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Enhancing the public health benefits of mammography screening by informing women of both breast cancer and breast arterial calcification results: A randomized trial to promote cardiovascular health

Award Number: R01CA251754
ORGANIZATION: NATIONAL CANCER INSTITUTE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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Enhancing the public health benefits of mammography screening by informing women of both breast cancer and breast arterial calcification results: A randomized trial to promote cardiovascular health - Breast mammography is one of the most successful cancer screening tools in the cancer prevention arsenal. 37 million women in the US will receive a mammogram this year, and following that, these women will receive a letter letting them know whether they do or do not have evidence of breast cancer. Recent research indicates that standard digital mammography also yields additional information critical to women’s health; that is, information about the presence of calcifications within breast arteries - breast arterial calcification (BAC). The presence of BAC has been associated with calcification within coronary arteries, which is a marker of coronary artery disease (CAD). Research indicates that at least 12.7% of women’s mammograms reveal BAC – about 1 in 8. Of those with BAC, 32%-96% have CAD. Thus, conservatively, mammography could detect over 1.5 million cases of CAD each year. Despite this potential public health boon, BAC information is not directly communicated to patients in the post-mammography letter. The failure to communicate BAC status is a missed opportunity to inform women about CAD risk, and is inconsistent with patient preferences. The goal of this proposal is to investigate whether provision of BAC information to women post-mammography influences their cardiovascular health behaviors. We will randomize mammography patients whose imaging reveals BAC (N=1,889, English and Spanish-speaking) to either: a) the BAC-Enhanced letter condition which informs women about their positive BAC findings and the BAC-CAD association, encourages women to seek preventive cardiology care, and provides cardiology referral information; or b) the Waitlist Control condition, where patients receive a standard mammography letter initially and learn their BAC status 6 months later. We hypothesize that women who receive the BAC-Enhanced letter will be more likely to attend a cardiovascular health appointment (primary outcome), engage in heart healthy behavior, and have CAD detected. Guided by the Common Sense Model, we seek to understand which psychological factors mediate the relationship between the intervention and the outcomes. Also, most BAC prevalence literature has been conducted on predominantly white samples. To remedy this, we will describe BAC prevalence in a large, racially and ethnically diverse sample (N=14,875). Innovation: This will be the first study of an intervention to directly share BAC information with women undergoing mammography in a “direct to consumer” approach, and the first to report BAC prevalence in a racially and ethnically diverse sample. Public health impact: The project is a first step towards ensuring that women benefit directly from all of the rich health data that mammography can yield.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $695,964 )
2025	2025	ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI	1 GUSTAVE L LEVY PL	NEW YORK	NY	10029	NEW YORK	USA	Cancer Cause and Prevention Research	001	5	5/23/2025	NON-COMPETING CONTINUATION	$69,595
2025	2025	ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI	1 GUSTAVE L LEVY PL	NEW YORK	NY	10029	NEW YORK	USA	Cancer Cause and Prevention Research	000	5	3/17/2025	NON-COMPETING CONTINUATION	$626,369
														Subtotal = $695,964

Issue Date FY: 2024 ( Subtotal = $665,018 )
2024	2024	ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI	1 GUSTAVE L LEVY PL	NEW YORK	NY	10029	NEW YORK	USA	Cancer Cause and Prevention Research	001	4	4/16/2024	NON-COMPETING CONTINUATION	$35,001
2024	2024	ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI	1 GUSTAVE L LEVY PL	NEW YORK	NY	10029	NEW YORK	USA	Cancer Cause and Prevention Research	000	4	3/4/2024	NON-COMPETING CONTINUATION	$630,017
														Subtotal = $665,018

Issue Date FY: 2023 ( Subtotal = $686,017 )
2023	2023	ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI	ONE GUSTAVE L LEVY PL	NEW YORK	NY	10029	NEW YORK	USA	Cancer Cause and Prevention Research	000	3	5/25/2023	NON-COMPETING CONTINUATION	$686,017
														Subtotal = $686,017

Issue Date FY: 2022 ( Subtotal = $686,017 )
2022	2022	ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI	ONE GUSTAVE L LEVY PL	NEW YORK	NY	10029	NEW YORK	USA	Cancer Cause and Prevention Research	000	2	6/3/2022	NON-COMPETING CONTINUATION	$686,017
														Subtotal = $686,017

Issue Date FY: 2021 ( Subtotal = $702,634 )
2021	2021	ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI	ONE GUSTAVE L LEVY PL	NEW YORK	NY	10029	NEW YORK	USA	Cancer Cause and Prevention Research	000	1	3/31/2021	NEW	$702,634
														Subtotal = $702,634

Grand Total All Awards = $3,435,650

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Enhancing the public health benefits of mammography screening by informing women of both breast cancer and breast arterial calcification results: A randomized trial to promote cardiovascular health

Award Number: R01CA251754

ORGANIZATION: NATIONAL CANCER INSTITUTE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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