Midcareer Mentoring Award for Patient-Oriented Research in Aging

描述（由申请人提供）：本提案的目的是（1）使候选人能够进一步发展她的研究计划，重点是改善老年人的癌症筛查和预防，（2）利用她的研究计划作为指导对老龄化研究感兴趣的初级患者为导向的研究人员的平台，无论是在老年医学和医学亚专业。该候选人是一名老年病学家，他建立了一个高影响力的独立临床研究项目，该项目资金充足，具有出色的出版记录。在完成她的老年医学奖学金后的10年里，她已经成为学生，研究员和初级教师的成功导师，他们发表了高影响力的老龄化研究，成功获得资助，并继续参与以患者为导向的老龄化研究。候选人开发了广泛的研究组合，重点关注老年人癌症筛查的结果，通过更好地定义风险和益处，特别是作为预期寿命的函数，寻求改善癌症筛查的目标。这项工作影响了美国的筛查指南，他们利用这项研究建议筛查决策更关注预期寿命而不是实际年龄，并更好地认识到筛查的潜在危害。这项提案将为候选人提供受保护的时间，以扩大她的研究在一个新的方向，重点是监测检测癌症复发的老年癌症幸存者。对老年癌症幸存者的监测提出了与筛查类似的问题，因为它可以通过发现仍可治疗的复发性癌症而使老年人受益，但也可能通过过度治疗导致大量发病率。本提案中的研究将通过更好地定义老年前列腺癌幸存者监测检测的风险和益处，为该领域的决策提供信息。这个新方向保持了她的研究重点，同时与肿瘤学建立了新的合作。候选人还将制定一个正式的指导计划，计划招募，选择，发展和评估将成为老龄化研究领导者的学员。每个学员都将有一个有重点的职业发展计划，他们在其中完成研究项目，并发展成为老龄化研究独立调查员所需的技能。该提案将候选人的指导计划整合到UCSF出色的临床研究培训环境中，利用她在老年医学部和临床和转化科学研究所（CTSI）职业发展（KL 2学者）计划中的领导地位，招募更多对老龄化研究感兴趣的学员。 公共卫生相关性：该提案将具有独特的公共卫生重要性，因为（1）它将增加对有兴趣进行研究以改善快速增长的老年人口护理的新临床研究者的指导，以及（2）通过更好地定义老年前列腺癌幸存者中前列腺特异性抗原（PSA）监测实践的风险和益处，它将为国家指南和临床决策提供信息。

DESCRIPTION (provided by applicant): The aims of this proposal are to (1) enable the candidate to further develop her research program focused on improving cancer screening and prevention in older adults and (2) use her research program as a platform for mentoring junior patient-oriented investigators interested in aging research, both within Geriatrics and within the medical subspecialties. The candidate is a Geriatrician who has established a high-impact independent clinical research program that is well funded with an outstanding publication record. In the 10 years since completing her Geriatrics fellowship she has established herself as a successful mentor of students, fellows, and junior faculty who have published high-impact aging research, become successfully funded, and continue to participate in patient-oriented research in aging. The candidate has developed an extensive research portfolio focused on the outcomes of cancer screening in elders that has sought to improve the targeting of cancer screening by better defining the risks and benefits, particularly as a function of life expectancy. This work has influenced screening guidelines in the U.S., which have used this research to recommend that screening decisions focus more on life expectancy than chronological age and better recognize the potential harms of screening. This proposal will provide the candidate with protected time to expand her research in a new direction focused on surveillance testing for cancer recurrence in older cancer survivors. Surveillance in older cancer survivors poses similar issues to screening in that it can potentially benefit elders by finding recurrent cancers when still treatable but also may cause substantial morbidity through overtreatment. The research in this proposal will inform decision making in this area by better defining the risks and benefits of surveillance testing in older prostate cancer survivors. This new direction maintains her research focus while building new collaborations with oncology. The candidate will also develop a formal mentoring program with plans for the recruitment, selection, development, and evaluation of mentees who will become leaders in aging research. Each mentee will have a focused career development plan in which they complete research projects and develop the skills needed to become independent investigators in aging research. This proposal integrates the candidate's mentoring program into the outstanding clinical research training environment at UCSF, leveraging her leadership positions in the Division of Geriatrics and the Clinical and Translational Science Institute (CTSI) Career Development (KL2 Scholars) Program to recruit more mentees interested in aging research. PUBLIC HEALTH RELEVANCE: This proposal will have unique public health importance because (1) it will increase mentoring of new clinical investigators interested in conducting research to improve care for the rapidly growing elderly population, and (2) it will inform national guidelines and clinical decision-making by better defining the risks and benefits of prostate-specific antigen (PSA) surveillance practices in elderly prostate cancer survivors.