National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (3)
- Blood Clots (1)
- Cancer (13)
- (-) Cancer: Breast Cancer (19)
- Cancer: Colorectal Cancer (1)
- Cancer: Ovarian Cancer (1)
- Cardiovascular Conditions (1)
- Case Study (2)
- Clinician-Patient Communication (1)
- Communication (1)
- Education: Patient and Caregiver (1)
- Evidence-Based Practice (1)
- Family Health and History (2)
- Genetics (2)
- Guidelines (1)
- Healthcare-Associated Infections (HAIs) (1)
- Health Information Technology (HIT) (2)
- Heart Disease and Health (1)
- Imaging (3)
- Injuries and Wounds (1)
- Medication (3)
- Patient-Centered Outcomes Research (3)
- Patient Safety (2)
- Prevention (4)
- Racial and Ethnic Minorities (1)
- (-) Risk (19)
- Screening (5)
- Shared Decision Making (1)
- Social Determinants of Health (1)
- Stroke (1)
- Surgery (2)
- Treatments (1)
- U.S. Preventive Services Task Force (USPSTF) (4)
- Women (10)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 19 of 19 Research Studies DisplayedSprague BL, Ichikawa L, Eavey J
Breast cancer risk characteristics of women undergoing whole-breast ultrasound screening versus mammography alone.
This study evaluated mammography screening failure risk among women undergoing supplemental ultrasound screening in clinical practice in comparison with women undergoing mammography alone. Screening ultrasounds and screening mammograms without supplemental screening were identified within three Breast Cancer Surveillance Consortium registries. A clinically significant proportion of women who had undergone mammography screening alone were at high mammography screening failure risk. Ultrasound screening was highly targeted to women with dense breasts, but only a small proportion were high mammography screening failure risk.
AHRQ-funded; HS018366.
Citation: Sprague BL, Ichikawa L, Eavey J .
Breast cancer risk characteristics of women undergoing whole-breast ultrasound screening versus mammography alone.
Cancer 2023 Aug 15; 129(16):2456-68. doi: 10.1002/cncr.34768..
Keywords: Cancer: Breast Cancer, Cancer, Women, Imaging, Screening, Risk
Lowry KP, Ichikawa L, Hubbard RA
Variation in second breast cancer risk after primary invasive cancer by time since primary cancer diagnosis and estrogen receptor status.
This study examined the timing of second breast cancers by primary cancer estrogen receptor (ER) status in the Breast Cancer Surveillance Consortium. The cohort studied included women who were diagnosed with American Joint Commission on Cancer stage I-III breast cancer identified within six Breast Cancer Surveillance Consortium registries from 2000 to 2017. Characteristics collected during primary breast cancer diagnosis included demographics, ER status, and treatment. Second breast cancer events included subsequent ipsilateral or contralateral breast cancers diagnosed >6 months after primary diagnosis. Cumulative incidence and second breast cancer rates by primary cancer ER status during 1-5 versus 6-10 years after diagnosis was examined. At 10 years, the cumulative second breast cancer incidence was 11.8% for women with ER-negative disease and 7.5% for those with ER-positive disease. Women with ER-negative cancer had higher second breast cancer rates than those with ER-positive cancer during the first 5 years of follow-up. After 5 years, second breast cancer rates were similar for women with ER-negative versus ER-positive breast cancer.
AHRQ-funded; HS018366.
Citation: Lowry KP, Ichikawa L, Hubbard RA .
Variation in second breast cancer risk after primary invasive cancer by time since primary cancer diagnosis and estrogen receptor status.
Cancer 2023 Apr 15;129(8):1173-82. doi: 10.1002/cncr.34679.
Keywords: Cancer: Breast Cancer, Cancer, Women, Risk
Conley CC, Wernli KJ, Knerr S
Using protection motivation theory to predict intentions for breast cancer risk management: intervention mechanisms from a randomized controlled trial.
The objective of this study was to evaluate direct and indirect effects of a web-based, Protection Motivation Theory (PMT)-informed education and decision support tool for risk-reducing medication and breast MRI among women with high risk of breast cancer. Findings indicated that PMT-informed intervention effected behavioral intentions. No direct intervention effect on intentions for risk-reducing medication or MRI were found, but there were significant indirect effects on risk-reducing medication intentions via perceived risk, self-efficacy, and response efficacy, and on MRI intentions via perceived risk and response efficacy, The authors suggested that future research should extend these findings from intentions to behavior.
