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THE MARIN WOMEN’S STUDY

THE MARIN WOMEN’S STUDY. Why was it initiated? What is happening now? What will the future bring?. Why Was it Initiated?. Breast Cancer Incidence Trends in Marin County* (2001-02). * White non-Hispanic women, invasive cancers only. The Breast Cancer Incidence Rates Comparison – 2004-05.

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THE MARIN WOMEN’S STUDY

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  1. THE MARIN WOMEN’S STUDY

  2. Why was it initiated? • What is happening now? • What will the future bring?

  3. Why Was it Initiated?

  4. Breast Cancer Incidence Trends in Marin County* (2001-02) * White non-Hispanic women, invasive cancers only

  5. The Breast Cancer Incidence Rates Comparison – 2004-05 Marin SFBA CA US Mortality Rates in the1990’s Re-calculated based on new Census Phipps A, Clark C, Ereman R; Breast Cancer Research, June 7, 2005

  6. MANY Questions WHY Marin’s Breast Cancer Rates High 2001-2005

  7. YES, More women in Marin: drink alcohol daily, have fewer children, later in life, higher income/education. All would act to increase Marin’s rates. Why Marin? BUT – Marin women are thinner, exercise more and report eating healthier… These would act to decrease Marin’s rates More women screening? NO, slightly higher screening rates, expect 1-2 more cases a year Lifestyle Differences? Data lacking on exposures More Toxins?

  8. Left with the question • Do the women in Marin who get breast cancer have more of the risk factors that are more prevalent here? • We needed risk factor information from women getting cancer, so we could answer this crucial question.

  9. 2004 - What Next? • Research suggests that lifestyle risk factors play a role in Marin • We need to gather individual risk factors and breast health information from each Marin woman • The County/Community IS where research needs to be – Community is determined and cares deeply • All women do not respond to risk factors in the same way, We need to to look at gene-environment interactions • Can we pave a way for investigating environmental toxins. THE MARIN WOMEN’S STUDY WAS BORN

  10. HISTORY • Funded by the CDC in July 2005 • Multiple stakeholder planning meetings during 2005-2006 • Data Collection Launched November 2006 • First Research Results January 2008

  11. Marin Women’s Study GOALS • Investigate how reproductive, lifestyle, demographic and biologic factors affect breast cancer risk in Marin • Alcohol, Hormone Therapy, Reproductive Factors, Socio-economic Status, Stress, Environmental Exposures. • Understand why breast cancer risk factors do not affect all women in the same way.

  12. MWS COMPONENTS Breast Density Breast Cancer

  13. Who is Involved?

  14. COLLABORATION

  15. MARIN COUNTY DHHS BUCK INSTITUTE KAISER MEDICAL GROUP MARIN GENERAL HOSPITAL UCSF ZERO BREAST CANCER SCIENTIFIC ADVISORY TEAM

  16. Marin General Hospital Meals of Marin Marin Family Action Marin Friends of Women Kaiser Permanente Marin Center for Independent Living Zero Breast Cancer 15 Individuals & Community Groups Marin Breast Cancer Council Breast Cancer Resource Center American Cancer Society Tina Action Programs Fair Housing of Marin COMMUNITY INVOLVEMENT GROUP

  17. AND …MANY VOLUNTEERS!!

  18. What Is Happening Now?

  19. STUDY SUCCESSES – Oct. 2009 QUESTIONNAIRE • Almost 14,000 Questionnaires received! BIOSPECIMEN • Saliva Collection 6,000 Samples! • AVON funding received July 2007, Sept 2009 CAMPAIGN • Campaign – Banners, Movie Theatres, Grocers… • 80% of women surveyed knows about MWS

  20. Hormone Therapy Study In Review

  21. Hormone Therapy Use, 2001Women, ages 50+ • Marin: 40.7%, California: 39.3% - used any type of prescription hormone therapy. • % of women >50 yrs. with a Hysterectomy: • Marin 29.4% • California- 38.1% • Kings County – 53.7% E + P E + P

  22. HORMONE THERAPY USE BY YEAR Estrogen Only and Estrogen plus Progestin ESTROGEN ONLY HERS Estrogen/Progestin WHI 6% Women 50+ in that year, all ethnicities

  23. Alternative Hormone Use Current E+P Use 6%

  24. What’s Next?

  25. MWS Next Steps • Complete cleaning and scanning data into database. • Complete analysis of first saliva study • Embark on second ‘spit study’! • Conduct analyses on key research questions. • Track Hormone Therapy use - ‘re-starting’, replacement regimens, - Are emerging CAMS safe?

  26. Selected Risk Factors in Women 50-80 in DRAFT Marin n=5438 DRAFT

  27. Cancer Root Flower Growth similar to cancer in humans To remind us that the cure is in the earth.

  28. CONTACT INFO • Web Site: www.mwstudy.org marinwomensstudy.org • Contact Epidemiology Program for materials or information: 507-4077 • Rochelle Ereman, Study Director 499-3056 • Kathy Koblick, Outreach and Campaign 507-2578 • Mark Powell, MD, MPH, Biospecimen 499-6969

  29. Percentage of Women with Hysterectomies, selected CA counties • San Francisco, Santa Cruz and Marin –counties with lowest hysterectomy rates. (24.5-30.6%) • Kings, Madera and Kern counties – highest hysterectomy rates (55-62%) • Average 41.5% CA 31% 62% NOT MORE WOMEN ON HRT: Current use of HRT 35% in 2001 CA, Marin

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