Breast Cancer Early Detection Intervention at Community Health Centers in China

描述（由研究者提供）：乳腺癌仍然是东亚和东南亚妇女的主要死亡原因。研究表明，在过去20年中，在没有进行乳腺癌筛查的情况下，中国妇女的乳腺癌发病率持续上升。尽管中国城市的大型医院可以使用乳房X线摄影技术，但由于公众普遍缺乏对乳房X线摄影的认识，以及缺乏在筛查项目中应用该技术的标准指南，因此其在早期检测中的使用有限。 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。该项目的总体目标是：1）调整和试点测试社区健康中心（CHC）干预措施，以提高中国妇女乳腺癌的早期发现率; 2）加强研究能力和美国NIH资助的首席研究员与中国研究人员之间的合作。为了实现这一目标，我们将 依托我们经验丰富的跨学科、双语/双文化研究团队，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）修改文化上适合的教育课程和行为干预，以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，并评估社区卫生中心为基础的干预在增加知识方面的可行性，可接受性和成功证据，改变态度和提高乳腺癌筛查率~和3）通过指导研究项目、访问学者和讲座加强/扩大美国NIH资助的U 54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，旨在建立进行癌症干预研究的知识和技能。为配合中国近期的医疗改革，将医院护理改为社区护理，本研究将在中国南京的四个社区卫生中心进行，其中两个将被分配为干预组，两个为对照组（每个中心N=400~ 100）。该研究的主要结果是检查社区卫生中心干预对接受干预后六个月提高乳腺癌筛查率的影响。该应用程序是首席研究员的NIH-NCI资助的U 54亚洲社区癌症健康差异中心（9/10-9/15）的扩展，直接关系到其通过增加早期发现来降低癌症发病率和风险行为的目标，并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。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，解决了一个重要的全球健康问题，乳腺癌。这是一个与中国城市高度相关的项目，这些城市的乳腺癌发病率惊人地增加，乳房X射线摄影技术利用不足。它还代表了一种新的模式，即使用乳房X线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.