Elissa Ozane, PhD
Associate Professor, Population Health Sciences, The University of Utah
Elissa holds a bachelor's in biological sciences, a master's degree in engineering economic systems, and a doctorate in management science and engineering specializing in decision analysis and risk analysis from Stanford University. Prior to joining the Institute, she completed a post-doctoral fellowship at the Carol Franc Buck Breast Care Center at the University of California San Francisco Medical Center. Dr. Ozanne also has experience working with leading biotechnology companies in the California Bay Area including Entelos, Inc. and Pharsight, Inc. She completed a fellowship with the ITA's Program for Cancer Outcomes Research Training (PCORT) in 2005. Dr. Ozannne was a Senior Scientist at the ITA and Assistant Professor of Radiology at Harvard Medical School before becoming an Associate Professor UCSF Medical Center in 2011. She was an Associate Professor, The Dartmouth Institute for Health Policy and Clinical Practice from 2013-2016. She joined the faculty of the University of Utah School of Medicine in 2016.
Her primary career goal is to guide effective, patient-centered use of prevention, screening, and treatment strategies in cancer and other contexts. Her research is focused on decision-making, including the developing and testing of clinical decision aids, risk communication methods, cost-effectiveness and risk modeling.
Visit web site
Selected Publications
Lauren, Brianna N; Silver, Elisabeth R; Faye, Adam S; Rogers, Alexandra M; Baidal, Jennifer A Woo; Ozanne, Elissa; Hur, Chin
Predictors of households at risk for food insecurity in the United States during the COVID-19 pandemic. Journal Article
In: Public health nutrition, vol. 24, no. 12, pp. 3929-3036, 2021, ISSN: 1475-2727, ().
@article{Lauren2021,
title = {Predictors of households at risk for food insecurity in the United States during the COVID-19 pandemic.},
author = {Brianna N Lauren and Elisabeth R Silver and Adam S Faye and Alexandra M Rogers and Jennifer A Woo Baidal and Elissa Ozanne and Chin Hur},
url = {https://pubmed.ncbi.nlm.nih.gov/33500018/},
doi = {10.1017/S1368980021000355},
issn = {1475-2727},
year = {2021},
date = {2021-08-01},
journal = {Public health nutrition},
volume = {24},
number = {12},
pages = {3929-3036},
abstract = {To examine associations between sociodemographic and mental health characteristics with household risk for food insecurity during the COVID-19 outbreak. Cross-sectional online survey analyzed using univariable tests and a multivariable logistic regression model. The United States during the week of March 30, 2020. Convenience sample of 1,965 American adults using Amazon's Mechanical Turk (MTurk) platform. Participants reporting household food insecurity prior to the pandemic were excluded from analyses. 1,250 participants reported household food security before the COVID-19 outbreak. Among this subset, 41% were identified as at risk for food insecurity after COVID-19, 55% were women and 73% were white. On multivariable analysis, race, income, relationship status, living situation, anxiety, and depression were significantly associated with incident risk for food insecurity. Black, Asian, and Hispanic/Latino respondents, respondents with annual income less than $100,000, and those living with children or others were significantly more likely to be newly at risk for food insecurity. Individuals at risk for food insecurity were 2.60 (95% CI 1.91-3.55) times more likely to screen positively for anxiety and 1.71 (95% CI 1.21-2.42) times more likely to screen positively for depression. Increased risk for food insecurity during the COVID-19 pandemic is common, and certain populations are particularly vulnerable. There are strong associations between being at risk for food insecurity and anxiety/depression. Interventions to increase access to healthful foods, especially among minority and low-income individuals, and ease the socioemotional effects of the outbreak are crucial to relieving the economic stress of this pandemic.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
To examine associations between sociodemographic and mental health characteristics with household risk for food insecurity during the COVID-19 outbreak. Cross-sectional online survey analyzed using univariable tests and a multivariable logistic regression model. The United States during the week of March 30, 2020. Convenience sample of 1,965 American adults using Amazon's Mechanical Turk (MTurk) platform. Participants reporting household food insecurity prior to the pandemic were excluded from analyses. 1,250 participants reported household food security before the COVID-19 outbreak. Among this subset, 41% were identified as at risk for food insecurity after COVID-19, 55% were women and 73% were white. On multivariable analysis, race, income, relationship status, living situation, anxiety, and depression were significantly associated with incident risk for food insecurity. Black, Asian, and Hispanic/Latino respondents, respondents with annual income less than $100,000, and those living with children or others were significantly more likely to be newly at risk for food insecurity. Individuals at risk for food insecurity were 2.60 (95% CI 1.91-3.55) times more likely to screen positively for anxiety and 1.71 (95% CI 1.21-2.42) times more likely to screen positively for depression. Increased risk for food insecurity during the COVID-19 pandemic is common, and certain populations are particularly vulnerable. There are strong associations between being at risk for food insecurity and anxiety/depression. Interventions to increase access to healthful foods, especially among minority and low-income individuals, and ease the socioemotional effects of the outbreak are crucial to relieving the economic stress of this pandemic.
