ANN ARBOR, Mich.—The federal Centers for Disease Control and Prevention has awarded a three-year, $900,000 grant to a University of Michigan School of Nursing-led multidisciplinary team that will develop methods to increase cancer screening by young breast cancer survivors and their high-risk female relatives.
The project director is Maria Katapodi, assistant professor at the U-M School of Nursing and a Robert Wood Johnson Nurse Faculty Scholar. In addition to the School of Nursing, collaborators on the project include the U-M School of Public Health and the Comprehensive Cancer Center at the U-M Medical School, the Prevention Research Center of Michigan, the Michigan Department of Community Health and the Michigan Cancer Consortium.
"This collaboration clearly links the research that is being conducted at the University of Michigan by Dr. Katapodi and her team to state officials who have the ability to readily disseminate these findings through the public health system," said team member and School of Nursing professor Laurel Northouse.
The project proposal, submitted in response to a call for Special Interest Projects put forward by the CDC-funded Prevention Research Center of Michigan, was the only proposal in the country selected for funding.
"Since this specific SIP was only funding one proposal in the whole U.S., we didn't think we were going to get it," Katapodi said. "It was a very pleasant surprise."
Using data from the Cancer Registry, Katapodi and her fellow researchers will identify 3,000 women in Michigan, between the ages of 20 and 45, who have been diagnosed with breast cancer. Diagnosis during this premenopausal age range classifies the disease as high-risk and indicates that there is most likely a strong hereditary component in the cancer.
Next, the research team will survey the women via mail to ascertain their knowledge of their disease, their strategies for managing their cancer risk, and whether they would be willing to act as advocates for their high-risk family members.
"While breast cancer may, in fact, run in families, family members of breast cancer patients often do not participate in screening for early detection of breast cancer, which can enhance survival," said Sonia Duffy, an associate professor at the School of Nursing. "Therefore outreach to family members of breast cancer patients is needed."
The team will then collect information from the women who agree to participate in order to identify who in their families are potentially at high risk for breast cancer. Participants will invite two female relatives from the list supplied by the team to contribute to the study, thus forming family units composed of one breast cancer survivor and two high-risk relatives.
The team will then randomly assign one of two versions of a booklet, so that roughly half of the family units receive version A and the other half receive version B. Version A will present general information on cancer genetics, the importance of early diagnosis and the Michigan Department of Community Health guidelines for breast cancer screening. Version B, however, will be an enhanced, tailored version of the booklet, presenting information personalized for each woman and describing her specific risk assessment based on epidemiologically established models. Each woman's age, family history and personal health history will be taken into account.
After nine months, the participants will be surveyed again to determine whether or not the enhanced, tailored intervention was more efficacious at increasing awareness, knowledge about the genetics of breast cancer, and motivating high-risk relatives to seek screening and genetic counseling. This objective reflects Katapodi's unique interest in how the study of genetics can be better used by nurses and practitioners.
"I'm interested in looking at family history as the most effective and cheapest method of risk assessment for all chronic diseases, not just for cancer," she said. "Getting families talking about their health history is the first step for clinicians to get the information they need."
"This [research] has major policy implications because it represents the next level of trying to bring genetic information to people who do not have this access," said Katapodi. "We're in the unique position to bridge the gap between the people in the labs who generate the knowledge about the contribution of genetic factors in common chronic diseases and the public."