Community Impact of Breast Cancer: The Social Context
A woman determined to be "at high risk", diagnosed with, or surviving breast cancer is changed forever. The CBCRP supports research and formulation of public policy alternatives that would contribute to breast cancer prevention and improve outcome. The CBCRP recognizes the need for reducing inequities in access to prevention, detection, treatment, and survivorship services for underserved populations. Finally, we encourage sociocultural, psychological, and behavioral research to reduce the impact of breast cancer on each woman.
Three of CBCRP's Priority Issues are represented in this section:
- Health Policy and Health Services: Better Serving Women's Needs
- Sociocultural, Behavioral & Psychological Issues Relevant to Breast Cancer: The Human Side
- Racial/Ethnic Differences in Breast Cancer: Eliminating Disparity
Funding Data:
Proportion of CBCRP's Total |
||
Community Impact grants awarded in 2002: |
6 |
9% |
Funded Amount: |
$926,646 |
6% |
Community Impact Portfolio Summary:
Concerned women and scientists alike have long been puzzled by differences in breast cancer incidence and mortality outcomes among racial/ethnic populations. For example, while African American women have a lower incidence of breast cancer, they have a higher mortality rate. Three grants in the community impact section of this year's research portfolio are looking at both health care system and biological factors that may shed light on this issue.
Priscilla Banks with the African American Advisory Committee and Carol Somkin with the Kaiser Foundation Research Institute will carry out a qualitative study to investigate what it is about the health care settings and interactions with providers and staff that promotes and inhibits the delivery of culturally sensitive care for African American women. They will explore issues of cultural sensitivity in patient-provider/staff communications and the physical and social environment of the health care settings in which the communications take place. They intend to develop testable hypotheses not only about each of these areas separately but also about their interrelationships.
Barbara Cohn of the Public Health Institute is following up her very recent, exciting findings (that certain placental factors during pregnancy seem to be protective factors for breast cancer later in life) for the first time among African American, Asian, and Hispanic women. Sally Glaser of the Northern California Cancer Center, in view of the fact that known risk factors do not explain the majority of the racial/ethnic variation in occurrence, is looking at a novel factor, human leukocyte antigen (HLA), as a new possible genetic factor underlying incidence differences between African American, Hispanic, and white women.
Until the disease is prevented, quality of life issues will continue to be important, especially as new treatment options lengthen survival. Three grants are looking at this issue: two considering various physiological and hormonal aspects of quality of life and one looking at the psychological dimensions. Carolyn Crandall, a clinician practicing at the University of California, Los Angeles, will use a new investigator award to help her in transition to a clinical research career by looking at the quality-of-life impact of treatment on bone density and osteoporosis in breast cancer survivors. Rowan Chlebowski at the Harbor-UCLA Research and Education Institute will test the feasibility of an intervention to achieve weight loss, sufficient to show a reduction in fasting insulin levels in a racially and ethnically diverse population of breast cancer patients in a public hospital setting. He is hoping to eventually be able to show not only an increase in quality of life, but also perhaps a reduction in rates of recurrence.
Finally, Jill Mitchell, a doctoral student at the University of California, Los Angeles, will look at what can be learned from the meaning women give to their breast cancer experience, the processes through which they achieve meaning, and what the differences are among women who achieve positive meaning and those who do not. She will also look at how different themes of meaning correspond to cortisol profiles, which is a physiological measure of stress and a potential indicator of disease progression.
Community Impact Grants Funded in 2002:
African American Women and Breast Cancer: What Works?
[Tax Check-off!]
Banks, Priscilla
African American Advisory Committee
Somkin, Carol
Kaiser Foundation Research Institute
Community Research Collaboration, Pilot Award
1.5 years, $132,055
Weight Loss in Public Hospital Breast Cancer Patients
Chlebowski, Rowan
Harbor-UCLA Research & Education Institute
IDEA Award
1.5 years, $140,941
Can Placenta Factors Explain Race Patterns of Breast Cancer?
Cohn, Barbara
Public Health Institute
IDEA Award
1 year, $86,175
Impact of Breast Cancer and its Therapy on Bone Density
Crandall, Carolyn
University of California, Los Angeles
New Investigator Award
3 years, $300,000
Immune-Function Genes and Race Differences in Breast Cancer
Glaser, Sally
Northern California Cancer Center
STEP Award
2 years, $203,388
Constructed Meaning and Stress in Breast Cancer Experience
Mitchell, Jill
University of California, Los Angeles
Dissertation Award
2 years, $64,087
