Pilot Project 2: Assessing the Needs of Cancer Survivors

摘要：癌症的存活率持续提高，目前为65%。有据可查的是 在美国，非裔美国人背负着不成比例的癌症发病率和死亡率负担，但 人们对这些差异的原因只有部分了解。此外，对于那些癌症治愈的人来说， 人们对癌症及其治疗带来的不利的长期健康相关后遗症的负担知之甚少。 尽管在知识上存在这些差距，但非洲裔美国人在临床试验和 流行病学研究。癌症的不良长期后遗症及其治疗在以下方面有很好的文献记载 儿科癌症幸存者，以及几项大型队列研究正在跟踪这些患者。然而，更少的是 已知的幸存者在他们成年后被诊断出来。专注于癌症生存的合作伙伴关系 在NCI指定的癌症中心和少数族裔服务机构之间是开始的理想机制 这样的调查。因此，我们建议开展一项试点项目，以确定、建立和遵循一项种族政策。 乳腺癌、结直肠癌、肺癌和前列腺癌成年幸存者的不同队列，以记录 长期结果，并按种族和性别调查这些结果差异的原因 社会经济地位。这项研究将协同利用和利用三个突出的资源：(1) 范德比尔特-英格拉姆癌症中心(VICC)，NCI指定的综合癌症中心和(2)Meharry 医学院(MMC)，一所历史悠久的黑人学院或大学(HBCU)，主要服务于少数族裔 患者群体，以及田纳西州立大学(TSU)专家的咨询，这是一个合作项目 以少数族裔教职员工和学生为主的机构，建立300名成人癌症队列 幸存者，其中一半是非裔美国人。我们假设不良后果的范围会很广， 因种族和社会经济地位不同而不同，包括与治疗有关的器官功能障碍、心血管疾病 以及肺部合并症、心理社会损害和身体功能减退。此外，风险 不良结果、死亡率和发病率的因素将包括癌症诊断的晚期、癌症 治疗，医疗并存，较低的社会经济地位，以及获得常规医疗和医疗服务的机会减少 后续的肿瘤护理。这些因素将影响幸存者健康状况的种族差异，并告知 今后的干预措施旨在消除这种差距。

Abstract: The rate of survival for cancer continues to improve and is now 65%. It is well-documented that African Americans bear a disproportionate burden of cancer incidence and mortality in the United States, but reasons for these disparities are only partly understood. Furthermore, for those that are cured of their cancer, little is known about the burden of adverse long-term health-related sequelae of the cancer and its treatment. Despite these gaps in knowledge, African Americans remain underrepresented in clinical trials and epidemiologic studies. Adverse long-term sequelae of cancer and its treatment are well-documented amongst pediatric cancer survivors, and several large cohort studies are following such patients. However, far less is known about survivors diagnosed during their adult years. A partnership focusing on cancer survivorship between an NCI-designated Cancer Center and a Minority-Serving Institution is the ideal mechanism to begin such investigations. Therefore, we therefore propose a pilot project, to identify, establish and follow a racially diverse cohort of adult survivors of breast, colorectal, lung and prostate cancer to document the prevalence of long-term outcomes and to investigate the reasons for disparities in these outcomes by race and socioeconomic status. This study will utilize and leverage three outstanding resources collaboratively: (1) Vanderbilt-lngram Cancer Center (VICC), an NCI-designated Comprehensive Cancer Center and (2) Meharry Medical College (MMC), an historical black college or university (HBCU) serving a predominantly minority patient population, along with consultation from experts at (3) Tennessee State University (TSU), a partnering institution with a predominant minority faculty and student body, to establish a cohort of 300 adult cancer survivors, half being African American. We hypothesize that the spectrum of adverse outcomes will be broad, differ by race and socioeconomic status, and will include organ dysfunction related to treatment, cardiovascular and pulmonary co-morbidities, psychosocial impairment and reduced physical function. Furthermore, risk factors for adverse outcomes, mortality and morbidity will include later stage at cancer diagnosis, cancer therapy, medical co-morbidities, lower socioeconomic status, and decreased access to routine medical and follow-up oncology care. These factors will influence racial disparities in survivor health status and inform future interventions targeted to eliminate such disparities.