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

项目摘要 本提案的总体目标是利用现有和新的伙伴关系和基础设施， 统一的、全国范围的、以人口和临床为基础的区域卓越研究中心（RCRE） 该组织致力于在印度预防和控制非传染性疾病。研究 基础设施将包括三个共享的核心资源（生物储存库/实验室、数据管理和实地 数据收集），以及加强研究的培训，以建立能力（基础科学研究员，肿瘤登记员， 研究支持人员）。随着时间的推移，这些基础设施组件将应用于三个 示范项目在过去的五年里，我们的团队已经开发了四个大规模的，良好的表型， 生物库、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。单独而言，这些队列的规模不足以评估癌症发病率， 结果，但如果结合起来，这些队列与超过150，000人年的后续行动，迄今提供了及时的 和强大的平台，以满足当地癌症和NCD研究的优先事项。资源综合招聘考试将分阶段进行 实现不同地域的短，中，长期规划目标。2年 短期（第一阶段）目标将集中在北部的新德里（国家首都直辖区）和钦奈 （泰米尔纳德邦）在南部，以有效地建立我们的纵向心脏代谢风险中心 南亚减少（CARRS）监测研究队列和基于人群的癌症登记研究 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个城市化水平不同的州的其他群组。第三阶段（Phase III） 目标（5-10年）将是在全国范围内扩大RCRE活动，首先是10个地点的DISHA研究， 并最终到该地区的其他国家，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）和印度公共卫生基金会（PHFI）共同领导。 印度三角研究所（RTI）与包括马德拉斯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）和德里和 金奈癌症登记处。RCRE活动将由一个指导委员会监督，并由一个科学委员会指导。 咨询小组，并得到社区合作委员会的推动， 国家和州一级的利益攸关方。在印度，我们重点关注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，研究重点将进一步扩大 纳入其他高负担、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，结肠直肠癌和宫颈癌，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.