Ovarian Cancer Survival in African-American Women

非裔美国女性卵巢癌的生存率

• 批准号: 10434896
• 负责人: Andrew B. Lawson
• 金额: $ 127.3万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-01 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10434896
• 关键词: Address; Affect; African American; Age; American; Analgesics; Archives; B-Lymphocytes; Biological Factors; Biological Markers; Cancer Etiology; Cancer Prognosis; Cancer Survivor; Case Study; Case-Control Studies; Censuses; Cessation of life; Characteristics; Clinical; Cohort Studies; Collection; Complex; Data; Data Collection; Data Sources; Databases; Diagnosis; Disease; Enrollment; Ensure; Environment; Epidemiologic Factors; Epidemiology; Epithelial ovarian cancer; European; Evaluation; Exposure to; Formalin; Funding; Geographic Locations; Goals; Health Services Accessibility; High Prevalence; Immunohistochemistry; Incidence; Individual; Inflammation; Inflammatory; Inflammatory Response; Infrastructure; Length; Life Style; Malignant neoplasm of ovary; Manuscripts; Measures; Medical Records; Methodology; Methods; Neighborhoods; Obesity; Outcome; Paraffin Embedding; Participant; Pathologic; Pathology; Pathway interactions; Patients; Pharmaceutical Preparations; Physical environment; Play; Polymerase Chain Reaction; Population; Positioning Attribute; Prevention strategy; Prognosis; Prognostic Factor; Proteins; Psychosocial Factor; Publishing; Quality of life; Questionnaires; Reproductive History; Research Design; Resources; Reverse Transcription; Risk; Risk Factors; Role; Sample Size; Site; Social Environment; Specimen; Therapeutic Intervention; Time; Tissues; Tumor Markers; Tumor Tissue; Tumor-Infiltrating Lymphocytes; Tumor-associated macrophages; United States; Woman; advanced disease; anticancer research; burden of illness; cancer diagnosis; cancer epidemiology; cancer survival; carcinogenesis; clinical effect; comorbidity; cytokine; epidemiology study; experience; follow-up; immune checkpoint; improved; individual patient; lifestyle factors; low socioeconomic status; mortality; mortality disparity; multidisciplinary; multilevel analysis; novel; recruit; residence; social factors; sociodemographic factors; survival disparity; virtual

ABSTRACT Although epithelial ovarian cancer (EOC) is the fifth-leading cause of cancer death in women in the U.S.—with worse survival in African-American (AA) women than European-American (EA) women—little is known about factors affecting survival among AAs. The causes for this disparity are likely multifactorial and need to be examined from multiple levels, including factors affecting the neighborhood social environment and individual- level factors. We posit that inflammatory exposures may explain some of the disparity in EOC survival among AA women due to important role of inflammation on carcinogenesis and prognosis and the higher levels of inflammatory biomarkers present among AA women. The African American Cancer Epidemiology Study (AACES) is a multi-site epidemiologic study of AA women in diverse geographic regions. Due to comprehensive data collection, pathology assessment and length of follow-up, AACES is uniquely positioned to evaluate factors influencing the survival of EOC in AA women. AACES has enrolled an unprecedented number of AA participants during a previous funding period, making AACES the largest study of ovarian cancer in AA women to date: 595 AA women with invasive EOC and 752 controls. Prior to AACES, no epidemiologic study of ovarian cancer had enrolled more than 150 AA cases and 150 AA controls. The overarching goal of this proposal is to assemble the first cohort study of AA EOC survivors by expanding recruitment to reach a sample size of ~944 cases and continuing follow-up of existing AACES cases. We propose a novel multi-level approach to evaluate the impact of neighborhood, lifestyle factors and biomarkers on survival. We propose the following aims that build on our current infrastructure and accomplishments: 1) investigate the effects of the neighborhood social and physical environment on EOC survival; 2) evaluate the association between individual characteristics and EOC survival; 3) characterize inflammatory tumor markers that may be key treatment targets; and 4) use multi-leveling modeling to integrate the impact of the Aim 1-3 variables. Our multi- disciplinary investigative team has extensive experience in all facets of ovarian cancer research, which ensures comprehensive, synergistic approaches to understanding factors that affect survival in AA women diagnosed with invasive EOC. The critical deficit of information on the epidemiologic and prognostic factors for ovarian cancer survival among AA women is addressed comprehensively in the proposed study. Our study will inform strategies to reduce mortality in AA women with EOC.

抽象的 尽管上皮性卵巢癌 (EOC) 是美国女性癌症死亡的第五大原因 非洲裔美国 (AA) 女性的生存率比欧洲裔美国 (EA) 女性更差——我们对此知之甚少 影响 AA 生存的因素。造成这种差异的原因可能是多因素的，需要加以解决 从多个层面进行考察，包括影响邻里社会环境和个人的因素 水平因素。我们认为，炎症暴露可能可以解释 EOC 生存率差异的部分原因 AA 女性由于炎症对癌变和预后的重要作用以及较高水平的 AA 女性中存在炎症生物标志物。非裔美国人癌症流行病学研究 (AACES) 是一项针对不同地理区域的 AA 女性的多地点流行病学研究。由于 全面的数据收集、病理学评估和随访时间，AACES 具有独特的地位 评估影响 AA 女性 EOC 生存的因素。 AACES 招募了前所未有的 上一个资助期间 AA 参与者的数量，使 AACES 成为最大的卵巢癌研究 迄今为止，在 AA 女性中：595 名患有侵入性 EOC 的 AA 女性和 752 名对照女性。在 AACES 之前，没有流行病学 卵巢癌研究招募了超过 150 名 AA 病例和 150 名 AA 对照者。总体目标是 该提案旨在通过扩大招募范围来开展首个针对 AA EOC 幸存者的队列研究，以达到 样本量约为 944 例，并对现有 AACES 病例进行持续随访。我们提出了一种新颖的多层次 评估邻里、生活方式因素和生物标志物对生存影响的方法。我们建议 以下目标建立在我们当前的基础设施和成就的基础上：1）调查 社区社会和物质环境对 EOC 生存的影响； 2）评估个体之间的关联 特征和 EOC 生存； 3）表征可能是关键治疗的炎症肿瘤标志物 目标； 4) 使用多层次建模来整合目标 1-3 变量的影响。我们的多 学科调查团队在卵巢癌研究的各个方面都拥有丰富的经验， 确保采用全面、协同的方法来了解影响 AA 女性生存的因素 诊断为侵袭性 EOC。关于流行病学和预后因素的信息严重缺乏 拟议的研究全面探讨了 AA 女性卵巢癌的生存率。我们的研究将 为降低患有 EOC 的 AA 女性死亡率提供策略。