Optimizing the Impact of Aspirin for Chemoprevention

优化阿司匹林对化学预防的影响

• 批准号: 10212338
• 负责人: Yin Cao
• 金额: $ 10.87万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-07-06 至 2022-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10212338
• 关键词: Address; Adherence; Adult; Adverse effects; Advisory Committees; Age; Area; Aspirin; Award; Cancer Burden; Cancer Intervention; Cardiovascular Diseases; Chemoprevention; Chronic Disease; Clinical; Clinical Trials; Collaborations; Colorectal Cancer; Data; Decision Analysis; Decision Modeling; Development; Dose; Elderly; Epidemiology; Equilibrium; Event; Future; Gastrointestinal Hemorrhage; Genetic Predisposition to Disease; Goals; Grant; Guidelines; Health; Health behavior; Incidence; Individual; Intake; International; Intervention; Interview; Intracranial Hemorrhages; Iris; Journals; Knowledge; Life; Link; Malignant Neoplasms; Medical; Medical Genetics; Mentors; Mentorship; Nutritional; Older Population; Patients; Peer Review; Physicians; Policies; Policy Making; Population; Prevention strategy; Preventive service; Primary Prevention; Provider; Publications; Quality-Adjusted Life Years; Randomized Controlled Trials; Recommendation; Recording of previous events; Reporting; Research; Research Personnel; Research Project Grants; Resources; Risk; Risk Factors; Role; Science; Structure; Surveys; Training; Translational Research; Uncertainty; Universities; Work; aged; aging population; base; cancer epidemiology; cancer prevention; cardiovascular disorder prevention; cardiovascular disorder risk; career; clinical predictors; clinical risk; colorectal cancer prevention; colorectal cancer risk; colorectal cancer screening; compliance behavior; experience; genetic risk factor; high risk population; implementation barriers; implementation facilitators; implementation research; implementation science; implementation tool; improved; individualized prevention; innovation; meetings; models and simulation; molecular marker; mortality; multidisciplinary; novel; precision cancer prevention; predictive modeling; prevent; screening; skills; surveillance network; translational impact; willingness

PROJECT SUMMARY / ABSTRACT The candidate's long-term career goal is to become an academic leader in “precision cancer prevention”, by linking clinical and epidemiological risk factors with novel molecular markers, and applying decision and implementation tools to direct heathcare resources to the most effective and practical prevention strategies in the appropriate risk groups. The U.S. Preventive Services Task Force (USPSTF) recently released new recommendations supporting the use of low-dose aspirin for the primary prevention of CRC and CVD in adults aged 50-59 with certain CVD risk profiles. However, evidence for the efficacy of daily low-dose aspirin use among older people are lacking, and net benefits were not considered in the context of baseline CRC risk. In addition, impact and challenges in implementing the 2016 USPSTF guideline, and potential more refined precision-based recommendations have not been investigated. Building on the candidate's passion to bridge evidence with policy to improve practice in real world settings, as well as her prior research experience in cancer epidemiology and aspirin chemoprevention, the candidate seeks to fill these knowledge gaps through this novel and high impact research project to 1) examine the overall benefits and harms of low-dose daily aspirin use in a large randomized controlled trial among adults aged 65 and above, and estimate aspirin's efficacy on CRC according to CRC screening and baseline CRC risk predicted by clinical and genetic susceptibility (Aim 1); 2) refine the net benefits of low-dose aspirin use among adults aged 50 and above according to both CRC and CVD risk integrating findings from the RCT and stratified analyses using decision modeling (Aim 2); 3) examine the impact of 2016 USPSTF recommendations using national survey, and identify the barriers and facilitators for implementation at provider and patient level through interviews (Aim 3). The candidate will develop the necessary skills to conduct this work through a multidisciplinary mentoring committee, consisting of internationally recognized experts in cancer prevention and implementation science (Dr. Graham Colditz), aspirin chemoprevention (Dr. Andrew Chan), decision modeling (Dr. Ann Zauber), and health behaviors (Dr. Aimee James). The candidate will also receive committed mentorship from Dr. John McNeil at Monash University and Dr. Iris Lansdorp-Vogelaar from Erasmus MC, and collaborate with Dr. Nathan Moore from BJC Medical Group. In addition to mentored research, the candidate will also benefit from formal training through didactic coursework, attendance at scientific meetings, publication in peer-reviewed journals, and submission of an R01 grant. This mentoring and in-depth training in decision science and implementation science as well as national and international collaborations, will be critical for the candidate to develop new, interdisciplinary, and unique areas of expertise, and establish a strong research network that expands from cancer epidemiology to policy making to implementation, which will be instrumental for her transition to an independent investigator and as an emerging leader in cancer prevention.

