1997 WHRG Grant Program

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Symposia

Health Awareness Screening and Tamoxifen Use Among Women Treated for Breast Cancer
Michelle Althuis
School of Medicine, University of Maryland, Baltimore

Introduction. By the year 2000, new breast cancer will be diagnosed in close to one million women per year, of whom ten percent will develop a second primary cancer during their lifetime. Given the current trends in increased incidence of first primary breast cancer, improved survival and increased risk of many second primary cancers, particularly tamoxifen associated endometrial cancer, screening for subsequent cancers in these patients is an issue of increasing public health importance.

Hypothesis. Breast cancer patients who have characteristics which are positively associated with healthy behaviors and survival have more frequent screens for subsequent cancers of the breast, endometrium, ovaries, and cervix, than women with fewer of these characteristics. The primary characteristics we will examine are 1) use of tamoxifen, 2) sociodemographic factors, and 3) greater knowledge of breast cancer etiology and treatment.

Study Design and Methods This study is a cross-sectional assessment of medical and non-medical prognostic factors for survival, health awareness, screening, and TAM use of 300 women diagnosed with primary, non-metastatic breast cancer between 1/93 and 12/95. Breast cancer patients will be identified from five selected Baltimore area practices. The following outcomes, study variables and key covariates will be obtained from a telephone interview: sociodemographic characteristics, screening attitudes and behaviors, knowledge of cancer etiology and treatment, and risk factors for subsequent cancers. Medical and pathology information, such as stage of disease and therapy, for each woman will be obtained from the Maryland Cancer Registry.

Data Analysis. Multiple regression analysis will be used to assess the relationship between:

tamoxifen use,
sociodemographic characteristics, and
knowledge of breast cancer etiology and treatment and screening, controlling for potential confounders and effect modifiers, specifically disease stage, date of diagnosis, and estrogen receptor status.

Public Health Impact. The proposed study will be the first to our knowledge to collect detailed information on TAM use, medical and non-medical prognostic factors for survival, health awareness, and screening attitudes and behaviors of breast cancer patients from primary sources, that is, by interviewing women as well as relying on cancer registry data. Understanding screening behaviors of breast cancer patients can lead to improved screening compliance and ultimately reduced morbidity and mortality in this rapidly growing population, resulting in decreased burden of these cancers on our health care system.