Social Networks & Breast Cancer Prognosis in the Chinese and US Evaluation Study

社交网络

• 批准号: 8547798
• 负责人: CANDYCE H KROENKE
• 金额: $ 7.15万
• 依托单位: KAISER FOUNDATION RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-19 至 2015-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8547798
• 关键词: Address; Affect; Aging; Behavior; Behavioral; Body Weight; Breast Cancer Treatment; Cancer Burden; Cancer Prognosis; Cancer Survivor; Cardiovascular system; Caring; Cessation of life; Characteristics; China; Chinese People; Cohort Studies; Communities; Community Participation; Cox Models; Data; Data Set; Demographic Factors; Diagnosis; Diet; Eating; Emotional; Ethnic Origin; Evaluation; Evaluation Studies; Family; Family Relationship; First Degree Relative; Frequencies; Friends; Generations; Goals; Grant; Health; Health Care Costs; Heterogeneity; Incidence; Individual; Internet; Intervention; Knowledge; Life; Life Style; Linear Regressions; Literature; Logistic Regressions; Malignant Neoplasms; Meta-Analysis; Modification; Nurses' Health Study; Outcome; Participant; Persons; Physical activity; Population; Population Characteristics; Population Growth; Postmenopause; Prognostic Factor; Race; Randomized; Recruitment Activity; Religion and Spirituality; Research; Risk Factors; Severities; Severity of illness; Site; Smoking; Social Impacts; Social Network; Social support; Socioeconomic Status; Spouses; Staging; Survivors; Testing; Variant; Weight; Woman; Women' s Group; Women' s Health; Women' s Role; Work; adverse outcome; behavior influence; breast cancer diagnosis; cancer epidemiology; caregiving; cohort; cost; improved; lifestyle factors; malignant breast neoplasm; member; mortality; older women; outcome forecast; prospective; public health relevance; social; socioeconomics; tumor; tumor progression

DESCRIPTION (provided by applicant): Each year, more than 200,000 women are diagnosed with, and nearly 40,000 die from their breast cancer (BC) but variations in treatment and tumor characteristics explain only a fraction of breast cancer deaths. It is important to determine those factors that may help prolong survival given the aging of the population and the greater incidence of breast cancer in older women. Social networks are defined as the web of social relationships that surround an individual. Previous literature demonstrates that women with larger social networks have longer survival after a BC diagnosis, but the mechanisms through which social networks influence prognosis and in what populations are unknown. The aims of this grant are to examine associations between social network size, network members (presence of a spouse/partner, number of first-degree relatives, community participation, religious participation), and 1) major behavioral risk factors for survival including physical activity, diet, smoking, and body weight, as well as 2) breast cancer-specific mortality and all-cause mortality. We will consider the modifying influence of relationship quality, (i.e., levels of social support and social burden) on BC outcomes. Associations will also be examined in different populations of women defined by socioeconomic status, race/ethnicity, cancer severity, and extensiveness of treatment. Aims will be addressed in a pooled analysis of 10,239 breast cancer survivors in the Chinese and US Evaluation (CAUSE) Cohort which includes women from the Life After Cancer Epidemiology (LACE), the Women's Healthy Eating and Living (WHEL) and the Shanghai Breast Cancer Cohort (SBCC) studies. Multiple linear and logistic regression will be used to evaluate associations with behavioral factors, and Cox models will be used to evaluate associations with mortality, after evaluating heterogeneity. Associations will be examined by sociodemographic factors, disease severity and treatment, and levels of social support and burden, testing for effect modification. The proposed study is the first to examine associations with lifestyle factors and weight. It is the first pooled study of social networks and breast cancer outcomes, the largest of its kind, and represents a new generation of studies to examine in a more nuanced way how and in what populations social networks influence BC outcomes, including the possible costs and burdens, and not just benefits of social relationships. We expect that influences on behavioral factors will in part explain associations with mortality. I we demonstrate these findings, family interventions previously employed to improve lifestyle factors in persons with cardiovascular conditions might inform possible new strategies to improve health and survival in women with BC. Previous social interventions in BC survivors have largely focused on social-emotional supports, but these have failed to improve survival. It is hoped that addressing gaps in the literature will help point to potential avenues through which relationships with network members might be augmented to promote survival, or managed to mitigate costs of social relationships.

描述（由申请人提供）：每年有超过20万名妇女被诊断患有乳腺癌，近4万人死于乳腺癌（BC），但治疗和肿瘤特征的变化只能解释乳腺癌死亡的一小部分。重要的是要确定这些 考虑到人口老龄化和老年妇女乳腺癌发病率较高，可能有助于延长生存期的因素。社交网络被定义为围绕个人的社会关系网。先前的文献表明，具有较大社交网络的女性在BC诊断后具有较长的生存期，但社交网络影响预后的机制以及在哪些人群中尚不清楚。这项研究的目的是检查社交网络规模，网络成员（配偶/伴侣的存在，一级亲属的数量，社区参与，宗教参与）之间的关联，以及1）生存的主要行为风险因素，包括体力活动，饮食，吸烟和体重，以及2）乳腺癌特异性死亡率和全因死亡率。我们将考虑关系质量的修正影响（即，水平 社会支助和社会负担）对业连成果的影响。还将在由社会经济地位、种族/民族、癌症严重程度和治疗广泛性定义的不同女性人群中检查相关性。目的将在中国和美国评估（CAUSE）队列的10，239名乳腺癌幸存者的汇总分析中进行，其中包括来自癌症流行病学（LACE），女性健康饮食和生活（WHEL）和上海乳腺癌队列（SBCC）研究的女性。在评价异质性后，将使用多元线性和逻辑回归评价与行为因素的相关性，并使用考克斯模型评价与死亡率的相关性。将通过社会人口因素、疾病严重程度和治疗以及社会支持和负担水平来检查相关性，并测试影响修正。这项拟议中的研究是第一次研究生活方式因素和体重之间的联系。这是第一个对社交网络的汇总研究， 乳腺癌结果是同类研究中规模最大的，代表了新一代的研究，以更细致的方式研究人群社交网络如何以及以何种方式影响BC结果，包括可能的成本和负担，而不仅仅是社会关系的好处。我们预计，对行为因素的影响将部分解释与死亡率的关联。我们证明了这些发现，以前用于改善心血管疾病患者生活方式因素的家庭干预措施可能会为改善BC女性健康和生存的新策略提供信息。BC幸存者以前的社会干预主要集中在社会情感支持，但这些都未能提高生存。希望解决文献中的空白将有助于指出潜在的途径，通过这些途径，与网络成员的关系可能会被增强，以促进生存，或设法减轻社会关系的成本。