AHRQ-funded; HS022982.
Citation: Conley CC, Wernli KJ, Knerr S .
Using protection motivation theory to predict intentions for breast cancer risk management: intervention mechanisms from a randomized controlled trial.
J Cancer Educ 2023 Feb; 38(1):292-300. doi: 10.1007/s13187-021-02114-y..
Keywords: Cancer: Breast Cancer, Cancer, Risk, Education: Patient and Caregiver, Health Information Technology (HIT)
Kerlikowske K, Su YR, Sprague BL
Association of screening with digital breast tomosynthesis vs digital mammography with risk of interval invasive and advanced breast cancer.
The purpose of this study was to compare digital breast tomosynthesis (DBT) with digital mammography to determine whether DBT was correlated with lower rates of internal invasive cancer and advanced breast cancer, taking into consideration breast density and breast cancer risk. From 2011 through 2018, the researchers studied a cohort of 504,427 women between the ages of 40 and 79 who underwent 375,189 screening DBT exams and 1,003,900 screening digital mammography exams, and who were then followed up for cancer diagnoses between 2011 and 2019 after being identified via linkage to state or regional cancer registries. The median age at the time of screening was 58 years (IQR 50-65 years) and the diagnostic screenings took place at 44 Breast Cancer Surveillance Consortium (BCSC) facilities in the United States. The study found that among women at low to average risk, or at high risk with almost entirely fatty, scattered fibroglandular densities, or heterogeneously dense breasts, advanced cancer rates were not significantly different for DBT vs digital mammography. There was no significant difference between DBT and digital mammography for interval cancer rates per 1000 exams. Interval invasive cancer rates were also not significantly different among the 413,061 examinations with BCSC 5-year risk of 1.67% or higher (high risk) across breast density categories, or among all the 836,250 examinations with BCSC 5-year risk less than 1.67% (low to average-risk). For the 3.6% of women with extremely dense breasts and at high risk of breast cancer (13,291 examinations in the DBT group and 31,300 in the digital mammography group) advanced cancer rates per 1000 examinations were significantly lower for DBT vs digital mammography, but not for women at low to average risk (10,611 examinations in the DBT group and 37,796 in the digital mammography group). The researchers reported that there was no significant difference in the 96.4% of women with extremely dense breasts not at high risk, heterogeneously dense breasts, or nondense breasts, and concluded that screening with DBT vs digital mammography was associated with a significantly lower risk of advanced breast cancer among the 3.6% of women with extremely dense breasts and at high risk of breast cancer, and was not associated with a significant difference in risk of interval invasive cancer.
AHRQ-funded; HS018366.
Citation: Kerlikowske K, Su YR, Sprague BL .
Association of screening with digital breast tomosynthesis vs digital mammography with risk of interval invasive and advanced breast cancer.
JAMA 2022 Jun 14;327(22):2220-30. doi: 10.1001/jama.2022.7672..
Keywords: Cancer: Breast Cancer, Cancer, Screening, Women, Imaging, Risk
Eden KB, Ivlev I, Bensching KL
Use of an online breast cancer risk assessment and patient decision aid in primary care practices.
A cross-sectional study evaluating a web-based breast cancer risk assessment and decision aid (MammoScreen) was conducted in an academic general internal medicine clinic. Breast cancer risk assessment and mammography screening decision support were efficiently implemented through a web-based tool for patients sent through an electronic patient portal. Findings indicated that integration of patient decision aids with risk algorithms in clinical practice may help support the implementation of USPSTF recommendations that include risk assessment and shared decision-making.
AHRQ-funded; HS026370.
Citation: Eden KB, Ivlev I, Bensching KL .
Use of an online breast cancer risk assessment and patient decision aid in primary care practices.
J Womens Health 2020 Jun;29(6):763-69. doi: 10.1089/jwh.2019.8143..
Keywords: U.S. Preventive Services Task Force (USPSTF), Cancer: Breast Cancer, Cancer, Screening, Shared Decision Making, Risk, Health Information Technology (HIT), Prevention, Women
Mahorter SS, Knerr S, Bowles EJA
Prior breast density awareness, knowledge, and communication in a health system-embedded behavioral intervention trial.
This study examined knowledge of breast density as an important breast cancer risk factor among a set of women in a health system-embedded trial who had clinically elevated breast cancer risk 1 year before state-mandated density disclosure. The majority of the women (91%) had heard of breast density and were aware of its masking effect (87%). Only 60% had ever discussed their breast density with a provider.