Rogers, Alexandra M.; Lauren, Brianna N.; Baidal, Jennifer A. Woo; Ozanne, Elissa; Hur, Chin
In: Appetite, vol. 167, pp. 105639, 2021, ISSN: 1095-8304.
@article{Rogers2021,
title = {Persistent effects of the COVID-19 pandemic on diet, exercise, risk for food insecurity, and quality of life: A longitudinal study among U.S. adults.},
author = {Alexandra M. Rogers and Brianna N. Lauren and Jennifer A. Woo Baidal and Elissa Ozanne and Chin Hur},
url = {https://pubmed.ncbi.nlm.nih.gov/34384807/},
doi = {10.1016/j.appet.2021.105639},
issn = {1095-8304},
year = {2021},
date = {2021-08-01},
urldate = {2021-08-01},
journal = {Appetite},
volume = {167},
pages = {105639},
abstract = {COVID-19 has affected the health and well-being of almost every American. The aim of this study was to examine the sustained impacts of COVID-19 prevention measures on the diet and exercise habits, risk for food insecurity, and quality of life among adults in the U.S. We conducted a longitudinal study using a convenience sample of participants recruited via Amazon's Mechanical Turk (MTurk) platform between March 30 and April 7, 2020, and 8 months into the outbreak, from November 2 to November 21, 2020. We compared self-reported diet and exercise habits and risk for food insecurity shortly after the pandemic began, in April, to those reported in November. We also measured changes in quality-of-life using the PROMIS-29 + 2 (PROPr) scale. A total of 636 respondents completed both surveys. Compared to reports in April, respondents ate lunch and dinner out more frequently in November and consumed more take-out and fast food. Weekly frequencies of consuming frozen food and the number of daily meals were slightly lower in November than they were in April. 54% of respondents screened positively for being at risk for food insecurity in April, reducing to 41% by November. In April, survey respondents were found to have lower quality-of-life relative to U.S. population norms, but by November levels of depression and cognitive function had improved. Our findings underscore how the initial effects of the pandemic on diet, exercise, risk for food insecurity, and quality of life have evolved. As U.S. states re-open, continued efforts to encourage healthy eating and support mental health, especially to reduce feelings of anxiety and social isolation, remain important to mitigate the potential long-term effects of the pandemic.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
COVID-19 has affected the health and well-being of almost every American. The aim of this study was to examine the sustained impacts of COVID-19 prevention measures on the diet and exercise habits, risk for food insecurity, and quality of life among adults in the U.S. We conducted a longitudinal study using a convenience sample of participants recruited via Amazon's Mechanical Turk (MTurk) platform between March 30 and April 7, 2020, and 8 months into the outbreak, from November 2 to November 21, 2020. We compared self-reported diet and exercise habits and risk for food insecurity shortly after the pandemic began, in April, to those reported in November. We also measured changes in quality-of-life using the PROMIS-29 + 2 (PROPr) scale. A total of 636 respondents completed both surveys. Compared to reports in April, respondents ate lunch and dinner out more frequently in November and consumed more take-out and fast food. Weekly frequencies of consuming frozen food and the number of daily meals were slightly lower in November than they were in April. 54% of respondents screened positively for being at risk for food insecurity in April, reducing to 41% by November. In April, survey respondents were found to have lower quality-of-life relative to U.S. population norms, but by November levels of depression and cognitive function had improved. Our findings underscore how the initial effects of the pandemic on diet, exercise, risk for food insecurity, and quality of life have evolved. As U.S. states re-open, continued efforts to encourage healthy eating and support mental health, especially to reduce feelings of anxiety and social isolation, remain important to mitigate the potential long-term effects of the pandemic.
Ozanne, Elissa M.; Silver, Elisabeth R.; Saini, Sameer D.; Rubenstein, Joel H.; Lansdorp-Vogelaar, Iris; Bowers, Nicole; Tan, Sarah Xinhui; Inadomi, John M.; Hur, Chin
Surveillance Cessation for Barrett's Esophagus: A Survey of Gastroenterologists. Journal Article
In: The American journal of gastroenterology, vol. 116, pp. 1730–1733, 2021, ISSN: 1572-0241, ().
