Evidence-Based Interventions for Reducing Breast Cancer Disparities: What Works and Where the Gaps Are?
Evidence-Based Interventions for Reducing Breast Cancer Disparities: What Works and Where the Gaps Are?
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DOI：
10.3390/cancers14174122
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发表时间：
2022-08-26
期刊：
影响因子：
5.2
通讯作者：
Terry, Mary Beth
中科院分区：
文献类型：
--
作者：
Kehm, Rebecca D.;Llanos, Adana A. M.;McDonald, Jasmine A.;Tehranifar, Parisa;Terry, Mary Beth
关键词：
乳腺癌是美国和世界上大多数国家妇女最常见的癌症。有许多乳腺癌的危险因素是可以干预的。这包括长期存在的风险因素（体力活动、肥胖、饮酒、母乳喂养）以及新出现的风险因素（早期吸烟、环境化学品）。为了告知未来的预防，我们在国家癌症研究所的在线存储库中列出了现有的循证癌症控制计划（EBCCP）。我们发现，目前还没有针对酒精、母乳喂养或环境化学品的EBCCP。虽然有身体活动，肥胖和早期生活烟草控制的EBCCP，但只有三个项目被确定为高质量，多层次的项目，是为面临乳腺癌差异的人群开发的。因此，仍然需要循证干预措施，以减少乳腺癌的差异。美国国家癌症研究所（NCI）已经建立了一个循证癌症控制计划（EBCCP）的在线存储库，并越来越多地呼吁使用这些EBCCP来减少癌症负担。为了清点现有的EBCCP并确定剩余的差距，我们总结了NCI的EBCCP与降低乳腺癌风险相关，着眼于干预措施，解决面临乳腺癌差异的人群中的多层次影响。对于每个计划，NCI EBCCP库提供了以下专家小组确定的汇总指标：（a）研究完整性，干预影响和传播能力的计划评级（1 - 5级，5个最佳），以及（B）RE-AIM框架评估（0 - 100%）计划范围，有效性，采用和实施。我们量化了符合以下质量标准的EBCCP数量：研究完整性、干预影响和传播能力得分≥ 3，可用RE-AIM覆盖率、有效性、采用和实施得分≥ 50%。为了降低乳腺癌风险，我们评估了与身体活动（PA），肥胖，酒精，早期生活中的烟草控制，母乳喂养和环境化学品暴露相关的EBCCP的存在和质量。我们的综述揭示了EBCCP在降低乳腺癌负担方面的几个主要差距：（1）没有针对关键乳腺癌风险因素（包括酒精，母乳喂养和环境化学品暴露）的EBCCP;（2）在早期生活中存在的PA，肥胖和烟草控制的EBCPP中，只有一小部分（分别为24%、17%和31%）符合所有质量标准（≥ 3 EBCCP评分和≥ 50% RE-AIM评分）和;（3）在符合质量标准的患者中，只有两项PA干预，一项肥胖，没有烟草控制干预措施解决多层次的影响，并在面临乳腺癌差异的人群中制定。因此，需要制定、评估和传播干预措施，以解决重要的风险因素，减少乳腺癌的差异。
Breast cancer is the most common cancer in women in the United States and most countries around the world. There are many breast cancer risk factors that are amenable to intervention. This includes long-established risk factors (physical activity, obesity, alcohol consumption, breastfeeding), as well as emerging risk factors (tobacco smoke in early life, environmental chemicals). To inform future prevention, we inventoried existing evidence-based cancer control programs (EBCCP) in the National Cancer Institute’s online repository. We found that there are no existing EBCCPs for alcohol, breastfeeding, or environmental chemicals. While there are EBCCPs for physical activity, obesity, and early life tobacco control, only three programs were identified as high-quality, multilevel programs that were developed for populations that face breast cancer disparities. There thus remains a need for evidence-based interventions that can reduce breast cancer disparities. The National Cancer Institute (NCI) has established an online repository of evidence-based cancer control programs (EBCCP) and increasingly calls for the usage of these EBCCPs to reduce the cancer burden. To inventory existing EBCCPs and identify remaining gaps, we summarized NCI’s EBCCPs relevant to reducing breast cancer risk with an eye towards interventions that address multiple levels of influence in populations facing breast cancer disparities. For each program, the NCI EBCCP repository provides the following expert panel determined summary metrics: (a) program ratings (1–5 scale, 5 best) of research integrity, intervention impact, and dissemination capability, and (b) RE-AIM framework assessment (0–100%) of program reach, effectiveness, adoption, and implementation. We quantified the number of EBCCPs that met the quality criteria of receiving a score of ≥3 for research integrity, intervention impact, and dissemination capability, and receiving a score of ≥50% for available RE-AIM reach, effectiveness, adoption, and implementation. For breast cancer risk reduction, we assessed the presence and quality of EBCCPs related to physical activity (PA), obesity, alcohol, tobacco control in early life, breastfeeding, and environmental chemical exposures. Our review revealed several major gaps in EBCCPs for reducing the breast cancer burden: (1) there are no EBCCPs for key breast cancer risk factors including alcohol, breastfeeding, and environmental chemical exposures; (2) among the EBCPPs that exist for PA, obesity, and tobacco control in early life, only a small fraction (24%, 17% and 31%, respectively) met all the quality criteria (≥3 EBCCP scores and ≥50% RE-AIM scores) and; (3) of those that met the quality criteria, only two PA interventions, one obesity, and no tobacco control interventions addressed multiple levels of influence and were developed in populations facing breast cancer disparities. Thus, developing, evaluating, and disseminating interventions to address important risk factors and reduce breast cancer disparities are needed.
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DOI：
10.1093/annonc/mdu042
发表时间：
2014-10
期刊：
Annals of oncology : official journal of the European Society for Medical Oncology
影响因子：
--
作者：
Chan DSM;Vieira AR;Aune D;Bandera EV;Greenwood DC;McTiernan A;Navarro Rosenblatt D;Thune I;Vieira R;Norat T
通讯作者：
Norat T
体重指数对HER2阳性乳腺癌中对新辅助治疗的反应的影响：Neoaltto试验的探索性分析。
DOI：
10.1186/s13058-020-01356-w
发表时间：
2020-10-27
期刊：
Breast cancer research : BCR
影响因子：
--
作者：
Di Cosimo S;Porcu L;Agbor-Tarh D;Cinieri S;Franzoi MA;De Santis MC;Saura C;Huober J;Fumagalli D;Izquierdo M;Piccart M;Daidone MG;de Azambuja E
通讯作者：
de Azambuja E
DOI：
10.15585/mmwr.mm7021a1
发表时间：
2021-05-28
期刊：
MMWR. Morbidity and mortality weekly report
影响因子：
--
作者：
Chiang KV;Li R;Anstey EH;Perrine CG
通讯作者：
Perrine CG
DOI：
10.2147/bctt.s268401
发表时间：
2021
期刊：
Breast cancer (Dove Medical Press)
影响因子：
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作者：
Daly AA;Rolph R;Cutress RI;Copson ER
通讯作者：
Copson ER
影响因子：
3.8
作者：
Gaudet MM;Press MF;Haile RW;Lynch CF;Glaser SL;Schildkraut J;Gammon MD;Douglas Thompson W;Bernstein JL
通讯作者：
Bernstein JL