Mammography and High-Risk Survivors of Pediatric Cancer

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DESCRIPTION (provided by applicant) Female survivors who were treated with chest radiation for a pediatric malignancy face a significantly increased risk of breast cancer at a young age. Current recommendations in this high-risk population are to initiate screening mammography at age 25 or eight years after completion of radiation therapy. Most women who were exposed to radiation therapy for a pediatric cancer are not engaged in an age appropriate program of regular screening mammography. How the cancer experience influences the health beliefs and practices of this high-risk group, especially as they relate to breast cancer screening practices, is not known. It is critically important to characterize the perception and knowledge of risk, health beliefs, and the barriers to and facilitators of mammography in this unique population. The aims of this two-year exploratory R-21 are: (1) to determine the prevalence and frequency of screening mammography in female survivors, 25-49 years of age, who were treated with chest radiation (CHEST RT); (2) to identify predictors/correlates of screening mammography in the CHEST RT group; correlates to be studied will include sociodemographics, survivor-related health beliefs, knowledge and risk perception, health locus of control, and measures of psychological distress; (3a) for ages 25-39 years, to determine if knowledge and risk perception of breast cancer in the CHEST RT group are different from age matched survivors at standard risk (NO CHEST RT) and siblings of survivors (SIBLINGS); and (3b) for ages 40-49 years, to determine if screening practices and correlates in the CHEST RT group are different from age-matched NO CHEST RT and SIBLINGS groups. This study will be conducted through the Childhood Cancer Survivor Study (CCSS), an NCI-supported cohort study following 14,000 long-term survivors of childhood cancer and 3,500 siblings. A questionnaire will be mailed to a random sample of 2100 females (700 females/group), 25-49 years of age, from the following three groups: CHEST RT, SIBLINGS, and NO CHEST RT. Telephone interviews will be conducted with passive non-responders. Findings from this exploratory study will provide the critically important theoretical foundation needed to develop a targeted intervention intended to increase the breast cancer screening rate of this vulnerable and high-risk population.