BREAST CANCER SURVEILLANCE RESEARCH IN NEW MEXICO

虽然在对照试验中筛查乳房X光检查能够减少 乳腺癌死亡率下降30%，其有效性，成本和利用率 在农村和多民族社区，情况不明。我们建议 在该州创建地理上定义的、基于人口的资源 位于新墨西哥州，一个多民族和大部分是农村的州。该资源将 包括完全确定乳房X光检查、乳腺癌 和良性乳腺肿瘤，以及一项基于人群的乳腺癌调查， 筛查和未筛查妇女的风险因素和筛查行为。 这一资源将允许分析和描述性的研究， 筛查乳房X线摄影的以下方面：1）结果的差异， 农村与城市之间以及不同地区之间的 种族人群，2）放射学、病理学和分子差异 在筛查发现的癌症和筛查遗漏的癌症中，3） 该地区最大的HMO的筛查费用，包括 作为诊断时分期函数的后续治疗，和4） 利用非专业健康顾问加强筛查干预项目 在北方新墨西哥州的一个农村和大部分西班牙裔地区， 拟议研究的核心是扩大阿尔伯克基 大都市地区监测系统（由 新墨西哥州肿瘤登记处（1990年）），以包括完整的覆盖范围， 国家的农村地区。此资源由乳房X光检查数据组成，良性 乳腺活检数据和偶发乳腺癌数据。这些联系 三个数据库允许计算乳房X线摄影灵敏度，阳性 预测价值和乳腺X线摄影诊断时的分期分布- 检测癌症我们建议收集所有乳房X光照片的电子数据 在新墨西哥州进行，所有良性和恶性肿瘤的数据 乳腺活检的质量保证和图像质量数据， 放射学小组。对整个妇女人口的监测数据 乳腺癌的风险将因基于人口的 筛查知识、态度和行为电话调查 包括正在和没有接受筛查的女性 乳房X光检查这一资源将提供一个独特的机会， 在西班牙裔、美洲印第安人和 居住在农村和服务不足的非西班牙裔白人。

While screening mammography in controlled trials is capable of decreasing breast cancer mortality by 30%, its effectiveness, Costs, and utilization in rural and ethnically diverse Communities is not known. We propose to create a geographically defined, population-based resource in the state of New Mexico, a multi-ethnic and largely rural state. The resource will include complete ascertainment of screening mammograms, breast cancers, and benign breast tumors, and a population-based survey of breast cancer risk factors and screening behaviors in screened and unscreened women. This resource will allow analytic and descriptive studies of the following aspects of screening mammography: 1) differences in outcomes, performance, and utilization in rural vs. urban and among different ethnic populations, 2) radiologic, pathologic and molecular differences in cancers detected by screening and cancers missed by screening, 3) screening costs in the region's largest HMO, including costs of subsequent treatment as a function of stage at diagnosis, and 4) an intervention project using lay health advisors to increase screening rates in a rural and largely Hispanic region in northern New Mexico. The core of the proposed study is the expansion of the Albuquerque metropolitan area surveillance system (established as a pilot study by the New Mexico Tumor Registry in 1990) to include complete coverage of the state's rural areas. This resource consists of mammogram data, benign breast biopsy data, and incident breast cancer data. Linkage of these three data bases allows calculation of mammography sensitivity, positive predictive value, and stage at diagnosis distribution of mammography- detected cancers. We propose to collect electronic data on all mammograms performed in the state of New Mexico, data on all benign and malignant breast biopsies, and data on quality assurance and image quality for radiology groups. Surveillance data for the entire population of women at risk for breast cancer will be augmented by a population-based telephone survey concerning screening knowledge, attitudes, and behaviors that will include women who are and who are not undergoing screening mammography. This resource will provide a unique opportunity to examine screening mammography performance in Hispanics, American Indians, and non-Hispanic whites residing in rural and underserved populations.