@article{Ozanne2021,
title = {Surveillance Cessation for Barrett's Esophagus: A Survey of Gastroenterologists.},
author = {Elissa M. Ozanne and Elisabeth R. Silver and Sameer D. Saini and Joel H. Rubenstein and Iris Lansdorp-Vogelaar and Nicole Bowers and Sarah Xinhui Tan and John M. Inadomi and Chin Hur},
url = {https://pubmed.ncbi.nlm.nih.gov/34049319/},
doi = {10.14309/ajg.0000000000001323},
issn = {1572-0241},
year = {2021},
date = {2021-08-01},
journal = {The American journal of gastroenterology},
volume = {116},
pages = {1730--1733},
abstract = {Regular endoscopic surveillance is the gold standard Barrett's esophagus (BE) surveillance, yet harms of surveillance for some patients may outweigh the benefits. We sought to characterize physicians' BE surveillance cessation recommendations. We surveyed gastroenterologists about their BE surveillance recommendations varying patient age, comorbidity, and BE length. Clinicians varied in recommendations for repeat surveillance. Patient age showed the largest variation among decisions, whereas BE length varied the least. Age and comorbidities seem to influence BE surveillance cessation decisions, but with variation. Clear cessation guidelines balancing the risks and benefits for BE surveillance are warranted.},
keywords = {},
pubstate = {ppublish},
tppubtype = {article}
}
Regular endoscopic surveillance is the gold standard Barrett's esophagus (BE) surveillance, yet harms of surveillance for some patients may outweigh the benefits. We sought to characterize physicians' BE surveillance cessation recommendations. We surveyed gastroenterologists about their BE surveillance recommendations varying patient age, comorbidity, and BE length. Clinicians varied in recommendations for repeat surveillance. Patient age showed the largest variation among decisions, whereas BE length varied the least. Age and comorbidities seem to influence BE surveillance cessation decisions, but with variation. Clear cessation guidelines balancing the risks and benefits for BE surveillance are warranted.
Lockwood, Robert; Ozanne, Elissa; Hur, Chin; Yachimski, Patrick
Patient decision-making and clinical outcomes following endoscopic therapy or esophagectomy for Barrett's neoplasia. Journal Article
In: Endoscopy international open, vol. 5, pp. E1128–E1135, 2017, ISSN: 2364-3722, ().
@article{Lockwood2017,
title = {Patient decision-making and clinical outcomes following endoscopic therapy or esophagectomy for Barrett's neoplasia.},
author = {Robert Lockwood and Elissa Ozanne and Chin Hur and Patrick Yachimski},
url = {http://www.ncbi.nlm.nih.gov/pubmed/29124122},
doi = {10.1055/s-0043-118096},
issn = {2364-3722},
year = {2017},
date = {2017-11-01},
journal = {Endoscopy international open},
volume = {5},
pages = {E1128--E1135},
abstract = { The objective of this study was to assess patient involvement in decision-making, decision confidence, and decision regret among patients who had undergone endoscopic eradication therapy (EET) or esophagectomy for Barrett's esophagus (BE) associated neoplasia. Patients with BE high grade dysplasia or intramucosal (T1a) adenocarcinoma who had undergone EET or esophagectomy were invited to complete a survey. The cohort included 50 subjects, 70 % (35/50) of whom had undergone EET and 30 % (15/50) of whom had undergone esophagectomy. Subjects who underwent esophagectomy were more likely to report post-treatment dysphagia (47 % vs 14 },
keywords = {},
pubstate = {published},
tppubtype = {article}
}
The objective of this study was to assess patient involvement in decision-making, decision confidence, and decision regret among patients who had undergone endoscopic eradication therapy (EET) or esophagectomy for Barrett's esophagus (BE) associated neoplasia. Patients with BE high grade dysplasia or intramucosal (T1a) adenocarcinoma who had undergone EET or esophagectomy were invited to complete a survey. The cohort included 50 subjects, 70 % (35/50) of whom had undergone EET and 30 % (15/50) of whom had undergone esophagectomy. Subjects who underwent esophagectomy were more likely to report post-treatment dysphagia (47 % vs 14
Yachimski, Patrick; Wani, Sachin; Givens, Tonya; Howard, Eric; Higginbotham, Tina; Price, Angie; Berman, Kenneth; Hosford, Lindsay; Katcher, Paul Menard; Ozanne, Elissa; Perzan, Katherine; Hur, Chin
Preference of Endoscopic Ablation Over Medical Prevention of Esophageal Adenocarcinoma by Patients with Barrett's Esophagus Journal Article
In: Clin Gastroenterol Hepatol, vol. 13, no. 1, pp. 84-90, 2015, ().
