Cancer Prevention, Detection and Control

该计划追求一套最重要的科学目标：(1)确定环境、生物、 影响癌症风险、发生和进展的心理社会、表观遗传和遗传因素 基础、遗传学和表观遗传学以及流行病学研究；(2)阐明癌症和癌症的影响 通过结果研究进行治疗；(3)制定、实施、评估和传播教育， 旨在预防癌症的行为和心理社会干预，改善早期发现，加强 症状管理，改善癌症幸存者、照顾者和家庭的健康和生活质量，以及 推动科学进步，以改善姑息和临终关怀；以及(4)推进癌症预防， 在更广泛的制度和社会背景下通过质量、经济和 政策研究。方案活动针对五个优先主题：差异、戒烟、肥胖和 营养、老年肿瘤学和生存(包括症状控制和姑息治疗)。从结构上讲， 三个主要计划部门的研究--流行病学和遗传学研究、行为科学 研究、应用研究--解决这些交叉主题。尖端研究正在进行中 每一节；例子是癌症风险的表观遗传标记的研究(流行病学和遗传学 尼古丁成瘾的神经关联(行为科学研究)，以及医疗保险的影响 关于获得化疗机会的政策变化(应用研究)。该计划完整地参与了 国家和机构倡议的先行者。这些方向包括：个性化用药；患者报告 结果；生存护理，包括临终关怀和临终关怀；增加少数族裔的入学率 在临床试验中，将生物信息学和复杂的数据功能纳入整个研究范围； 开发质量评估方法；创造一个学习的医疗保健环境。这 该项目目前由杜克综合癌症研究所21个部门的46名成员组成， 部门、学校和研究所。自我们上次提交以来，赠款资金已从13,177,478美元增加 直接资助从2004年的21,317,489美元增加到2008年的21,317,489美元(NCI资助11%，NIH资助40%)。在最近五年中 在此期间，我们发表了1100多篇同行评议的论文；152篇论文(13%)表明了计划内 协作和162篇论文(14%)说明了方案间的协作。

This program pursues a set of overarching scientific goals: (1) to identify environmental, biological, psychosocial, epigenetic, and genetic factors that influence cancer risk, occurrence, and progression through basic, genetic and epigenetic, and epidemiologic research; (2) to clarify the impact of cancer and cancer treatment through outcomes research; (3) to develop, implement, evaluate, and disseminate educational, behavioral, and psychosocial interventions aimed at preventing cancer, improving eariy detection, enhancing symptom management, improving health and quality of life for cancer survivors, caregivers, and families, and advancing the science to improve palliative and end-of-life care; and (4) to advance cancer prevention, detection, and control within the broader contexts of institution and society through quality, economic, and policy studies. Program activities target five prioritized themes: disparities, tobacco cessation, obesity and nutrition, geriatric oncology, and survivorship (including symptom control and palliative care). Structurally, research within three main program sections - Epidemiology and Genetics Research, Behavioral Sciences Research, Applied Research - address these cross-cutting themes. Leading-edge research is underway in each section; examples are studies of epigenetic markers of cancer risk (Epidemiology and Genetics Research), neural correlates of nicotine addiction (Behavioral Sciences Research), and impact of Medicare policy change on access to chemotherapy (Applied Research). The program is integrally involved in forerunning national and institutional initiatives. Among these directions are: personalized medicine; patientreported outcomes; survivorship care, including palliative and end-of-life care; increasing minority enrollment in clinical trials, incorporation of bioinformatics and complex data functions across the full research spectrum; development of quality assessment approaches; and creation of a learning healthcare environment. This program currently comprises 46 Duke Comprehensive Cancer Institute members across 21 departments, divisions, schools and institutes. Grant funding has increased since our last submission, from $13,177,478 direct funding in 2004 to $21,317,489 in 2008 (11% NCI funding, 40% NIH funding). During the recent fiveyear period, we have published over 1,100 peer-reviewed papers; 152 papers (13%) demonstrate intraprogrammatic collaboration and 162 papers (14%) demonstrate inter-programmatic collaborations.