Current Epidemiology and Interventions Program Projects

Prostate Cancer Stage Study (PCaSS)

Background: The cause of prostate cancer remains largely unknown, but accepted risk factors of the disease are increasing age, being of African American race/ethnicity, and having a family history of prostate cancer. In addition, African American men are also more likely to be diagnosed at an earlier age, at a later stage, to have recurrence and to die from the disease. In contrast, microscopic foci of prostate cancer are reportedly detectable in similar proportions at earlier ages in men across various populations around the world, yet, for reasons unknown, the prostate cancer foci in African Americans are more likely to progress to clinically significant disease. Further, it is not clear whether the tendency for diagnosis at more advanced stage is due to the delay in presentation due to low socioeconomic status (SES) resulting in limited access to and use of health services, and a greater exposure to environmental risk factors, or it is due to greater biologic predisposition to the disease or a combination of these factors, that causes the rapid progression of prostate cancer to an advanced stage. To add to this, the role of SES as a predisposing factor to advanced stage diagnosis is unclear as previous reports are inconsistent. This inconsistency may be due to the absence of a validated instrument that can capture the differences in the social environments of prostate cancer patients from diverse racial/ethnic backgrounds.

Objective and Hypothesis: We hypothesize that men of low SES, men with higher levels of exposure to enviromental and biologic risk factors will be diagnosed with advanced stage prostate cancer. The specific aims of the PCaSS are,
1. To validate the Socioeconomic Status Instrument derived from the Health Care Access and Demographics components of the Behavioral Risk Factor Surveillance System questionnaire for 2004 in a study population of Whites, African Americans, and Hispanic prostate cancer patients recently diagnosed with localized, regional or advanced stage disease, and
2. To generate preliminary data to assess the potential environmental and biological determinants of the stage at diagnosis of prostate cancer.

Study Design: These will be done on a random sample of 501 prostate cancer patients of low, middle, or high socioeconomic status, stratified by racial/ethnic background who reside in Houston, Texas metropolis using questionaires for personal interviews, height and weighing scales, tape measures and calipers for anthropometric measurements and blood samples for biochemical analyses.

Cancer Relevance: Our study will lay the foundation for a larger cohort study to assess the epidemiological determinants of prostate cancer progression and death. Consequently, this will help us to identify modifiable risk or protective factors for educational and chemopreventive interventions.

download PCaSS project brochure for more information

Acceptance of Breast Cancer Chemoprevention Therapy Project (ABCCPT)

The ABCCPT Project is funded by the National Cancer Institute with the goals to first validate the Breast Cancer Risk Reduction Health Belief (BCRRHB) Scale developed to assess the attitude of women who are at increased risk of developing breast cancer towards the use of tamoxifen and raloxifene for chemoprevention therapy. Second, to assess the general knowledge of breast cancer and attitudes toward chemoprevention therapy using the Health Belief Model constructs in the study population, and how these factors correlate with the acceptance of the therapy. Third, using a multivariate statistical model, to determine the correlates of acceptance of breast cancer chemoprevention therapy. These goals will be achieved through a cross-sectional survey (telephone interviews) of a random sample of 1000 high-risk women stratified by menopausal status and race/ethnicity (Caucasian [50%], Hispanic [30%] and African American [20%]) who reside in and around Harris County, Texas. This project is significant in that, using the known correlates of acceptance, tailored interventions to enhance informed decision-making among high-risk women will be developed, and the scientific community will be provided with the validated BCRRHB scale, a useful tool for the future assessments of the attitudes of high-risk women toward future breast cancer chemopreventive agents.

download ABCCPT project brochure in English
download ABCCPT project brochure in Spanish

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