@article{Yachimski2014,
title = {Preference of Endoscopic Ablation Over Medical Prevention of Esophageal Adenocarcinoma by Patients with Barrett's Esophagus},
author = {Patrick Yachimski and Sachin Wani and Tonya Givens and Eric Howard and Tina Higginbotham and Angie Price and Kenneth Berman and Lindsay Hosford and Paul Menard Katcher and Elissa Ozanne and Katherine Perzan and Chin Hur},
url = {http://www.ncbi.nlm.nih.gov/pubmed/24681073},
doi = {10.1016/j.cgh.2014.03.017},
year = {2015},
date = {2015-01-01},
journal = {Clin Gastroenterol Hepatol},
volume = {13},
number = {1},
pages = {84-90},
institution = {Institute for Technology Assessment, Massachusetts General Hospital,
Harvard Medical School, Boston, MA USA.},
abstract = {\& Aims: Endoscopic intervention or pharmacologic inhibition of cyclooxygenase
might be used to prevent progression of Barrett's esophagus (BE)
to esophageal adenocarcinoma (EAC). We investigated whether patients
with BE prefer endoscopic therapy or chemoprevention of EAC.Eighty-one
subjects with nondysplastic BE were given a survey that described
2 scenarios. The survey explained that treatment A (ablation), endoscopy,
reduced lifetime risk of EAC by 50%, with a 5% risk for esophageal
stricture, whereas treatment B (aspirin) reduced lifetime risk of
EAC by 50% and the risk of heart attack by 30%, yet increased the
risk for ulcer by 75%. Subjects indicated their willingness to undergo
either treatment A and/or treatment B if endoscopic surveillance
was required every 3-5 years, every 10 years, or was not required.
Visual aids were included to represent risk and benefit percentages.When
surveillance was required every 3-5 years, more subjects were willing
to undergo treatment A than treatment B (78% [63/81] vs 53% [43/81],
P},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
& Aims: Endoscopic intervention or pharmacologic inhibition of cyclooxygenase
might be used to prevent progression of Barrett's esophagus (BE)
to esophageal adenocarcinoma (EAC). We investigated whether patients
with BE prefer endoscopic therapy or chemoprevention of EAC.Eighty-one
subjects with nondysplastic BE were given a survey that described
2 scenarios. The survey explained that treatment A (ablation), endoscopy,
reduced lifetime risk of EAC by 50%, with a 5% risk for esophageal
stricture, whereas treatment B (aspirin) reduced lifetime risk of
EAC by 50% and the risk of heart attack by 30%, yet increased the
risk for ulcer by 75%. Subjects indicated their willingness to undergo
either treatment A and/or treatment B if endoscopic surveillance
was required every 3-5 years, every 10 years, or was not required.
Visual aids were included to represent risk and benefit percentages.When
surveillance was required every 3-5 years, more subjects were willing
to undergo treatment A than treatment B (78% [63/81] vs 53% [43/81],
P
might be used to prevent progression of Barrett's esophagus (BE)
to esophageal adenocarcinoma (EAC). We investigated whether patients
with BE prefer endoscopic therapy or chemoprevention of EAC.Eighty-one
subjects with nondysplastic BE were given a survey that described
2 scenarios. The survey explained that treatment A (ablation), endoscopy,
reduced lifetime risk of EAC by 50%, with a 5% risk for esophageal
stricture, whereas treatment B (aspirin) reduced lifetime risk of
EAC by 50% and the risk of heart attack by 30%, yet increased the
risk for ulcer by 75%. Subjects indicated their willingness to undergo
either treatment A and/or treatment B if endoscopic surveillance
was required every 3-5 years, every 10 years, or was not required.
Visual aids were included to represent risk and benefit percentages.When
surveillance was required every 3-5 years, more subjects were willing
to undergo treatment A than treatment B (78% [63/81] vs 53% [43/81],
P
Ozanne, Elissa; Howe, Rebecca; Omer, Zehra; Esserman, Laura J.
Development of a personalized decision aid for breast cancer risk reduction and management Journal Article
In: BMC Med Inform Decis Mak, vol. 14, pp. 4, 2014, ().
