Planning a Regional Center of Research Excellence in Non-communicable Diseases in India

项目总结 这项提议的总体目标是利用现有的和新的伙伴关系和基础设施来开发 统一的、覆盖全国、以人口和诊所为基础的区域卓越研究中心(RCRE) 致力于预防和控制印度的非传染性疾病。这项研究 基础设施将包括三个共享的核心资源(生物资源库/实验室、数据管理和现场 数据收集)，以及加强研究培训以建设能力(基础科学研究员、肿瘤登记员、 和研究支持人员)。随着时间的推移，这些基础设施组件将应用到三个 示范项目。在过去的五年里，我们团队开发了四种大型、表型良好的 生物银行、地理信息系统(GIS)与非传染性疾病风险数据相关联的基于人群的队列 因素和结果。单独来看，这些队列的规模不足以评估癌症发病率和 结果，但如果结合起来，这些队列和超过15万人年的随访到目前为止提供了一个及时的 以及强大的平台，以满足当地癌症和非传染性疾病研究的优先事项。RCRE将分阶段发展 通过实现涉及不同地理区域的短期、中期和长期规划目标。两年制 短期(第一阶段)目标将集中在北部的新德里(国家首都地区)和金奈 位于南部的泰米尔纳德邦(Tamil Nadu State)将有效地加强我们的心脏代谢风险纵向中心 减少南亚(CARRS)监测研究队列和可联系的基于人群的癌症登记 位于这两个城市。中期(第二阶段)目标(2-5年)是将RCRE活动扩大到2 代表另外3个不同城市化水平的州的额外队列。长期(第三阶段) 目标(5-10年)将是在全国范围内扩大RCRE活动，从10个地点的Disha研究开始， 并最终到达该地区的其他国家，包括但不限于孟加拉国、尼泊尔和斯里兰卡。 RCRE由埃默里大学(HIC)、印度公共卫生基金会(PHFI)和研究机构共同领导 印度三角研究所(RTI)与包括Madras糖尿病在内的几个区域组织合作 研究基金会、全印度医学科学研究所(AIIMS)、癌症研究所(WIA)以及德里和 金奈癌症登记处。RCRE的活动将由一个指导委员会监督，该委员会由一名科学专家指导 咨询小组，并受到社区合作委员会的刺激，该委员会由不同的、以非传染性疾病为重点的全球、 国家和州一级的利益攸关方。我们专注于印度的三种高度优先的非传染性疾病-乳腺癌、口腔癌 癌症和糖尿病。随着规划阶段的完成，研究的重点将进一步扩大 包括其他高负担、新出现或以前被忽视的非传染性疾病，包括精神健康问题， 心血管疾病和中风、结直肠癌和宫颈癌、胆囊癌、上 胃肠道和肺。

PROJECT SUMMARY The overall goal of this proposal is to leverage existing and new partnerships and infrastructure to develop a unified, country-wide, population- and clinic-based Regional Center for Research Excellence (RCRE) dedicated to the prevention and control of non-communicable diseases (NCDs) in India. The research infrastructure will include three shared core resources (biorespository/laboratory, data management, and field data collection), and research enhancement training to build capacity (basic science fellows, tumor registrars, and research support personnel). These infrastructure components will be applied over time to three demonstration projects. Over the past five years our team has developed four large-scale, well-phenotyped, bio-banked, geographic information systems (GIS)-linked population-based cohorts with data on NCD risk factors and outcomes. Individually, these cohorts are not sufficient in size to evaluate cancer incidence and outcomes, but if combined, these cohorts with over 150,000 person-years of follow-up to-date offer a timely and robust platform to fulfill local cancer and NCD research priorities. The RCRE will be developed in phases by achieving short-, mid- and long- term planning objectives involving different geographic areas. The 2-year short term (Phase I) objective will focus on New Delhi (National Capital Territory) in the north and Chennai (Tamil Nadu State) in the south to efficiently build on our longitudinal Center for Cardiometabolic Risk Reduction in South Asia (CARRS) Surveillance Study cohort and linkable population-based cancer registries located in these two cities. The mid-term (Phase II) objective (2-5 years) is to expand RCRE activities to 2 additional cohorts representing 3 more states with varied levels of urbanization. The long-term (Phase III) objective (5-10 years) will be to expand the RCRE activities nationwide, starting with the 10-site DISHA study, and eventually to other countries of the region, including, but not limited to, Bangladesh, Nepal, and Sri Lanka. The RCRE is co-led by Emory University (HIC), and Public Health Foundation of India (PHFI) and Research Triangle Institute (RTI) India, in partnership with several regional organizations including Madras Diabetes Research Foundation, All India Institute of Medical Sciences (AIIMS), Cancer Institute (WIA), and the Delhi and Chennai Cancer Registries. RCRE activities will be overseen by a Steering Committee, guided by a Scientific Advisory Group, and stimulated by a Community Collaborative Board comprising diverse, NCD-focused global, national- and state-level stakeholders. We focus on three high priority NCDs in India - breast cancer, oral cancer, and diabetes mellitus. Follow completion of the planning phase the research focus will further expand to include other high-burden, emerging or previously neglected NCDs including mental health problems, cardiovascular diseases and stroke, colorectal cancer and cancers of the cervix, gallbladder, upper gastrointestinal tract and lung.