Georgetown University Lombardi Comprehensive Cancer Center Support Grant

乔治城大学隆巴迪综合癌症中心支持补助金

• 批准号: 10405729
• 负责人: Louis M. Weiner
• 金额: $ 16.97万
• 依托单位: GEORGETOWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-01-22 至 2023-01-21
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10405729
• 关键词: Georgetown; University; Lombardi; Comprehensive; Cancer

The intent of NOT-CA-21-026 is to “assess [stigma’s] impact on cancer control and prevention, and develop stigma-reduction interventions to improve cancer outcomes in low- and middle-income countries (LMICs)”. Thailand definitely qualifies under this criterion, and is the focus of an ongoing molecular epidemiology study on hepatocellular carcinoma (HCC) and cholangiocarcinoma (CCA), in which Drs. Wang and Loffredo (MPIs of the proposed administrative supplement) have active collaborations. The proposed pilot project results would be used to inform the design of interventions to lower stigma associated with liver malignancies and thereby improve cancer outcomes. The parent grant (P30 CA51008) has a strong population science component, the Cancer Prevention and Control Program, with depth of expertise in prevention sciences. Cancer disparities is a cross-cutting theme of the program, and the proposed work will deepen our engagement in global oncology in Asia, specifically in Thailand. This will provide added value to the parent grant in providing a population-based assessment of stigma in liver cancers that can serve as a model for work in Asians (who have high risk of liver cancers) living in our catchment area and LMICs. Study findings will also lay the groundwork for interventions to reduce stigma and improve outcomes. In Thailand, both HCC and CCA occur at high levels: its rate of CCA is the world’s highest. To address knowledge gaps about risk factors, our existing consortium was formed in 2010 among five major cancer referral centers in Thailand, covering about 80% of the country, which recruit HCC and CCA cases and age-, gender- and region-matched controls. Results identified hepatitis B and C viral infections as the major risk factors for HCC, and consumption of fish infested with the liver fluke, Opisthorchis viverrini, as the main risk factor for CCA. With this infrastructure, newly diagnosed cases can be identified for our proposed stigma research. Importantly, the consortium also recruits two high-risk groups with pre- malignant disease: those with chronic liver disease and those with liver fluke infestation, both of which will be included in our stigma project. Thus, the information from HCC and CCA patients will deepen the understanding of the stigma that they experience and the consequences for screening, treatment, and survivorship programs, while the inclusion of the pre-malignant groups affords an unparalleled opportunity to explore their stigma experiences and to plan for future interventions to prevent cancer. In Specific Aim 1, we will examine associations of liver cancer stigma with depression and use of ultrasound screening among liver cancer patients and high risk, pre-malignant patients. Specific Aim 2 is to conduct qualitative interviews with samples of patients from Aim 1, and with community health workers and healthcare providers to understand causes of cancer stigma and their prevention. The results will reveal ways to minimize the influence of cancer stigma on liver prevention and control in targeted patients to inform the development of behavioral or multi- level interventions (including screening) for targeted high-risk populations.

NOT-CA-21-026的目的是“评估[污名]对癌症控制和预防的影响，并制定 减少耻辱干预措施，以改善低收入和中等收入国家（LMICs）的癌症结局。 泰国绝对符合这一标准，并且是正在进行的分子流行病学研究的重点 在肝细胞癌（HCC）和胆管癌（CCA），其中王博士和Loffredo（MPI的 行政补充建议）进行积极合作。拟议的试点项目结果将 用于为干预措施的设计提供信息，以降低与肝脏恶性肿瘤相关的耻辱感， 改善癌症预后。父母补助金（P30 CA 51008）有很强的人口科学成分， 癌症预防和控制方案，在预防科学方面具有深厚的专业知识。癌症是一种 该计划的交叉主题，拟议的工作将加深我们在全球肿瘤学的参与， 亚洲，尤其是泰国。这将为父母补助金提供附加值， 评估肝癌的耻辱感，可作为亚洲人（肝癌风险高）工作的模型 癌症）生活在我们的集水区和中低收入国家。研究结果还将为干预措施奠定基础 减少耻辱感并改善结果。在泰国，HCC和CCA的发生率都很高： 是世界上最高的。为了填补有关风险因素的知识空白，我们现有的联盟成立于年。 2010年在泰国的五个主要癌症转诊中心中，覆盖了全国约80%的地区， HCC和CCA病例以及年龄、性别和地区匹配的对照。结果鉴定出B和C型肝炎病毒 感染是肝癌的主要危险因素，以及食用感染肝吸虫、后睾吸虫的鱼类 灵猫是CCA的主要危险因素。有了这个基础设施，新诊断的病例可以被识别出来， 我们提议的污名化研究重要的是，该财团还招募了两个高危人群， 恶性疾病：那些患有慢性肝病和肝吸虫感染，这两个将是 包括在我们的耻辱项目中。因此，来自HCC和CCA患者的信息将加深 了解他们所经历的耻辱以及筛查、治疗和 生存方案，而纳入前恶性组提供了一个无与伦比的机会， 探讨他们的耻辱经历，并计划未来的干预措施，以预防癌症。在具体目标1中， 将研究肝癌污名与抑郁症的关系，以及在肝癌患者中使用超声筛查。 癌症患者和高风险、癌前病变患者。具体目标2是进行定性访谈， 目标1的患者样本，以及社区卫生工作者和医疗保健提供者，以了解 癌症污名化的原因及其预防研究结果将揭示最大限度地减少癌症影响的方法 目标患者对肝脏预防和控制的耻辱感，以告知行为或多- 针对高风险人群的一级干预措施（包括筛查）。