@article{Ozanne2014,
title = {Development of a personalized decision aid for breast cancer risk reduction and management},
author = {Elissa Ozanne and Rebecca Howe and Zehra Omer and Laura J. Esserman},
url = {http://www.ncbi.nlm.nih.gov/pubmed/24422989},
doi = {10.1186/1472-6947-14-4},
year = {2014},
date = {2014-01-01},
urldate = {2014-01-01},
journal = {BMC Med Inform Decis Mak},
volume = {14},
pages = {4},
institution = {Department of Surgery, Institute for Health Policy Studies, University of California at San Francisco, San Francisco, CA, USA. .},
abstract = {Breast cancer risk reduction has the potential to decrease the incidence
of the disease, yet remains underused. We report on the development
a web-based tool that provides automated risk assessment and personalized
decision support designed for collaborative use between patients
and clinicians.Under Institutional Review Board approval, we evaluated
the decision tool through a patient focus group, usability testing,
and provider interviews (including breast specialists, primary care
physicians, genetic counselors). This included demonstrations and
data collection at two scientific conferences (2009 International
Shared Decision Making Conference, 2009 San Antonio Breast Cancer
Symposium).Overall, the evaluations were favorable. The patient focus group evaluations and usability testing (N = 34) provided qualitative
feedback about format and design; 88% of these participants found
the tool useful and 94% found it easy to use. 91% of the providers (N = 23) indicated that they would use the tool in their clinical
setting.BreastHealthDecisions.org represents a new approach to breast
cancer prevention care and a framework for high quality preventive
healthcare. The ability to integrate risk assessment and decision
support in real time will allow for informed, value-driven, and patient-centered
breast cancer prevention decisions. The tool is being further evaluated
in the clinical setting.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Breast cancer risk reduction has the potential to decrease the incidence
of the disease, yet remains underused. We report on the development
a web-based tool that provides automated risk assessment and personalized
decision support designed for collaborative use between patients
and clinicians.Under Institutional Review Board approval, we evaluated
the decision tool through a patient focus group, usability testing,
and provider interviews (including breast specialists, primary care
physicians, genetic counselors). This included demonstrations and
data collection at two scientific conferences (2009 International
Shared Decision Making Conference, 2009 San Antonio Breast Cancer
Symposium).Overall, the evaluations were favorable. The patient focus group evaluations and usability testing (N = 34) provided qualitative
feedback about format and design; 88% of these participants found
the tool useful and 94% found it easy to use. 91% of the providers (N = 23) indicated that they would use the tool in their clinical
setting.BreastHealthDecisions.org represents a new approach to breast
cancer prevention care and a framework for high quality preventive
healthcare. The ability to integrate risk assessment and decision
support in real time will allow for informed, value-driven, and patient-centered
breast cancer prevention decisions. The tool is being further evaluated
in the clinical setting.
of the disease, yet remains underused. We report on the development
a web-based tool that provides automated risk assessment and personalized
decision support designed for collaborative use between patients
and clinicians.Under Institutional Review Board approval, we evaluated
the decision tool through a patient focus group, usability testing,
and provider interviews (including breast specialists, primary care
physicians, genetic counselors). This included demonstrations and
data collection at two scientific conferences (2009 International
Shared Decision Making Conference, 2009 San Antonio Breast Cancer
Symposium).Overall, the evaluations were favorable. The patient focus group evaluations and usability testing (N = 34) provided qualitative
feedback about format and design; 88% of these participants found
the tool useful and 94% found it easy to use. 91% of the providers (N = 23) indicated that they would use the tool in their clinical
setting.BreastHealthDecisions.org represents a new approach to breast
cancer prevention care and a framework for high quality preventive
healthcare. The ability to integrate risk assessment and decision
support in real time will allow for informed, value-driven, and patient-centered
breast cancer prevention decisions. The tool is being further evaluated
in the clinical setting.
Omer, Zehra; Hwang, E Shelley; Esserman, Laura J.; Howe, Rebecca; Ozanne, Elissa
Impact of ductal carcinoma in situ terminology on patient treatment preferences Journal Article
In: JAMA Intern Med, vol. 173, no. 19, pp. 1830–1831, 2013, ().
@article{Omer2013,
title = {Impact of ductal carcinoma in situ terminology on patient treatment preferences},
author = {Zehra Omer and E Shelley Hwang and Laura J. Esserman and Rebecca Howe and Elissa Ozanne},
url = {http://www.ncbi.nlm.nih.gov/pubmed/23978843},
doi = {10.1001/jamainternmed.2013.8405},
year = {2013},
date = {2013-10-01},
urldate = {2013-10-01},
journal = {JAMA Intern Med},
volume = {173},
number = {19},
pages = {1830--1831},
institution = {Massachusetts General Hospital-Institute for Technology Assessment, Boston.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Ozanne, Elissa; O'Connell, Adrienne; Bouzan, Colleen; Bosinoff, Phil; Rourke, Taryn; Dowd, Dana; Drohan, Brian; Millham, Fred; Griffin, Pat; Halpern, Elkan F.; Semine, Alan; Hughes, Kevin S.
Bias in the reporting of family history: implications for clinical care Journal Article
In: J Genet Couns, vol. 21, no. 4, pp. 547–556, 2012, ().
@article{Ozanne2012,
title = {Bias in the reporting of family history: implications for clinical care},
author = {Elissa Ozanne and Adrienne O'Connell and Colleen Bouzan and Phil Bosinoff and Taryn Rourke and Dana Dowd and Brian Drohan and Fred Millham and Pat Griffin and Elkan F. Halpern and Alan Semine and Kevin S. Hughes},
url = {http://www.ncbi.nlm.nih.gov/pubmed/22237666},
doi = {10.1007/s10897-011-9470-x},
year = {2012},
date = {2012-08-01},
journal = {J Genet Couns},
volume = {21},
number = {4},
pages = {547--556},
institution = {Institute for Health Policy Studies, Department of Surgery, University of California, San Francisco, CA, USA. },
abstract = {Family history of cancer is critical for identifying and managing
patients at risk for cancer. However, the quality of family history
data is dependent on the accuracy of patient self reporting. Therefore,
the validity of family history reporting is crucial to the quality
of clinical care. A retrospective review of family history data collected
at a community hospital between 2005 and 2009 was performed in 43,257
women presenting for screening mammography. Reported numbers of breast,
colon, prostate, lung, and ovarian cancer were compared in maternal
relatives vs. paternal relatives and in first vs. second degree relatives.
