A School of Public Health researcher has recently been awarded a grant from the Medical Service Incorporated (MSI) Foundation to identify gaps in care during the diagnosis of breast cancer. Over two years, Yan Yuan will be working with a variety of clinicians to analyze the entire diagnostic process in Alberta between 2006 and 2010.

Yuan’s interest in health services research extends back to 2009 when she attended a talk by Marcy Winget, associate professor in the School of Public Health. After Yuan joined the School as an assistant professor, further conversations with Winget revealed a lack of information on the quality of breast cancer care.

Through this research, Yuan and Winget will delve into the diagnostic experience of Albertan women, from the point where cancer is suspected through to when treatment is given, or the individual is cleared. Using guidelines from the American College of Radiology and the Public Health Agency of Canada, as well as data from her collaborators, she will evaluate diagnostic care. The aim is to assess whether patients received the appropriate tests at the appropriate time. Using data from physician billing and the Canadian census, Yuan will also look at how factors such as socioeconomic status or geographic location affect the quality of care.

“We are interested in identifying gaps and informing solutions in the breast cancer diagnostic process,” Yuan says. “We will also evaluate certain aspects of the breast cancer screening program such as the impact of false positive screening results on future participation in screening. As part of this, we’ll assess whether there are important regional differences in care.”

Her clinical co-investigators include a family physician, a breast cancer surgeon and a radiologist to help her understand crucial data related to diagnostic tests and schedules. Yuan believes that this interdisciplinary approach to the research is critical to providing the big picture and will lead to better patient care. 

“I am very lucky to be collaborating with these individuals, as they will bring important clinical perspectives and experiences to the research,” she says. “They will help ensure that the research is relevant to clinical practice, and will eventually bring our findings to their respective professional communities. As a result, this research could ultimately impact every female in Alberta.”

As she gets underway with the research, Yuan’s first task will be to hire a research assistant and graduate students to assist her in the analysis of vast quantities of data. Although it is a daunting project, Yuan is optimistic about the success of the research.

“As Alberta’s population ages, a clear picture of diagnostic services and care is urgently needed to plan for the projected need and to ensure that women receive appropriate care,” she says. “There is a lot of work ahead, but I am excited to get started.”