Breast Cancer Early Detection Intervention at Community Health Centers in China

描述(由调查人员提供)：乳腺癌仍然是东亚和东南亚妇女死亡的主要原因。研究表明，在过去20年里，在没有乳腺癌筛查的情况下，中国女性的乳腺癌发病率持续上升。虽然中国在城市的大型医院都有乳房X光检查技术，但由于公众普遍缺乏对乳房X光检查的认识，以及在筛查项目中应用该技术缺乏标准指南，因此其在早期检测中的使用受到限制。然而，中国公共卫生官员和科学家对使用乳房X光检查进行乳腺癌筛查的兴趣仍然很高。这个拟议项目的总体目标是：1)调整和试点社区卫生中心干预措施，以增加中国女性乳腺癌的早期发现~2)加强美国国立卫生研究院资助的知名首席研究员和中国研究员之间的研究能力和合作。为了实现这一目标，我们将 以我们经验丰富的跨学科、双语/双文化研究团队为基础，在中国开展社区卫生中心干预研究，以实现以下具体目标：1)修改因地制宜的教育课程和行为干预，增加中国社区卫生中心中国妇女的乳腺癌筛查~2)进行试点干预试验，评估以社区卫生中心为基础的干预在增加知识、改变态度和提高乳腺癌筛查率方面的可行性、可接受性和成功的证据~3)通过导师研究项目，加强/扩大美国国立卫生研究院资助的U54首席研究员和中国LMIC科学家之间关于乳腺癌干预的研究能力访问学者和讲座，旨在建立进行癌症干预研究的知识和技能。为配合中国最近的医疗改革，将医院服务改为社区服务，本次研究将在南京市4个社区卫生中心进行，中国，其中2个被分配到干预组，2个被分配到对照组(每个点N=400~100)。这项研究的主要结果是在接受干预后六个月检查社区卫生中心干预对提高乳腺癌筛查率的影响。这项申请是首席调查员NIH-NCI资助的U54亚洲社区癌症健康差异中心(9/10-9/15)的延伸，该中心直接与其目标相关，即通过增加早期发现和刺激合作伙伴在癌症控制培训和研究能力建设方面的合作来减少癌症的发病率和危险行为。这是第一项测试社区卫生中心干预措施以增加中国乳腺癌筛查的研究，以解决一个重要的全球健康问题-乳腺癌。对于中国所在的城市来说，这是一个高度相关的项目，这些城市的乳腺癌发病率上升到了令人震惊的水平，乳房X光检查技术也没有得到充分利用。它还代表了一种新的模式做法，即使用乳房X光摄影进行主动早期检测，而不仅仅是作为一种诊断工具。

DESCRIPTION (provided by investigator): Breast cancer continues to be the primary cause of death among East and Southeast Asian women. Studies indicated a consistent rise in breast cancer rates among Chinese women over the past two decades in the absence of breast cancer screening. Although mammography technology is available in China's large hospitals of urban cities, its use in early detection is limited due to a general lack of public awareness of mammography and to the absence of standard guidelines for the application of this technology in screening programs. However, interest in using mammography for breast cancer screening remains high among Chinese public health officials and scientists. The overall goal of this proposed project is to: 1) adapt and pilot test a community health center (CHC) intervention to increase breast cancer early detection for women in China~ and 2) strengthen a research capacity and collaboration between the U.S. NIH-funded established principal investigator and researchers in China. To accomplish this goal, we will build on our experienced interdisciplinary, bilingual/bicultural research team to conduct a community health center intervention research in China to achieve the following specific aims:1) modify a culturally tailored educational curriculum and behavioral intervention t increase breast cancer screening among Chinese women at community health centers in China~ 2) conduct a pilot intervention trial and evaluate the feasibility, acceptability and evidence of success of the community health center-based intervention in increasing knowledge, changing attitudes and improving breast cancer screening rate~ and 3) strengthen/expand research capacity between the NIH-funded U54 Principal Investigator in the U.S. and LMIC scientists in China on breast cancer intervention through mentored research project, visiting scholars and lectures designed to build knowledge and skills for conducting cancer intervention research. In line with recent China's healthcare reform in changing hospital-care to community care, the study will be carried out at four community health centers in Nanjing, China, two of which will be assigned to intervention group and two to control group (N=400~ 100 from each site). The primary outcome of the study is to examine the impact of a community health center intervention on increasing breast cancer screening rates at six months after receiving the intervention. This application is an extension of Principal Investigator's NIH-NCI funded U54 Asian Community Cancer Health Disparities Center (9/10-9/15) that directly relates to its goals of reducing incidence and risk behaviors of cancer by increasing early detection~ and stimulating partners' collaboration in training and research capacity building on cancer control. This is the first study to test a community health center intervention to increase breast cancer screening in China, addressing a significant globl health problem, breast cancer. It is a highly relevant project for China's urban cities, which hav an alarming increase in incidence rates of breast cancer and underutilization of mammography technology. It also represents a new model practice in using mammography for proactive early detection rather than as a diagnostic tool only.