Significant reporting differences were found between maternal and
paternal family history of cancer, in addition to degree of relative.
The number of paternal family histories of cancer was significantly
lower than that of maternal family histories of cancer. Similarly,
the percentage of grandparents' family histories of cancer was significantly
lower than the percentage of parents' family histories of cancer.
This trend was found in all cancers except prostate cancer. Self-reported
family history in the community setting is often influenced by both
bloodline of the cancer history and the degree of relative affected.
This is evident by the underreporting of paternal family histories
of cancer, and also, though to a lesser extent, by degree. These
discrepancies in reporting family history of cancer imply we need
to take more care in collecting accurate family histories and also
in the clinical management of individuals in relation to hereditary
risk.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Family history of cancer is critical for identifying and managing
patients at risk for cancer. However, the quality of family history
data is dependent on the accuracy of patient self reporting. Therefore,
the validity of family history reporting is crucial to the quality
of clinical care. A retrospective review of family history data collected
at a community hospital between 2005 and 2009 was performed in 43,257
women presenting for screening mammography. Reported numbers of breast,
colon, prostate, lung, and ovarian cancer were compared in maternal
relatives vs. paternal relatives and in first vs. second degree relatives.
Significant reporting differences were found between maternal and
paternal family history of cancer, in addition to degree of relative.
The number of paternal family histories of cancer was significantly
lower than that of maternal family histories of cancer. Similarly,
the percentage of grandparents' family histories of cancer was significantly
lower than the percentage of parents' family histories of cancer.
This trend was found in all cancers except prostate cancer. Self-reported
family history in the community setting is often influenced by both
bloodline of the cancer history and the degree of relative affected.
This is evident by the underreporting of paternal family histories
of cancer, and also, though to a lesser extent, by degree. These
discrepancies in reporting family history of cancer imply we need
to take more care in collecting accurate family histories and also
in the clinical management of individuals in relation to hereditary
risk.
patients at risk for cancer. However, the quality of family history
data is dependent on the accuracy of patient self reporting. Therefore,
the validity of family history reporting is crucial to the quality
of clinical care. A retrospective review of family history data collected
at a community hospital between 2005 and 2009 was performed in 43,257
women presenting for screening mammography. Reported numbers of breast,
colon, prostate, lung, and ovarian cancer were compared in maternal
relatives vs. paternal relatives and in first vs. second degree relatives.
Significant reporting differences were found between maternal and
paternal family history of cancer, in addition to degree of relative.
The number of paternal family histories of cancer was significantly
lower than that of maternal family histories of cancer. Similarly,
the percentage of grandparents' family histories of cancer was significantly
lower than the percentage of parents' family histories of cancer.
This trend was found in all cancers except prostate cancer. Self-reported
family history in the community setting is often influenced by both
bloodline of the cancer history and the degree of relative affected.
This is evident by the underreporting of paternal family histories
of cancer, and also, though to a lesser extent, by degree. These
discrepancies in reporting family history of cancer imply we need
to take more care in collecting accurate family histories and also
in the clinical management of individuals in relation to hereditary
risk.
Lowry, Kathryn; Lee, Janie; Kong, Chung Yin; McMahon, Pamela M.; Gilmore, Michael; Chubiz, Jessica Cott; Pisano, E. D.; Gatsonis, C.; Ryan, P. D.; Ozanne, Elissa; Gazelle, G. Scott
Annual screening strategies in BRCA1 and BRCA2 gene mutation carriers: a comparative effectiveness analysis Journal Article
In: Cancer, vol. 118, no. 8, pp. 2021-30, 2012, ISSN: 1097-0142 (Electronic) 0008-543X, ().