AHRQ-funded; HS022982.
Citation: Mahorter SS, Knerr S, Bowles EJA .
Prior breast density awareness, knowledge, and communication in a health system-embedded behavioral intervention trial.
Cancer 2020 Apr 15;126(8):1614-21. doi: 10.1002/cncr.32711..
Keywords: Cancer: Breast Cancer, Cancer, Women, Communication, Clinician-Patient Communication, Risk, Patient-Centered Outcomes Research
Fan T, Fakolade A
AHRQ Author: Fan T
Medication use to reduce risk of breast cancer.
In this case study, a 40-year-old woman comes to her doctor’s office for a routine gynecologic visit. She is not taking any medications and is generally healthy. She is sexually active, and her last menstrual period started 10 days ago. She states that her mother was diagnosed with bilateral breast cancer at 49 years of age and that she would like to discuss her options for reducing the risk of breast cancer. Three questions are posed about risk-reducing medications.
AHRQ-authored
Citation: Fan T, Fakolade A .
Medication use to reduce risk of breast cancer.
Am Fam Physician 2020 Mar 15;101(6):373-74..
Keywords: U.S. Preventive Services Task Force (USPSTF), Cancer: Breast Cancer, Cancer, Medication, Risk, Prevention, Case Study, Women
Tice JA, Bissell MCS, Miglioretti DL
Validation of the breast cancer surveillance consortium model of breast cancer risk.
This study evaluated the breast cancer surveillance consortium (BCSC) model of breast cancer risk. The accuracy of the model was assessed using a racially diverse population followed for up to 10 years. An independent cohort of 252,997 women in the Chicago area was used to validate the model. The model was found to be well-calibrated, but underestimated the incidence of invasive breast cancer in younger women and in women with low mammographic density.
AHRQ-funded; HS018366.
Citation: Tice JA, Bissell MCS, Miglioretti DL .
Validation of the breast cancer surveillance consortium model of breast cancer risk.
Breast Cancer Res Treat 2019 Jun;175(2):519-23. doi: 10.1007/s10549-019-05167-2..
Keywords: Cancer, Cancer: Breast Cancer, Risk
Arasu VA, Miglioretti DL, Sprague BL
Population-based assessment of the association between magnetic resonance imaging background parenchymal enhancement and future primary breast cancer risk.
The purpose of this study was to evaluate comparative associations of breast magnetic resonance imaging (MRI) background parenchymal enhancement (BPE) and mammographic breast density with subsequent breast cancer risk. The investigators concluded that BPE was associated with future invasive breast cancer risk independent of breast density. They suggest that BPE should be considered for risk prediction models for women undergoing breast MRI.
AHRQ-funded; HS018366.
Citation: Arasu VA, Miglioretti DL, Sprague BL .
Population-based assessment of the association between magnetic resonance imaging background parenchymal enhancement and future primary breast cancer risk.
J Clin Oncol 2019 Apr 20;37(12):954-63. doi: 10.1200/jco.18.00378..
Keywords: Cancer, Cancer: Breast Cancer, Imaging, Patient-Centered Outcomes Research, Risk, Women
Sun D, Simon GJ, Skube S
Causal phenotyping for susceptibility to cardiotoxicity from antineoplastic breast cancer medications.
Cardiotoxicity is a relatively common and particularly important adverse event caused by chemotherapy for breast cancer patients. The authors of this study propose three phenotyping algorithms to assess breast cancer patients' susceptibility to cardiotoxicity caused by five first-line antineoplastic drugs. The study demonstrates the potential utility of causal phenotyping.
AHRQ-funded; HS022085.
Citation: Sun D, Simon GJ, Skube S .
Causal phenotyping for susceptibility to cardiotoxicity from antineoplastic breast cancer medications.
AMIA Annu Symp Proc 2018 Apr 16;2017:1655-64..
Keywords: Adverse Drug Events (ADE), Cancer: Breast Cancer, Medication, Risk
Punglia RS, Jiang W, Lipsitz SR
Clinical risk score to predict likelihood of recurrence after ductal carcinoma in situ treated with breast-conserving surgery.
In this article, the investigators developed a score to provide individualized information about ipsilateral breast tumor recurrence risk to guide treatment decisions. The authors indicate that their simple, no-cost risk score may be used by patients and physicians to facilitate preference-based decision-making about ductal carcinoma in situ management informed by a more accurate understanding of risks.
