Cancer Control in Older Adults

老年人的癌症控制

• 批准号: 7922485
• 负责人: REBECCA A SILLIMAN
• 金额: $ 9.17万
• 依托单位: BOSTON MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-01 至 2011-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7922485
• 关键词: Adherence; Adjuvant Therapy; Age; Age-Years; Axillary Lymph Node Dissection; Basic Science; Breast Cancer Risk Factor; Breast Cancer Treatment; Breast-Conserving Surgery; Cancer Control; Cancer Patient; Cancer Research Network; Cancer Survivor; Caring; Cause of Death; Characteristics; Classification; Clinical; Clinical Trials; Cohort Studies; Combination Drug Therapy; Communication; Comorbidity; Coupled; Data; Databases; Diagnosis; Diagnostic Neoplasm Staging; Disease; Effectiveness; Elderly; Emotional; Epidemic; Epidemiologist; Epidemiology; Fee-for-Service Plans; Funding; Geographic Locations; Health; Healthcare; Joints; Knowledge; Life Expectancy; Link; Literature; Malignant Neoplasms; Measurement; Methods; Modified radical mastectomy; Morbidity - disease rate; Newly Diagnosed; Observational Study; Outcome; Patients; Physicians; Positioning Attribute; Prevalence; Preventive; Primary Neoplasm; Quality of Care; Radiation therapy; Research; Research Infrastructure; Research Personnel; Risk; Role; Scientist; Staging; Time; Treatment Effectiveness; Treatment Efficacy; Treatment outcome; Treatment-Related Cancer; Variant; Woman; Work; age related; breast cancer diagnosis; cancer care; cancer prevention; cancer recurrence; chemotherapy; compare effectiveness; comparison group; design; end of life care; functional disability; health care service utilization; hormone therapy; improved; malignant breast neoplasm; mortality; next generation; older women; prevent; treatment effect; tumor

DESCRIPTION (provided by applicant): Dr. Silliman is a geriatrician and clinical epidemiologist whose research over the past 20 years has highlighted age-associated disparities in cancer treatment, related in large part to the quality of patient- physician communication. Because of the critical role of comorbidity in the care of older cancer patients, her investigative work has also explored alternative methods of its measurement. Finally, her work has considered the implications of treatment variations on a range of health outcomes: (1) general and breast cancer-specific emotional health; (2) upper body function; and (3) breast cancer recurrence and mortality. Her currently funded R01s are designed to: (1) characterize the separate and joint effects of treatment, tumor, and patient characteristics on breast cancer-specific outcomes in the HMO setting; and (2) examine the relationships among breast cancer and its treatment, age-related comorbidities and functional impairments, and health outcomes in long-term older breast cancer survivors in the fee-for-service setting. During the K05 renewal period, Dr. Silliman proposes to study the impact of multiple morbidities on cancer care and outcomes. Specifically, she will (1) expand the scientific evidence that defines optimal breast cancer care for older women with multiple morbidities; (2) develop new measurement strategies and applications to improve our understanding of multiple morbidity as an independent variable, confounder, and effect modifier of breast cancer treatment and outcomes; (3) develop a research database infrastructure to support studies of cancer care quality and effectiveness among older cancer patients with multiple morbidities; and (4) develop young investigators whose research focuses on cancer prevention and control in older adults. New research during the funding period will compare the care for incident and prevalent non- breast cancer comorbid conditions, specifically quality of care and health care utilization; adherence to preventive health care strategies; and end of life care received by older breast cancer survivors and an age and comorbidity-matched comparison group. Relevance: Dr. Silliman has successfully applied the basic science of epidemiology to the cancer epidemic in older adults. She is positioned to enrich our knowledge of cancer prevention and control in older adults and to develop the next generation of cancer control scientists.

Silliman博士是一位老年病学家和临床流行病学家，他在过去20年的研究中强调了癌症治疗中与年龄相关的差异，这在很大程度上与患者-医生沟通的质量有关。由于合并症在老年癌症患者护理中的关键作用，她的研究工作也探索了其测量的替代方法。最后，她的工作考虑了治疗变化对一系列健康结果的影响：（1）一般和乳腺癌特异性情绪健康;（2）上身功能;（3）乳腺癌复发和死亡率。她目前资助的R 01旨在：（1）描述HMO环境中治疗，肿瘤和患者特征对乳腺癌特定结局的单独和联合影响;（2）检查乳腺癌及其治疗，年龄相关的合并症和功能障碍之间的关系长期老年乳腺癌幸存者在收费服务环境中的健康结局。在K 05更新期间，Silliman博士建议研究多种疾病对癌症护理和结局的影响。具体来说，她将（1）扩大科学证据，定义最佳乳腺癌护理的老年妇女与多种发病率;（2）开发新的测量策略和应用，以提高我们的理解多种发病率作为一个自变量，混杂因素，乳腺癌治疗和结果的影响修饰符;（3）建立研究数据库基础设施，以支持研究患有多种疾病的老年癌症患者的癌症护理质量和成效;（4）培养年轻的研究人员，他们的研究重点是老年人的癌症预防和控制。在资助期间的新研究将比较对事件和流行的非乳腺癌共病状况的护理，特别是护理质量和卫生保健利用;坚持预防性卫生保健策略;老年乳腺癌幸存者和年龄和共病匹配的对照组接受的临终关怀。相关性：Silliman博士成功地将流行病学的基础科学应用于老年人的癌症流行。她的定位是丰富我们对老年人癌症预防和控制的知识，并培养下一代癌症控制科学家。