Grace Hillyer

Grace Hillyer

Grace Hillyer

Assistant Professor
Epidemiology at the Columbia University Medical Center

Office/Address:

722 W. 168th Street, room 704
New York NY USA 10032
Phone:
212-342-1658
Email: CV:

Biography

Dr. Hillyer's research interests are centered on the behavioral aspects of cancer screening, prevention and early detection. With a background in the biological sciences and trained in both epidemiology and health education and behavior, Dr. Hillyer's research focuses specifically on patterns of screening and cancer prevention services utilization; underlying sociodemographic, environmental, psychological, and cultural factors associated with screening behavior; and screening outcomes. Recently named a National Institute of Health Cancer Research Network Scholar, Dr. Hillyer's current research explores the emotional, behavioral, and financial implications of false positive colorectal cancer screening using population-based data in collaboration with Population-Based Research Optimizing Screening through Personalized Regimens (PROSPR) Study at Kaiser Permanente of Northern California. In the past, Dr. Hillyer has managed multiple research studies including the Department of Defense Breast Cancer Center of Excellence to investigate racial disparity in the initiation and intensity of adjuvant breast cancer therapy and the New York State Department of Health Colorectal Cancer Screening Initiative that provides free colorectal cancer screening to the uninsured in Northern Manhattan. Working with the New York City Department of Health and Mental Hygiene, other projects include investigation of breast cancer care timelines comparing services between public and private health care settings in New York City and evaluation of the extent and impact of inadequate colonoscopy bowel preparation among patients navigated to colorectal cancer screening in NYC hospitals.

Education

EdD, 2011, Teachers College, Columbia University
MPH, 2000, Mailman School of Public Health, Columbia University
BA, 1986, Kean University

Columbia Affiliations

Member, Prevention, Control and Disparities Program, Herbert Irving Comprehensive Cancer Center

Other Affiliations

Honors & Awards

The President's Grant for Student Research in Diversity, 2009

Select Urban Health Activities

Breast Cancer Care Timelines: After controlling for setting of care, income, and education, Black and Hispanic women are diagnosed at later stages of breast cancer than White women. Delays in the screening, diagnosis and treatment of breast cancer have been identified as potential causes of racial/ethnic disparities in breast cancer outcomes. One review found that a delay of 3 months or more lowered the 5 year survival rate by 12%. These delays may be introduced at many points in the breast cancer continuum, and vary by race/ethnicity. Reasons for delay in care-seeking and/or diagnosis and treatment include factors associated with system capacity as well as factors related to quality of care, and may be rooted in structural barriers to care, provider behavior and/or individual behavior and cultural factors. By identifying key points along the spectrum of breast cancer care where delays may occur, it may be possible to identify specific causes of delay which may lead to the development of effective interventions to reduce disparities. Working in collaboration with The New York City Department of Health and Mental Hygiene (DOHMH), the Fund for Public Health in New York (FPHNY), and two public hospitals located in New York City, this study explores timelines in breast cancer screening, diagnosis, and treatment among women with breast cancer in New York City.
Bowel Preparation Quality Among Patients Navigated to Colonoscopy: Colorectal cancer is the third most commonly diagnosed cancer and third leading cause of cancer-related death in the United States. Colonoscopy has become the preferred method with which to screen for colorectal cancer in New York City. Diagnostic accuracy of colonoscopy is dependent on the endoscopist’s ability to adequately visualize the colonic mucosa1 and as the rate of colonoscopy screening increases bowel preparation quality becomes increasingly important. Up to 40% of all colonoscopies have suboptimal bowel preparation. The ramifications of poorly prepared bowels are serious and include decreased adenoma detection rates, missed neoplasia, increased duration and cost of colonoscopy, and greater number of repeated procedures at shorter follow-up intervals. Repeat procedures due to poor bowel prep expose patients to additional risks and increase the complication rate as well place unnecessary burden on the medical system. Despite the fact that most patients report the bowel preparation as a barrier to colonoscopy and that the preparation is the most difficult aspect of the examination, scant information regarding the prevalence of poor bowel preparation quality exists and the factors that predict poor quality preparations. This study seeks to examine the City-wide colonoscopy navigation program to evaluate the impact of poor bowel preparation, characterize those at greatest risk for poor bowel preparation, and elucidate the predictors of poor bowel preparation.

