Improving Screening Uptake among Breast Cancer Survivors and Their First-Degree Relatives at Elevated Risk to Breast Cancer: Results and Implications of a Randomized Study in the State of Georgia

Lipscomb, Joseph; Escoffery, Cam; Gillespie, Theresa W.; Henley, S. Jane; Smith, Robert A.; Chociemski, Toni; Almon, Lyn; Jiang, Renjian; Sheng, Xi; Goodman, Michael; Ward, Kevin C.

doi:10.3390/ijerph17030977

Open AccessArticle

Improving Screening Uptake among Breast Cancer Survivors and Their First-Degree Relatives at Elevated Risk to Breast Cancer: Results and Implications of a Randomized Study in the State of Georgia

by

Joseph Lipscomb

^1,2,*,

Cam Escoffery

^1,2,

Theresa W. Gillespie

^2,3,

S. Jane Henley

⁴

,

Robert A. Smith

^1,5,

Toni Chociemski

¹,

Lyn Almon

¹,

Renjian Jiang

¹,

Xi Sheng

¹,

Michael Goodman

^1,2 and

Kevin C. Ward

^1,2

¹

Rollins School of Public Health, Emory University; Atlanta, GA 30322, USA

²

Winship Cancer Institute of Emory University; Atlanta, GA 30322, USA

³

Department of Surgery and Department of Hematology and Medical Oncology, Emory University School of Medicine; Atlanta, GA 30322, USA

⁴

Division of Cancer Prevention and Control, U.S. Centers for Disease Control and Prevention; Atlanta, GA 30341, USA

⁵

Cancer Control Program, American Cancer Society; Atlanta, GA 30303, USA

^*

Author to whom correspondence should be addressed.

Int. J. Environ. Res. Public Health 2020, 17(3), 977; https://doi.org/10.3390/ijerph17030977

Submission received: 18 November 2019 / Revised: 20 January 2020 / Accepted: 24 January 2020 / Published: 4 February 2020

(This article belongs to the Special Issue Genomic Applications to Promote Public Health in the Context of Health Disparities)

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Abstract

Women diagnosed with breast cancer at a relatively early age (≤45 years) or with bilateral disease at any age are at elevated risk for additional breast cancer, as are their female first-degree relatives (FDRs). We report on a randomized trial to increase adherence to mammography screening guidelines among survivors and FDRs. From the Georgia Cancer Registry, breast cancer survivors diagnosed during 2000–2009 at six Georgia cancer centers underwent phone interviews about their breast cancer screening behaviors and their FDRs. Nonadherent survivors and FDRs meeting all inclusion criteria were randomized to high-intensity (evidence-based brochure, phone counseling, mailed reminders, and communications with primary care providers) or low-intensity interventions (brochure only). Three and 12-month follow-up questionnaires were completed. Data analyses used standard statistical approaches. Among 1055 survivors and 287 FDRs who were located, contacted, and agreed to participate, 59.5% and 62.7%, respectively, reported breast cancer screening in the past 12 months and were thus ineligible. For survivors enrolled at baseline (N = 95), the proportion reporting adherence to guideline screening by 12 months post-enrollment was similar in the high and low-intensity arms (66.7% vs. 79.2%, p = 0.31). Among FDRs enrolled at baseline (N = 83), screening was significantly higher in the high-intensity arm at 12 months (60.9% vs. 32.4%, p = 0.03). Overall, about 72% of study-eligible survivors (all of whom were screening nonadherent at baseline) reported screening within 12 months of study enrollment. For enrolled FDRs receiving the high-intensity intervention, over 60% reported guideline screening by 12 months. A major conclusion is that using high-quality central cancer registries to identify high-risk breast cancer survivors and then working closely with these survivors to identify their FDRs represents a feasible and effective strategy to promote guideline cancer screening.

Keywords: community-based research; population-based genetic risk screening; breast cancer survivors; first-degree relatives; disease screening; guideline adherence; cancer registries

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MDPI and ACS Style

Lipscomb, J.; Escoffery, C.; Gillespie, T.W.; Henley, S.J.; Smith, R.A.; Chociemski, T.; Almon, L.; Jiang, R.; Sheng, X.; Goodman, M.; et al. Improving Screening Uptake among Breast Cancer Survivors and Their First-Degree Relatives at Elevated Risk to Breast Cancer: Results and Implications of a Randomized Study in the State of Georgia. Int. J. Environ. Res. Public Health 2020, 17, 977. https://doi.org/10.3390/ijerph17030977

AMA Style

Lipscomb J, Escoffery C, Gillespie TW, Henley SJ, Smith RA, Chociemski T, Almon L, Jiang R, Sheng X, Goodman M, et al. Improving Screening Uptake among Breast Cancer Survivors and Their First-Degree Relatives at Elevated Risk to Breast Cancer: Results and Implications of a Randomized Study in the State of Georgia. International Journal of Environmental Research and Public Health. 2020; 17(3):977. https://doi.org/10.3390/ijerph17030977

Chicago/Turabian Style

Lipscomb, Joseph, Cam Escoffery, Theresa W. Gillespie, S. Jane Henley, Robert A. Smith, Toni Chociemski, Lyn Almon, Renjian Jiang, Xi Sheng, Michael Goodman, and et al. 2020. "Improving Screening Uptake among Breast Cancer Survivors and Their First-Degree Relatives at Elevated Risk to Breast Cancer: Results and Implications of a Randomized Study in the State of Georgia" International Journal of Environmental Research and Public Health 17, no. 3: 977. https://doi.org/10.3390/ijerph17030977

APA Style

Lipscomb, J., Escoffery, C., Gillespie, T. W., Henley, S. J., Smith, R. A., Chociemski, T., Almon, L., Jiang, R., Sheng, X., Goodman, M., & Ward, K. C. (2020). Improving Screening Uptake among Breast Cancer Survivors and Their First-Degree Relatives at Elevated Risk to Breast Cancer: Results and Implications of a Randomized Study in the State of Georgia. International Journal of Environmental Research and Public Health, 17(3), 977. https://doi.org/10.3390/ijerph17030977

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Improving Screening Uptake among Breast Cancer Survivors and Their First-Degree Relatives at Elevated Risk to Breast Cancer: Results and Implications of a Randomized Study in the State of Georgia

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