@article{Lowry2012,
title = {Annual screening strategies in BRCA1 and BRCA2 gene mutation carriers: a comparative effectiveness analysis},
author = {Kathryn Lowry and Janie Lee and Chung Yin Kong and Pamela M. McMahon and Michael Gilmore and Jessica Cott Chubiz and E. D. Pisano and C. Gatsonis and P. D. Ryan and Elissa Ozanne and G. Scott Gazelle},
url = {http://www.ncbi.nlm.nih.gov/pubmed/21935911},
issn = {1097-0142 (Electronic) 0008-543X},
year = {2012},
date = {2012-04-01},
urldate = {2012-04-01},
journal = {Cancer},
volume = {118},
number = {8},
pages = {2021-30},
abstract = {BACKGROUND: Although breast cancer screening with mammography and
magnetic resonance imaging (MRI) is recommended for breast cancer-susceptibility
gene (BRCA) mutation carriers, there is no current consensus on the
optimal screening regimen. METHODS: The authors used a computer simulation
model to compare 6 annual screening strategies (film mammography
[FM], digital mammography [DM], FM and magnetic resonance imaging
[MRI] or DM and MRI contemporaneously, and alternating FM/MRI or
DM/MRI at 6-month intervals) beginning at ages 25 years, 30 years,
35 years, and 40 years, and 2 strategies of annual MRI with delayed
alternating DM/FM versus clinical surveillance alone. Strategies
were evaluated without and with mammography-induced breast cancer
risk using 2 models of excess relative risk. Input parameters were
obtained from the medical literature, publicly available databases,
and calibration. RESULTS: Without radiation risk effects, alternating
DM/MRI starting at age 25 years provided the highest life expectancy
(BRCA1, 72.52 years, BRCA2, 77.63 years). When radiation risk was
included, a small proportion of diagnosed cancers was attributable
to radiation exposure (BRCA1, \<2%; BRCA2, \<4%). With radiation risk,
alternating DM/MRI at age 25 years or annual MRI at age 25 years/delayed
alternating DM at age 30 years was the most effective, depending
on the radiation risk model used. Alternating DM/MRI starting at
age 25 years also produced the highest number of false-positive screens
per woman (BRCA1, 4.5 BRCA2, 8.1). CONCLUSIONS: Annual MRI at age
25 years/delayed alternating DM at age 30 years is probably the most
effective screening strategy in BRCA mutation carriers. Screening
benefits, associated risks, and personal acceptance of false-positive
results should be considered in choosing the optimal screening strategy
for individual women.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Although breast cancer screening with mammography and
magnetic resonance imaging (MRI) is recommended for breast cancer-susceptibility
gene (BRCA) mutation carriers, there is no current consensus on the
optimal screening regimen. METHODS: The authors used a computer simulation
model to compare 6 annual screening strategies (film mammography
[FM], digital mammography [DM], FM and magnetic resonance imaging
[MRI] or DM and MRI contemporaneously, and alternating FM/MRI or
DM/MRI at 6-month intervals) beginning at ages 25 years, 30 years,
35 years, and 40 years, and 2 strategies of annual MRI with delayed
alternating DM/FM versus clinical surveillance alone. Strategies
were evaluated without and with mammography-induced breast cancer
risk using 2 models of excess relative risk. Input parameters were
obtained from the medical literature, publicly available databases,
and calibration. RESULTS: Without radiation risk effects, alternating
DM/MRI starting at age 25 years provided the highest life expectancy
(BRCA1, 72.52 years, BRCA2, 77.63 years). When radiation risk was
included, a small proportion of diagnosed cancers was attributable
to radiation exposure (BRCA1, <2%; BRCA2, <4%). With radiation risk,
alternating DM/MRI at age 25 years or annual MRI at age 25 years/delayed
alternating DM at age 30 years was the most effective, depending
on the radiation risk model used. Alternating DM/MRI starting at
age 25 years also produced the highest number of false-positive screens
per woman (BRCA1, 4.5 BRCA2, 8.1). CONCLUSIONS: Annual MRI at age
25 years/delayed alternating DM at age 30 years is probably the most
effective screening strategy in BRCA mutation carriers. Screening
benefits, associated risks, and personal acceptance of false-positive
results should be considered in choosing the optimal screening strategy
for individual women.
magnetic resonance imaging (MRI) is recommended for breast cancer-susceptibility
gene (BRCA) mutation carriers, there is no current consensus on the
optimal screening regimen. METHODS: The authors used a computer simulation
model to compare 6 annual screening strategies (film mammography
[FM], digital mammography [DM], FM and magnetic resonance imaging
[MRI] or DM and MRI contemporaneously, and alternating FM/MRI or
DM/MRI at 6-month intervals) beginning at ages 25 years, 30 years,
35 years, and 40 years, and 2 strategies of annual MRI with delayed
alternating DM/FM versus clinical surveillance alone. Strategies
were evaluated without and with mammography-induced breast cancer
risk using 2 models of excess relative risk. Input parameters were
obtained from the medical literature, publicly available databases,
and calibration. RESULTS: Without radiation risk effects, alternating
DM/MRI starting at age 25 years provided the highest life expectancy
(BRCA1, 72.52 years, BRCA2, 77.63 years). When radiation risk was
included, a small proportion of diagnosed cancers was attributable
to radiation exposure (BRCA1, <2%; BRCA2, <4%). With radiation risk,
alternating DM/MRI at age 25 years or annual MRI at age 25 years/delayed
alternating DM at age 30 years was the most effective, depending
on the radiation risk model used. Alternating DM/MRI starting at
age 25 years also produced the highest number of false-positive screens
per woman (BRCA1, 4.5 BRCA2, 8.1). CONCLUSIONS: Annual MRI at age
25 years/delayed alternating DM at age 30 years is probably the most
effective screening strategy in BRCA mutation carriers. Screening
benefits, associated risks, and personal acceptance of false-positive
results should be considered in choosing the optimal screening strategy
for individual women.