Select Publications

Hillyer GC, Neugut AI, Schmitt KM, Basch CE. Feasibility and efficacy of pairing fecal immunochemical testing with mammography for increasing colorectal cancer screening among uninsured Latinas in northern Manhattan. Preventive Medicine. 2011; 53(3): 194-8. doi: 10.1016/j.ypmed. 2011.06.11.
Hillyer GC, Neugut AI, Schmitt KM, Basch CE. Feasibility and efficacy of pairing fecal immunochemical testing with mammography for increasing colorectal cancer screening among uninsured Latinas in northern Manhattan. Preventive Medicine. 2011; 53(3): 194-8. doi: 10.1016/j.ypmed. 2011.06.11.
Hillyer GC, Lebwohl B, Rosenberg RM, Neugut AI, Wolf R, Basch CH, Hernandez E, Mata J, Corley DA, Shea SJC, Basch CE. Assessing bowel preparation quality using the mean number of adenomas per colonoscopy. Therapeutic Advances in Gastroenterology. 2014; 7(6):238-246. doi: 10.1177/1756283X14540222. PMCID: PMCID: PMC4212469
Clarke Hillyer G, Neugut AI, Crew KD, Kalinsky K, Maurer MA, Rotsides DZ, Danaceau J, Hershman DL. Use of a urine anastrozole assay to determine treatment discontinuation among women with hormone-sensitive breast cancer: A pilot study. Journal of Oncology Practice. 2012; e100-e104. doi: 10.1200/JOP.2011.000487. PMCID: PMC3439234
Hillyer GC, Hershman DL, Kushi LH, Lamerato L, Ambrosone C, Bovjberg DH, Mandelblatt JS, Rana S, Neugut AI. A survey of breast cancer physicians regarding patient involvement in breast cancer treatment decisions. The Breast. 2013;22(4):548-54. doi:10.1016/j.breast.2012.10.001. PMCID: PMC3640652
Vin-Raviv N, Hillyer GC, Hershman DL, Galea S, Leoce N, Bovbjerg DH, Kushi LH, Kroenke C, Lamerato L, Ambrosone CB, Valdimarsdottir H, Jandorf L, Mandelblatt JS, Tsai W-Y, Neugut AI. Racial disparities in post-traumatic stress following diagnosis of localized breast cancer: The Breast Cancer Quality of Care Study (BQUAL). Journal of the National Cancer Institute. 2013; 105(8):563-72. doi:10.1093/jnci/djt024. PMCID: PMC3627645.
Shelton RC, Clarke Hillyer G, Hershman DL, Leoce N, Bovbjerg DH, Mandelblatt JS, Kushi LH, Lamerato L, Nathanson SD, Ambrosone CB, Neugut AI. Interpersonal influences and attitudes about adjuvant therapy treatment decisions among non-metastatic breast cancer patients: an examination of differences by age and race/ethnicity in the BQUAL study. Breast Cancer Treatment and Research. 2013;137(3):817-28. doi: 10.1007/s10549-012-2370-4. PMCID: PMC3563273.
Hillyer GC, Neugut AI, Schmitt KM, Basch CE. Feasibility and efficacy of pairing fecal immunochemical testing with mammography for increasing colorectal cancer screening among uninsured Latinas in northern Manhattan. Preventive Medicine. 2011; 53(3): 194-8. doi: 10.1016/j.ypmed. 2011.06.11.
Clarke Hillyer G, Basch CH, Basch CE, Lebwohl B, Kastrinos F, Insel BJ, Neugut AI. Gastroenterologists' perceived barriers to optimal pre-colonoscopy bowel preparation: results of a national survey. Journal of Cancer Education. 2012; 27(3): 526-532. doi : 10.1007/s13187-012-0364-x. PMCID: PMC3559004
Clarke Hillyer G, Basch CH, Lebwohl B, Basch CE, Kastrinos, F, Insel BJ, Neugut AI. Shortened surveillance intervals following suboptimal bowel preparation for colonoscopy: Results of a national survey. International Journal of Colorectal Disease. 2013;28:73-81. doi: 10.1007/s00384-012-1559-7. PMCID: PMC3561457

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