Comparative Assessment of Screening Strategies for Melanoma

黑色素瘤筛查策略的比较评估

• 批准号: 8757665
• 负责人: Sandra J Lee
• 金额: $ 18.81万
• 依托单位: DANA-FARBER CANCER INST
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-07-01 至 2016-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8757665
• 关键词: Age; American Cancer Society; Applications Grants; Area; Breast Cancer Detection; Characteristics; Clinical; Complement; Consensus; Data; Data Element; Databases; Dermatologist; Diagnosis; Disease; Disease Progression; Disease susceptibility; Dysplastic Nevus; Early Diagnosis; Eastern Cooperative Oncology Group; Elements; Epidemiologist; Epidemiology; Family history of; Foundations; Future; General Population; German population; Grant; Guidelines; Incidence; Individual; Investigation; Lead; Lesion; Malignant Neoplasms; Measures; Medical Surveillance; Methods; Modeling; Natural History; Nevus; Patients; Pattern; Pigments; Population; Prevention; Probability; Process; Public Health; Race; Recording of previous events; Research; Research Personnel; Risk; Risk Factors; Schedule; Screening for Skin Cancer; Skin Carcinoma; Southwest Oncology Group; Stage at Diagnosis; Staging; Susceptibility Gene; TNM; Thick; Time; Woman; Work; base; comparative; compare effectiveness; cost; disease natural history; experience; high risk; innovation; melanoma; member; men; mortality; population based; pre-clinical; programs; public health relevance; randomized trial; screening; sex; tumor; working group

DESCRIPTION (provided by applicant): Comparative Assessments of Screening Strategies for Melanoma Project Summary This grant proposal is centered around research problems arising in the early detection of malignant melanoma with an emphasis on sex-based differences in the early diagnosis of melanoma. The principal research areas include: (i) Investigate the natural history of melanoma and develop stochastic models for early detection of melanoma, (ii) Evaluate the mortality benefit of potential screening programs in the general and high-risk populations, (iii) Establish a pilot database of individuals at high-risk of developing melanoma and evaluate the factors associated with the risk of developing melanoma and of fatal melanoma. The incidence of malignant melanoma in the U.S. has been steadily rising over the last 30 years and there are no population-based guidelines to screen for this relatively common and lethal cancer. The natural history of melanoma is not well-understood although age, sex, and race are risk factors in the general population. Radically different incidence rates and stage at diagnosis patterns between men and women suggest the disease progression process may be sex-specific. Known risk factors for developing the disease include personal history of melanoma, presence of atypical nevi, increased nevus count, presence of large congenital nevi, history of non-melanoma skin cancer, actinic damage and family history of melanoma and disease susceptibility genes. The first main aim of this research is to develop a stochastic model to evaluate the melanoma progression process and the sojourn time distribution in the preclinical disease state. This model will utilize data from the U.S. Surveillace Epidemiology and End Results (SEER) and Eastern Cooperative Oncology Group (ECOG) melanoma studies. The second aim compares the effectiveness of various screening scenarios, using mortality reduction from screening as a measure of benefit. Screening programs defined by starting/stopping ages and screening intervals as well as risk-based schedules will be evaluated. The third aim establishes a database of subjects at high-risk of developing melanoma. This database will utilize de-identified data from patients followed by members of the ECOG/Southwest Oncology Group (SWOG) Melanoma Prevention Working Group (MPWG) and Pigmented Lesion Subcommittee (PLS). Multiple risk factors for developing melanoma will be evaluated. Associations between the risk factors for developing melanoma and for fatal melanoma will also be investigated. Overall, the proposed research provides a foundation that is crucial in order to develop practical guidelines for early detection programs in melanoma. Programs for the general population as well as among individuals at higher risk of developing melanoma will be investigated.

描述（由申请人提供）：黑色素瘤筛查策略的比较评估项目摘要该拨款提案围绕恶性黑色素瘤早期检测中出现的研究问题，重点是黑色素瘤早期诊断中基于性别的差异。主要研究领域包括：（i）调查黑色素瘤的自然史，并开发黑色素瘤早期检测的随机模型，（ii）评估一般和高风险人群中潜在筛查计划的死亡率效益，（iii）建立黑色素瘤高风险个体的试点数据库，并评估与黑色素瘤和致命性黑色素瘤风险相关的因素。恶性黑色素瘤在美国的发病率在过去30年中一直在稳步上升，并且没有基于人群的指南来筛查这种相对常见和致命的癌症。黑色素瘤的自然史还不清楚，尽管年龄、性别和种族是一般人群的风险因素。男性和女性之间的发病率和诊断模式的阶段完全不同，表明疾病进展过程可能具有性别特异性。已知的发生该疾病的风险因素包括黑色素瘤的个人史、存在非典型痣、痣计数增加、存在大的先天性痣、非黑色素瘤皮肤癌史、光化性损伤和黑色素瘤家族史以及疾病易感基因。本研究的第一个主要目的是开发一个随机模型来评估黑色素瘤进展过程和在临床前疾病状态下的逗留时间分布。该模型将利用来自美国Surveillace流行病学和最终结果（SEER）和东部肿瘤协作组（ECOG）黑色素瘤研究的数据。第二个目标是比较各种筛查方案的有效性，使用筛查的死亡率降低作为获益的衡量标准。将评价根据开始/停止年龄和筛选间隔以及基于风险的时间表定义的筛选计划。第三个目标是建立一个黑色素瘤高危受试者数据库。该数据库将使用来自ECOG/西南肿瘤组（SWOG）黑色素瘤预防工作组（MPWG）和色素性病变小组委员会（PLS）成员随访的患者的去识别数据。将评价发生黑色素瘤的多种风险因素。还将研究发展黑色素瘤和致命性黑色素瘤的风险因素之间的关联。总的来说，拟议的研究提供了一个基础，这是至关重要的，以制定实用的指导方针，在黑色素瘤的早期检测计划。将研究针对一般人群以及发展黑色素瘤风险较高的个体的方案。