Browsing by Subject "Breast cancer screening"

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    A National Quality Improvement Study Identifying and Addressing Cancer Screening Deficits Due To the COVID-19 Pandemic
    (Wiley, 2022) Joung, Rachel Hae-Soo; Nelson, Heidi; Mullett, Timothy W.; Kurtzman, Scott H.; Shafir, Sarah; Harris, James B.; Yao, Katharine A.; Brajcich, Brian C.; Bilimoria, Karl Y.; Cance, William G.; Surgery, School of Medicine
    Background: Cancer-related deaths over the next decade are expected to increase due to cancer screening deficits associated with the coronavirus disease 2019 (COVID-19) pandemic. Although national deficits have been quantified, a structured response to identifying and addressing local deficits has not been widely available. The objectives of this report are to share preliminary data on monthly screening deficits in breast, colorectal, lung, and cervical cancers across diverse settings and to provide online materials from a national quality improvement (QI) study to help other institutions to address local screening deficits. Methods: This prospective, national QI study on Return-to-Screening enrolled 748 accredited cancer programs in the United States from April through June 2021. Local prepandemic and pandemic monthly screening test volumes (MTVs) were used to calculate the relative percent change in MTV to describe the monthly screening gap. Results: The majority of facilities reported monthly screening deficits (colorectal cancer, 80.6% [n = 104/129]; cervical cancer, 69.0% [n = 20/29]; breast cancer, 55.3% [n = 241/436]; lung cancer, 44.6% [n = 98/220]). Overall, the median relative percent change in MTV ranged from -17.7% for colorectal cancer (interquartile range [IQR], -33.6% to -2.8%), -6.8% for cervical cancer (IQR, -29.4% to 1.7%), -1.6% for breast cancer (IQR, -9.6% to 7.0%), and 1.2% for lung cancer (IQR, -16.9% to 19.0%). Geographic differences were not observed. There were statistically significant differences in the percent change in MTV between institution types for colorectal cancer screening (P = .02). Conclusion: Cancer screening is still in need of urgent attention, and the screening resources made available online may help facilities to close critical gaps and address screenings missed in 2020. Lay summary: Question: How can the effects of the coronavirus disease 2019 pandemic on cancer screening be mitigated? Findings: When national resources were provided, including methods to calculate local screening deficits, 748 cancer programs promptly enrolled in a national Return-to-Screening study, and the majority identified local screening deficits, most notably in colorectal cancer. Using these results, 814 quality improvement projects were initiated with the potential to add 70,000 screening tests in 2021. Meaning: Cancer screening is still in need of urgent attention, and the online resources that we provide may help to close critical screening deficits.
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    The Effect of Two Interventions to Increase Breast Cancer Screening in RuralWomen
    (MDPI, 2022-09-07) Champion, Victoria L.; Monahan, Patrick O.; Stump, Timothy E.; Biederman, Erika B.; Vachon, Eric; Katz, Mira L.; Rawl, Susan M.; Baltic, Ryan D.; Kettler, Carla D.; Zaborski, Natalie L.; Paskett, Electra D.; School of Nursing
    Guideline-based mammography screening is essential to lowering breast cancer mortality, yet women residing in rural areas have lower rates of up to date (UTD) breast cancer screening compared to women in urban areas. We tested the comparative effectiveness of a tailored DVD, and the DVD plus patient navigation (PN) intervention vs. Usual Care (UC) for increasing the percentage of rural women (aged 50 to 74) UTD for breast cancer screening, as part of a larger study. Four hundred and two women who were not UTD for breast cancer screening, eligible, and between the ages of 50 to 74 were recruited from rural counties in Indiana and Ohio. Consented women were randomly assigned to one of three groups after baseline assessment of sociodemographic variables, health status, beliefs related to cancer screening tests, and history of receipt of guideline-based screening. The mean age of participants was 58.2 years with 97% reporting White race. After adjusting for covariates, 54% of women in the combined intervention (DVD + PN) had a mammogram within the 12-month window, over 5 times the rate of becoming UTD compared to UC (OR = 5.11; 95% CI = 2.57, 10.860; p < 0.001). Interactions of the intervention with other variables were not significant. Significant predictors of being UTD included: being in contemplation stage (intending to have a mammogram in the next 6 months), being UTD with other cancer screenings, having more disposable income and receiving a reminder for breast screening. Women who lived in areas with greater Area Deprivation Index scores (a measure of poverty) were less likely to become UTD with breast cancer screening. For rural women who were not UTD with mammography screening, the addition of PN to a tailored DVD significantly improved the uptake of mammography. Attention should be paid to certain groups of women most at risk for not receiving UTD breast screening to improve breast cancer outcomes in rural women.
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    Translation, Adaptation, and Validation of the Modified Thai Version of Champion’s Health Belief Model Scale (MT-CHBMS)
    (MDPI, 2022-12-31) Suriyong, Patinya; Jiraniramai, Surin; Wongpakaran, Nahathai; Pinyopornpanish, Kanokporn; Angkurawaranon, Chaisiri; Jiraporncharoen, Wichuda; Champion, Victoria L.; Wongpakaran, Tinakon; School of Nursing
    Background: While breast cancer is the leading cause of cancer death among Thai women, breast self-examination (BSE), mammography, and ultrasound use are still underutilized. There is a need to assess women’s beliefs about breast cancer and screening in different cultural settings. As a result, a tool to measure the beliefs that influence breast-cancer-screening practices is needed. Champion’s Health Belief Model Scale (CHBMS) is a valid and reliable tool for assessing individuals’ attitudes toward breast cancer and screening methods, but it has not been validated in Thai women. The study aimed to translate and validate the CHBMS for breast self-examination and mammography among Thai women and to modify the original scale by adding ultrasound items for breast cancer screening. In addition, the purpose of this study was to create a modified Thai version of the CHBMS which could be used to better understand patients’ beliefs regarding breast cancer screening in Thailand, in order to develop practical and effective interventions suited to their beliefs. Methods: The CHBMS was translated into Thai, validated by a panel of experts, back-translated, modified by adding content about ultrasound for screening breast cancer, and pretested. Confirmatory factor analysis was used with a sample of 130 Thai women aged 40 to 70 years old. Result: The final MT-CHBMS consisted of 64 items determining ten subscales: susceptibility, seriousness, benefits—breast self-examination, benefits—mammogram, barriers—BSE, barriers—mammogram, confidence, health motivation, benefits—ultrasound, and barriers—ultrasound. The MT-CHBMS demonstrated excellent internal consistency. The ten-factor model was best fitted to the data. Conclusion: The MT-CHBMS was found to be a reliable and valid tool for measuring individuals’ attitudes toward breast cancer and screening methods. The scale could be easily used by healthcare providers to determine the beliefs before planning appropriate interventions to increase early detection.