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    Research Grants Awarded

    Associations between different levels of religiosity and prognosis in Breast cancer patients

    Study Section:
    Population Specific

    Scientific Abstract:
    Scientific Abstract Background : The impact which religiosity has on health behaviors, suggests that religious commitment may play a role in illness prevention and recovery. The Israeli population can be divided into 4 subgroups of religiosity ranging from Ultra Orthodox (UO) to secular, each characterized by unique religious practices, rituals and social organization that may have practical implications. The UO are the most distinct subgroup culturally and geographically, with a strong tendency to resolve problems internally. Preliminary data have shown that UO women in Israel had a lower compliance rate to a BC screening program compared to non-UO women (30% vs. 60% respectively), were diagnosed at more advanced stages and had a lower 5-year survival rate even when stratified by stage. The small sample size and the homogeneity of the population did not allow firm conclusions. Objective: Assess associations between different levels of religiosity and BC prognosis among Jewish female BC patients. We hypothesize that the weakest compliance to diagnostic and therapeutic regimens and the worst prognosis will be found among the UO women. Specific aims: 1. Compare BC recurrence and survival rates according to level of religiosity 2. Assess selected variables which may explain the differences in prognosis seen between the groups. Study design : The study population will include all Jewish females diagnosed with primary BC treated in 3 major centers in central Israel between June 2006 and June 2007 (n=1900). This group will be further divided into 4 religious categories by self-report: UO, religious, traditional and secular. Data on risk factors, health behavior, clinical characteristics and mortality will be collected through personal interviews, medical records and the Israeli Population Registry. Recurrence and survival probabilities for each religious category will be evaluated using Kaplan-Meier estimation. Cox proportional hazards regression will be used to compare prognosis adjusting for covariates. Potential outcome & benefits : Considering the high incidence rate of BC and the potential for cure at early diagnosis, investigation of variations in prognosis between distinct subpopulations is extremely important. Identification of high-risk subgroups, as well as the causes of their poorer outcome might form the basis for an intervention program specifically designed for unique cultural groups

    Lay Abstract:
    Breast cancer (BC) is the most common malignancy among women in the western world. Early diagnosis and compliance to treatment are of great importance for improving outcome. Religiosity has an impact on health behavior, and may influence compliance to medical recommendations including mammography screening for early detection and decisions about treatment. The Israeli population may be divided into 4 subgroups of religiosity ranging from Ultra Orthodox (UO) to secular, each characterized by unique religious practices, rituals and social organization that may have practical implications. The UO are the most distinct subgroup culturally and geographically, with a strong tendency to resolve problems internally. A preliminary survey, which evaluated possible associations between Jewish religiosity and characteristics of BC patients, showed the UO as having low compliance to screening and more advanced stages at diagnosis compared to non UO patients. In addition, survival rates were relatively low among the UO compared to other groups of patients regardless of disease severity. Objective: Assess associations between different levels of religiosity and BC prognosis, defined as disease recurrence and mortality, among Jewish female BC patients. We hypothesize that a lower compliance to medical regimens and a worse outcome will be found among UO women. Specific aims: 1. Compare BC prognosis according to level of religiosity 2. Assess the role of selected variables in explaining the differences in prognosis seen between the groups. Study design : The study population will include all Jewish females diagnosed with incident primary BC between 6.2006 and 6.2007, treated in 3 major centers in central Israel (n=1900). This group will be further divided into 4 religious categories by self-report: UO, religious, traditional and secular. Data on risk factors, health behavior, tumor characteristics and disease outcome will be collected. For each religious group, recurrence of breast cancer, as well as mortality will be evaluated, accounting for other important prognostic factors. Potential outcome and benefit: In light of the high rate of BC and the potential for cure at early diagnosis, investigation of variations in prognosis between distinct subpopulations is extremely important. Identification of high-risk subgroups, as well as the causes of their poorer outcome might form the basis for an intervention program specifically designed for unique cultural groups.