AHRQ-funded; 29020050016I.
Citation: Punglia RS, Jiang W, Lipsitz SR .
Clinical risk score to predict likelihood of recurrence after ductal carcinoma in situ treated with breast-conserving surgery.
Breast Cancer Res Treat 2018 Feb;167(3):751-59. doi: 10.1007/s10549-017-4553-5..
Keywords: Cancer: Breast Cancer, Risk, Surgery, Patient-Centered Outcomes Research
Taylor C, Correa C, Duane FK
Estimating the risks of breast cancer radiotherapy: evidence from modern radiation doses to the lungs and heart and from previous randomized trials.
The researchers estimated the absolute long-term risks of modern breast cancer radiotherapy. They concluded that, for long-term smokers, the absolute risks of modern radiotherapy may outweigh the benefits, yet for most nonsmokers (and ex-smokers), the benefits of radiotherapy far outweigh the risks. Hence, smoking can determine the net effect of radiotherapy on mortality, but smoking cessation substantially reduces radiotherapy risk.
AHRQ-funded; HS021681.
Citation: Taylor C, Correa C, Duane FK .
Estimating the risks of breast cancer radiotherapy: evidence from modern radiation doses to the lungs and heart and from previous randomized trials.
J Clin Oncol 2017 May 20;35(15):1641-49. doi: 10.1200/jco.2016.72.0722.
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Keywords: Adverse Events, Cancer: Breast Cancer, Risk, Treatments
Du XL, Zhang Y, Hardy D
Associations between hematopoietic growth factors and risks of venous thromboembolism, stroke, ischemic heart disease and myelodysplastic syndrome: findings from a large population-based cohort of women with breast cancer.
The researchers sought to determine the risk of venous thromboembolism (VTE), stroke, ischemic heart disease, and myelodysplastic syndrome (MDS) in association with the receipt of colony-stimulating factors (CSFs) and/or erythropoiesis-stimulating agents (ESAs) in women with breast cancer. They found that receipts of CSFs and ESAs were significantly associated with an increased risk of VTE in women with breast cancer.
AHRQ-funded; HS018956.
Citation: Du XL, Zhang Y, Hardy D .
Associations between hematopoietic growth factors and risks of venous thromboembolism, stroke, ischemic heart disease and myelodysplastic syndrome: findings from a large population-based cohort of women with breast cancer.
Cancer Causes Control 2016 May;27(5):695-707. doi: 10.1007/s10552-016-0742-5.
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Keywords: Blood Clots, Cancer: Breast Cancer, Cardiovascular Conditions, Risk, Stroke
Liu Z, Zhang K, Du XL
Risks of developing breast and colorectal cancer in association with incomes and geographic locations in Texas: a retrospective cohort study.
This study aimed to determine whether median household income was associated with the risk of developing breast and colorectal cancer in Texas and to identify higher cancer risks by race/ethnicity and geographic areas. It demonstrated that higher income was associated with an increased risk of breast cancer and a decreased risk of colorectal cancer in Texas.
AHRQ-funded; HS018956.
Citation: Liu Z, Zhang K, Du XL .
Risks of developing breast and colorectal cancer in association with incomes and geographic locations in Texas: a retrospective cohort study.
BMC Cancer 2016 Apr 26;16:294. doi: 10.1186/s12885-016-2324-z.
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Keywords: Cancer: Breast Cancer, Cancer: Colorectal Cancer, Racial and Ethnic Minorities, Risk, Social Determinants of Health
Lee K, Rossi C
AHRQ Author: Lee K
Risk assessment, genetic counseling, and genetic testing for BRCA-related cancer in women.
L.M. is a 37-year-old nonsmoking woman who is not taking any medications and has no significant past medical problems. As breast cancer runs in her family, she is interested in genetic testing for breast cancer. This case study poses three multiple choice questions together with the U.S. Preventive Services Task Force recommendations and related background information.
AHRQ-authored.
Citation: Lee K, Rossi C .
Risk assessment, genetic counseling, and genetic testing for BRCA-related cancer in women.
Am Fam Physician 2015 Jan 15;91(2):119-20.
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Keywords: Cancer, Cancer: Breast Cancer, Case Study, Family Health and History, Genetics, Prevention, Risk, Screening, U.S. Preventive Services Task Force (USPSTF), Women
Olsen MA, Nickel KB, Margenthaler JA
Increased risk of surgical site infection among breast-conserving surgery re-excisions.
