Marin County Breast Cancer Study of Adolescent Risk Factors
|Institution:||University of California, San Francisco|
Margaret Wrensch , M.P.H., Ph.D. -
Mary Gould-Doerr , -
|Award Cycle:||1998 (Cycle IV)||Grant #: 4AB-1801||Award: $77,407|
|Award Type:||CRC Pilot Award|
|Etiology>Other searches for the causes|
This is a collaboration with: 4AB-1800 -
Initial Award Abstract (1998)
Marin Breast Cancer Watch (MBCW) is a grass-roots, nonprofit, tax-exempt organization of approximately 350 members, established in 1995 because of community concern regarding the high incidence of breast cancer in Marin County, California. The long range goal of the MBCW project is to evaluate the hypothesis that, in addition to risk factors that are already well known, there are others, as yet unidentified that may be at play during adolescence and contribute to the high incidence of breast cancer later in life. If found, identification of these other risk factors ultimately may lead to a reduction in the risk of breast cancer. To develop this proposal, MBCW initiated a collaboration with established breast cancer researchers at the University of California, San Francisco to provide scientific input. Guided by the results of the pilot study, and in concert with our UCSF epidemiologic colleagues, we plan to conduct a population based case-control study in Marin County of breast cancer risk factors in adolescence including, but not limited to: physical development, physical activity; diet and nutrition; medical history; prescription, non-prescription, or recreational drug use, alcohol use and smoking, radiation and other potentially carcinogenic environmental exposures, residential history, and sexual activity. The goal of this CRC Pilot Project is to develop a research approach that will best address the potential relationships among breast cancer risk, established breast cancer risk factors (such as reproductive and menstrual histories and socioeconomic status) and novel adolescent and pre-adolescent factors. The preliminary data necessary to prepare a full-scale research proposal on this topic will be collected in this pilot effort. Few modifiable risk factors for breast cancer have yet been defined, despite population migration studies showing that breast cancer risk is modifiable over a single lifetime. In exploring the problem of high breast cancer rates among women in Marin County through a study of modifiable adolescent and pre-adolescent risk factors, we will address two priority areas of breast cancer research. These are breast cancer etiology, through greater attention to relatively unexplored adolescent and pre-adolescent factors, and prevention, through inclusion in the planned full-scale study of a large number of potentially modifiable factors. In this Pilot study, we will: (1) complete comprehensive literature reviews on the role of pre-adolescent and adolescent factors in breast cancer development and on methods to enhance women’s memory and minimize the effect that having breast cancer has on what women remember; (2) conduct three focus groups to review MBCW’s overall hypotheses and help develop methods for enhancing memory of pre-adolescent and adolescent experiences and exposures that can be used in population-based research; (3) refine study hypotheses; (4) develop the study questionnaire, orientation video, and other necessary study materials; (5) conduct informal and formal pilot testing of study materials and methods; and (6) prepare a comprehensive CIRC Full Research Award proposal. We expect that by increasing knowledge of breast cancer etiology, our studies ultimately will enhance possibilities for breast cancer prevention. Bringing together community members and scientists interested in breast cancer research in a successful initial collaborative endeavor will create enthusiasm for future studies. Most importantly, information obtained may suggest learning tools and lifestyle changes in adolescence that can be incorporated into the lives of our daughters to prevent breast cancer.
Final Report (2000)
Marin Breast Cancer Watch (MBCW) is a grassroots, nonprofit, tax-exempt organization of approximately 350 members, established in 1995 because of community concern regarding high incidence of breast cancer in Marin County, California. The long range goal of MBCW is to discover risk factors that ultimately may lead to a reduction of breast cancer. With the University of California, San Francisco, we are investigating the question: did adolescent and preadolescent experiences differ between women with and without breast cancer in Marin County? Specific factors of interest are (1) physical development and changes; (2) adolescent stress, family and social connections; (3) detailed adolescent and contemporary socioeconomic factors; (4) passive and active smoking; (5) alcohol use; (6) residency and migration and (7) standard breast cancer risk factors. Few modifiable risk factors for breast cancer have yet been defined, despite studies showing that breast cancer risk is modifiable over a single lifetime. Adolescent factors have been understudied. This study addressed two priority areas of breast cancer research, namely, breast cancer etiology, through greater attention to relatively unexplored adolescent and pre-adolescent factors, and prevention, through inclusion of some potentially modifiable behavioral and psychosocial factors. In this pilot study, we developed a full proposal to address the research question stated above. In particular, we accomplished the following:
- Completed comprehensive literature reviews of three topics (a) the role of preadolescent and adolescent factors in breast cancer development, (b) effects of recall (differential and non-differential) on interpretation of results of case control studies, and (c) mechanisms for enhancing recall and minimizing effects of recall bias.
- Conducted focus groups with random samples of women with and without breast cancer from Marin County in order to: (a) review MBCW's overall hypotheses to determine if they adequately represent research interests of women in Marin regarding breast cancer, (b) develop methods for enhancing recall of pre-adolescent and adolescent experiences and exposures that can be used in population based research, and (c) evaluate methods for enhancing recall.
- Developed and evaluated a questionnaire, innovative memory tools, and other interview materials necessary for a full study.