Ozanne, Elissa; Shieh, Yiwey; Barnes, James; Bouzan, Colleen; Hwang, E Shelley; Esserman, Laura J.
Characterizing the impact of 25 years of DCIS treatment Journal Article
In: Breast Cancer Res Treat, vol. 129, no. 1, pp. 165–173, 2011, ().
@article{Ozanne2011,
title = {Characterizing the impact of 25 years of DCIS treatment},
author = {Elissa Ozanne and Yiwey Shieh and James Barnes and Colleen Bouzan and E Shelley Hwang and Laura J. Esserman},
url = {http://www.ncbi.nlm.nih.gov/pubmed/21390494},
doi = {10.1007/s10549-011-1430-5},
year = {2011},
date = {2011-08-01},
journal = {Breast Cancer Res Treat},
volume = {129},
number = {1},
pages = {165--173},
institution = {Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA. },
abstract = {The significant increase in the detection and treatment of ductal
carcinoma in situ (DCIS) since the introduction of screening mammography
has not been accompanied by the anticipated reduction in invasive
breast cancer (IBC) incidence. The prevalence of DCIS requires a
reexamination of the population level effects of detecting and treating
DCIS. To further our understanding of the possible impact of DCIS
diagnosis and treatment on IBC incidence in the U.S., we simulated
breast cancer incidence over 25 years under various assumptions regarding
the baseline incidence of IBC and the progression of DCIS to IBC.
The simulations demonstrate a tradeoff between the expected increased
incidence of IBC absent any DCIS detection and treatment and the
rate of progression of DCIS to IBC. Our analyses indicate that a
high progression of DCIS to IBC implies a significant increase in
incidence of IBC over what is observed had we not detected and treated
DCIS. Conversely, if we assume that there would not have been a significant
increase over and above the observed incidence evident in SEER, then
our model indicates that the rate of DCIS progression to clinically
significant IBC is low. Given the tradeoff illustrated by our model,
we must reevaluate the assumption that DCIS is a short-term obligate
precursor of invasive cancer and instead focus on further exploration
of the true natural history of DCIS.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
The significant increase in the detection and treatment of ductal
carcinoma in situ (DCIS) since the introduction of screening mammography
has not been accompanied by the anticipated reduction in invasive
breast cancer (IBC) incidence. The prevalence of DCIS requires a
reexamination of the population level effects of detecting and treating
DCIS. To further our understanding of the possible impact of DCIS
diagnosis and treatment on IBC incidence in the U.S., we simulated
breast cancer incidence over 25 years under various assumptions regarding
the baseline incidence of IBC and the progression of DCIS to IBC.
The simulations demonstrate a tradeoff between the expected increased
incidence of IBC absent any DCIS detection and treatment and the
rate of progression of DCIS to IBC. Our analyses indicate that a
high progression of DCIS to IBC implies a significant increase in
incidence of IBC over what is observed had we not detected and treated
DCIS. Conversely, if we assume that there would not have been a significant
increase over and above the observed incidence evident in SEER, then
our model indicates that the rate of DCIS progression to clinically
significant IBC is low. Given the tradeoff illustrated by our model,
we must reevaluate the assumption that DCIS is a short-term obligate
precursor of invasive cancer and instead focus on further exploration
of the true natural history of DCIS.
carcinoma in situ (DCIS) since the introduction of screening mammography
has not been accompanied by the anticipated reduction in invasive
breast cancer (IBC) incidence. The prevalence of DCIS requires a
reexamination of the population level effects of detecting and treating
DCIS. To further our understanding of the possible impact of DCIS
diagnosis and treatment on IBC incidence in the U.S., we simulated
breast cancer incidence over 25 years under various assumptions regarding
the baseline incidence of IBC and the progression of DCIS to IBC.
The simulations demonstrate a tradeoff between the expected increased
incidence of IBC absent any DCIS detection and treatment and the
rate of progression of DCIS to IBC. Our analyses indicate that a
high progression of DCIS to IBC implies a significant increase in
incidence of IBC over what is observed had we not detected and treated
DCIS. Conversely, if we assume that there would not have been a significant
increase over and above the observed incidence evident in SEER, then
our model indicates that the rate of DCIS progression to clinically
significant IBC is low. Given the tradeoff illustrated by our model,
we must reevaluate the assumption that DCIS is a short-term obligate
precursor of invasive cancer and instead focus on further exploration
of the true natural history of DCIS.