项目总结/摘要 候选人的长期职业目标是成为“精准防癌”的学术带头人， 将临床和流行病学风险因素与新的分子标记联系起来，并应用决策和 将保健资源用于最有效和最实际的预防战略的执行工具， 适当的风险群体。美国预防服务工作组（USPSTF）最近发布了新的 支持使用低剂量阿司匹林作为成人CRC和CVD一级预防的建议 年龄在50 - 59岁之间，有一定的心血管疾病风险。然而，每天使用低剂量阿司匹林的疗效证据 在老年人中，没有考虑到基线CRC风险的净效益。在 此外，实施2016年USPSTF指南的影响和挑战，以及潜在的更完善 没有对基于精确度的建议进行调查。建立在候选人对桥梁的热情之上 证据与政策，以改善实践中的真实的世界设置，以及她以前的研究经验， 癌症流行病学和阿司匹林化学预防，候选人寻求填补这些知识空白，通过 这项新颖而具有高度影响力的研究项目旨在：1）检查每日低剂量的总体益处和危害 在65岁及以上的成年人中进行的一项大型随机对照试验中， 根据CRC筛查和通过临床和遗传学预测的基线CRC风险评估对CRC的疗效 敏感性（目标1）; 2）在50岁及以上的成年人中， 根据CRC和CVD风险整合RCT结果和分层分析， 建模（目标2）; 3）使用全国调查检查2016年USPSTF建议的影响，以及 通过访谈确定在提供者和患者层面实施的障碍和促进因素（目标3）。 候选人将通过多学科的指导来发展必要的技能来开展这项工作 委员会，由国际公认的癌症预防和实施科学专家组成 (Dr. Graham科迪茨）、阿司匹林化学预防（Andrew Chan博士）、决策模型（Ann Zauber博士）和 健康行为（Aimee James博士）候选人还将获得约翰博士的承诺指导 麦克尼尔在莫纳什大学和博士艾里斯兰斯多普Vogelaar从伊拉斯谟MC，并与博士合作。 我是BJC医疗集团的内森摩尔。除了指导研究，候选人还将受益于 通过教学课程进行正式培训，参加科学会议， 期刊，并提交R01补助金。这种指导和决策科学方面的深入培训， 实施科学以及国家和国际合作，将是至关重要的候选人， 发展新的、跨学科的和独特的专业领域，并建立强大的研究网络， 从癌症流行病学扩展到政策制定到实施，这将有助于她 转型为独立研究者并成为癌症预防领域的新兴领导者。

项目成果

Dairy intake during adolescence and risk of colorectal adenoma later in life.

• DOI: 10.1038/s41416-020-01203-x
• 发表时间: 2021-03
• 期刊: British journal of cancer
• 影响因子: 8.8
• 作者: Nimptsch K;Lee DH;Zhang X;Song M;Farvid MS;Rezende LFM;Cao Y;Chan AT;Fuchs C;Meyerhardt J;Nowak JA;Willett WC;Ogino S;Giovannucci E;Pischon T;Wu K
• 通讯作者: Wu K

Association Between Aspirin Use and Gastric Adenocarcinoma: A Prospective Cohort Study.

• DOI: 10.1158/1940-6207.capr-21-0413
• 发表时间: 2022-04-01
• 期刊: Cancer prevention research (Philadelphia, Pa.)