The aim of this study was to determine the risk of surgical site infection (SSI) after primary breast-conserving surgery (BCS) versus re-excision among women with carcinoma in situ or invasive breast cancer. It found that the risk of SSI after re-excision remained significantly higher after accounting for multiple procedures within a woman.
AHRQ-funded; HS019713.
Citation: Olsen MA, Nickel KB, Margenthaler JA .
Increased risk of surgical site infection among breast-conserving surgery re-excisions.
Ann Surg Oncol 2015;22(6):2003-9. doi: 10.1245/s10434-014-4200-x..
Keywords: Surgery, Risk, Cancer: Breast Cancer, Cancer, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Adverse Events, Patient Safety, Women
Nelson HD, Pappas M, Zakher B
Risk assessment, genetic counseling, and genetic testing for BRCA-related cancer in women: a systematic review to update the U.S. Preventive Services Task Force recommendation.
This systematic review was done in support of the U.S. Preventive Services Task Force (USPSTF) updated recommendation on the benefit and harms of risk assessment, genetic testing, and genetic counseling for BRCA-related cancer in women. A systematic review was done on literature from 2004 to July 30, 2013 from MEDLINE, PsycINFO, the Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Health Technology Assessment, Scopus, and reference lists. Data on the participants, study design, analysis, follow-up, and results was extracted and a second investigator confirmed key data. The studies were rated on study quality and applicability. The analysis found women with high-risk for breast cancer had decreased risk of breast cancer by 85% to 100% by having a mastectomy, and risk of mortality by 81% to 100% compared to women without surgery. There was also a lower risk of breast and ovarian cancer after having salpingo-oopherectomy surgery.
AHRQ-funded; 290200710057
Citation: Nelson HD, Pappas M, Zakher B .
Risk assessment, genetic counseling, and genetic testing for BRCA-related cancer in women: a systematic review to update the U.S. Preventive Services Task Force recommendation.
Ann Intern Med 2014 Feb 18;160(4):255-66. doi: 10.7326/m13-1684..
Keywords: U.S. Preventive Services Task Force (USPSTF), Cancer: Breast Cancer, Cancer: Ovarian Cancer, Cancer, Genetics, Screening, Prevention, Guidelines, Evidence-Based Practice, Women, Risk, Family Health and History
Ezaz G, Long JB, Gross CP
Risk prediction model for heart failure and cardiomyopathy after adjuvant trastuzumab therapy for breast cancer.
The investigators sought to develop a clinical risk score that identifies older women with breast cancer who are at higher risk of heart failure or cardiomyopathy after trastuzumab. That found that a 7-factor risk score was able to stratify 3-year risk of heart failure/cardiomyopathy after trastuzumab between the lowest and highest risk groups by more than 2-fold in a Medicare population.
AHRQ-funded; HS018781.
Citation: Ezaz G, Long JB, Gross CP .
Risk prediction model for heart failure and cardiomyopathy after adjuvant trastuzumab therapy for breast cancer.
J Am Heart Assoc 2014 Feb;3(1):e000472. doi: 10.1161/jaha.113.000472.
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Keywords: Cancer: Breast Cancer, Heart Disease and Health, Medication, Patient Safety, Risk
Boothe DL, Coplowitz S, Greenwood E
Transforming growth factor beta-1 (TGF-beta1) is a serum biomarker of radiation induced fibrosis in patients treated with intracavitary accelerated partial breast irradiation: preliminary results of a prospective study.
This study examined a relationship between serum transforming growth factor b-1 (TGF-b1) values and radiation-induced fibrosis (RIF). The results suggest that serum TGF-b1 levels before surgery, and during radiation therapy, and after radiation therapy could signal whether a patient is at risk for the development of moderate to severe RIF.
AHRQ-funded; HS016075.
Citation: Boothe DL, Coplowitz S, Greenwood E .
Transforming growth factor beta-1 (TGF-beta1) is a serum biomarker of radiation induced fibrosis in patients treated with intracavitary accelerated partial breast irradiation: preliminary results of a prospective study.
Int J Radiat Oncol Biol Phys 2013 Dec 1;87(5):1030-6. doi: 10.1016/j.ijrobp.2013.08.045..
Keywords: Adverse Events, Cancer, Cancer: Breast Cancer, Risk