, and 11.8 in white, black, and other races, respectively. On multivariate analysis, factors affecting overall survival were age greater than 70 [hazard ratio (HR) 1.3], male gender (HR 1.2), chemotherapy (HR 0.57), surgery (HR 0.37), radiation therapy (HR 0.9), and bronchoalveolar (BAL) histology (HR 0.69). Race was an independent risk factor for other races compared to white patients (HR 0.86, CI 0.83-0.90), but not for black compared to white patients (HR 1.01, CI 0.98-1.03).
Conclusion: Race is not an independent prognostic factor for overall survival for black patients, but was a better prognostic factor for other races when compared to white patients. A higher percentage of black patients presented at a later stage and a lower percentage received surgery, and these factors may have contributed to a lower MOS compared to whites and other races. BAL histology had a favorable prognosis than other histologies. Prospective, randomized clinical trials are required to explore differences noted in MOS, stage, and histology according to race.
Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):B78.
Abstract B80: Timing of radiation therapy for rectal cancer improves survival for select racial/ethnic groups
Authors: Lee Wendy , Artinyan Avo , Mailey Brian , Bhatia Smita , Garcia-Aguilar Julio , Kim Joseph 
Published: December 2010

Abstract
Background: Radiation therapy has an established role in the multimodal management of rectal cancer. Despite consensus on the benefit of radiation therapy, the optimal timing of radiation administration—neoadjuvant vs. adjuvant—has been much debated and is not yet established. Our group has recently shown that race and ethnicity correlate with rectal cancer outcomes. Our objective was to investigate the impact that race and ethnicity may have on rectal cancer outcomes in relation to timing of radiation therapy.
Methods: We used the Los Angeles County Cancer Surveillance Program (CSP) to identify patients who underwent curative surgical resection for rectal adenocarcinoma from 1988-2006. Patients were stratified by race and ethnicity (white, black, Hispanic, and Asian) and timing of radiation therapy (neoadjuvant or adjuvant). Clinical and pathologic characteristics were compared and survival curves were analyzed by Kaplan-Meier method.
Results: Of the 7,908 surgically resected patients identified from CSP, 39% (n=3,107) received radiation therapy. Among the patients receiving radiation therapy, the majority of patients received adjuvant radiation therapy (58%; n=1,789). Stratified by race and ethnicity (white, n=1,613; black, n=283; Hispanic, n=608; Asian, n=435), there was no difference in overall survival based on neoadjuvant vs. adjuvant timing of radiation therapy for black patients (median survival [MS] 4.1 vs. 4.9 years, respectively; p=NS) and Hispanic patients (MS 7.6 vs. 6.9 years, respectively; p=NS). However, overall survival was significantly improved for neoadjuvant vs. adjuvant timing of radiation therapy in Asian patients (MS 10.6 vs. 6.5 years; p&lt;0.001, respectively) and white patients (MS 8.4 vs. 6.5 years; p&lt;0.001, respectively).
Conclusions: This is the first report to identify racial and ethnic differences in benefit derived from radiation therapy for rectal cancer. We observed that neoadjuvant radiation compared to adjuvant radiation selectively improved survival in white and Asian patients, but not Hispanic and black patients. The reasons for these differences in treatment efficacy between racial and ethnic groups warrant further investigation to optimize timing of therapy and achieve maximum therapeutic benefit in patients with rectal cancer.
Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):B80.
Abstract B83: Breast cancer risk evaluation and action using the OncoVue Risk Tool in self-referred and targeted minority populations
Authors: Casas Kari A 
Published: December 2010

Abstract
The Breast Cancer RE-ACT (Risk Evaluation and Action) Program at Trinity Clinic provides medical genetics evaluation and personalized recommendations for breast cancer prevention and early detection. The RE-ACT Program has received funding from Komen for the Cure to reach medically underserved and minority women in Tyler, Texas, and our surrounding rural communities. As part of this project, use of the OncoVue breast cancer risk tool was compared between a self-referred population and a population targeted as medically underserved with at least two risk factors for breast cancer. Risk factors considered included affected first degree relative, early age of menarche, nulliparity or first liveborn delivery over age 30, and obesity. The OncoVue test incorporates a woman's personal and family history with a panel of her genetic variants associated with breast cancer risk. The OncoVue test was free to all participants in both of the populations studied. Women in the targeted population were more likely to have a first-degree relative with breast cancer than the self-referred population (48% versus 35%). Hispanic and African American women made up the majority of the targeted group (46% and 20%, respectively) compared to the self-referred population which was 91% Caucasian. Women in the targeted group were younger than the self-referred group (72% versus 45% under age 50). Interestingly, the stratification of results was similar in the two populations despite efforts to reach higher risk women in the targeted group. “Standard” risk was found in 77% and 76% of the self-referred and targeted populations, respectively. “Moderate” risk was identified in 16% and 20% of the self-referred and targeted populations, respectively. Only 7% of the self-referred and 4% of the targeted population of women was classified as “high” risk by the OncoVue.
Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):B83.