Health Behaviors and Mortality in Prostate Cancer Survivors in the Multiethnic Cohort Study

多种族队列研究中前列腺癌幸存者的健康行为和死亡率

• 批准号: 10512554
• 负责人: Stacey Kenfield
• 金额: $ 8.08万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-23 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10512554
• 关键词: Address; Adult; African American; American; American Association of Cancer Research; Animal Feed; Asian Americans; Asian Pacific American; Baseline Surveys; Behavior; Black race; Body Size; Body Weight; Body mass index; California; Cancer Survivor; Centers for Disease Control and Prevention (U.S.); Cessation of life; Chinese; Clinical; Coffee; Cohort Studies; Cox Proportional Hazards Models; Data; Diabetes Mellitus; Diagnosis; Diagnostic; Diet; Dietary Component; Dietary Factors; Dietary Fiber; Edible Plants; Enrollment; Ensure; Ethnic Origin; Ethnic group; Fabaceae; Family; Family Caregiver; Food; Frequencies; Funding; Health behavior; Heart Diseases; Hispanic; Incidence; Institutes; Intake; Intervention; Japanese; Knowledge; Latino; Latinx; Latinx population; Malignant neoplasm of prostate; Measures; Meat; Mediating; Medical; Native Hawaiian; Nonmetastatic; Nuts; Outcome; Pacific Island Americans; Participant; Patients; Persons; Pharmaceutical Preparations; Physical activity; Physicians; Plants; Population; Population Heterogeneity; Processed Meats; Progress Reports; Prospective Studies; Prostate; Public Health; Questionnaires; Race; Recommendation; Recording of previous events; Reporting; Research; Risk; Risk Factors; Self Administration; Smoking; Smoking History; Surveys; Tea; United States; Update; Vascular Plant; Vegetable Oils; Vegetables; Weight; Work; advanced disease; anticancer research; base; cancer diagnosis; cancer health disparity; cancer risk; cohort; demographics; dietary; egg; ethnic diversity; follow-up; fruits and vegetables; healthy lifestyle; high risk; improved; indexing; interest; men; modifiable risk; mortality; mortality risk; multi-ethnic; population based; primary outcome; prostate cancer risk; prostate cancer survivors; racial and ethnic; racial and ethnic disparities; research study; saturated fat; secondary outcome; tumor progression

PROJECT ABSTRACT: Large racial/ethnic disparities exist for prostate cancer (PC) incidence and mortality. Between 2001-2017, the 5-year relative survival for Black, Asian American/Pacific Islander, and Latinx groups was lower compared to non-Latinx White men. Progressing to advanced disease is a pivotal concern among patients with non- metastatic PC, their family, caregivers, and physicians. A major gap in current knowledge is the lack of research studies focused on post-diagnostic modifiable factors from racially/ethnically diverse populations. Preliminary data suggest that a Healthful Plant-based Diet Index may be associated with a ~60% lower risk of incident fatal PC among healthy men. In addition, our team recently developed a post-diagnostic Prostate Health Behavior Score (focused on physical activity, weight, and diet) with higher scores associated with a ~55% lower risk of PC-specific mortality among men with PC. Even so, 92% of participants in these two analyses identified as non-Latinx White; thus, the findings may not be generalizable to the racially/ethnically diverse populations of people living with PC. In this R03, we propose to examine whether a Healthful Plant- based Diet Index or composite Prostate Health Behavior Score is associated with survival among men with PC in the population-based Multiethnic Cohort Study (MEC). The MEC is a diverse cohort of over 215,000 adults living predominately in southern California and Hawai’i when enrolled between 1993-1996. For these analyses, we will use data from 2,652 men with PC who have measures of health behaviors before and after diagnosis; 19% identified as African American, 25% identified as non-Latino White, 23% identified as Latino, 28% identified as Asian American, and 5% identified as Native Hawaiian. A comprehensive self-administered questionnaire captured demographics, body size, medical and family histories, medication use, smoking history, and physical activity at enrollment; and a quantitative food frequency questionnaire (FFQ) was also administered. Follow-up surveys have been administered every 4-6 years. Data from the baseline survey will be used to adjust for pre-diagnosis health behaviors and body weight. Using these data, we aim to 1) examine whether the Healthful Plant-based Diet Index, a Prostate Health Behavior Score, and their components, measured after PC diagnosis, are associated with lower risk of all-cause and PC-specific mortality; and 2) explore whether associations between these modifiable risk factors and mortality vary across racial/ethnic groups and the degree to which health behaviors contribute to observed racial/ethnic disparities in PC mortality. This work will be completed in the largest prospective study of racially/ethnically diverse men with PC in the U.S., ensuring the generalizability of our results and directly informing clinical and public health recommendations. In addition, this proposal will strengthen the evidence on the impact of health behaviors on outcomes in cancer survivors and could help reduce racial/ethnic disparities in PC outcomes, and guide interventions to ultimately help people with PC lower their risk of cancer progression and death.

项目摘要： 前列腺癌（PC）的发病率和死亡率存在较大的种族/民族差异。2001-2017年间， 5-黑人、亚裔美国人/太平洋岛民和拉丁裔组的年相对生存率低于 非拉丁裔白色男人进展为晚期疾病是非肿瘤患者的关键问题。 转移性PC，他们的家人，护理人员和医生。目前知识的一个主要差距是缺乏 调查研究侧重于不同种族/族裔人口的诊断后可变因素。 初步数据表明，健康的植物性饮食指数可能与以下风险降低约60%有关： 健康男性中的致命PC事件。此外，我们的团队最近开发了一种诊断后前列腺 健康行为评分（侧重于体力活动、体重和饮食），得分较高的患者与 PC男性的PC特异性死亡风险降低约55%。即便如此，92%的参与者在这两个 分析确定为非拉丁裔白色;因此，结果可能无法推广到种族/族裔 不同人群的PC生活。在本R 03中，我们建议检查健康植物是否- 基于饮食指数或复合前列腺健康行为评分与PC男性患者的生存率相关 多种族队列研究（MEC）。MEC是一个由超过215，000名成年人组成的多元化队列 在1993-1996年注册时主要居住在南加州和夏威夷。对于这些分析， 我们将使用来自2,652名PC男性的数据，他们在诊断前后有健康行为的测量; 19%被确定为非裔美国人，25%被确定为非拉丁裔白色，23%被确定为拉丁裔，28% 被确定为亚裔美国人，5%被确定为夏威夷原住民。一个全面的自我管理 问卷采集人口统计学资料、体型、病史和家族史、药物使用、吸烟 病史和体力活动;定量食物频率问卷（FFQ）也被 管理。每4-6年进行一次后续调查。基线调查的数据将 用于调整诊断前的健康行为和体重。利用这些数据，我们的目标是1）检查 无论是健康植物性饮食指数，前列腺健康行为评分，及其组成部分， 在PC诊断后测量，与全因死亡率和PC特异性死亡率的风险较低相关;以及2） 探索这些可改变的风险因素与死亡率之间的关联是否因种族/民族而异 组和健康行为在多大程度上有助于观察到的种族/民族差异在PC mortality.这项工作将在最大的种族/民族多样化的PC男性前瞻性研究中完成 在美国，确保我们的结果的普遍性，并直接告知临床和公共卫生 建议.此外，这项建议将加强关于健康行为对健康的影响的证据。 癌症幸存者的结果，并可能有助于减少PC结果中的种族/民族差异，并指导 最终帮助PC患者降低癌症进展和死亡的风险。