Abramson Cancer Center Support Grant

艾布拉姆森癌症中心支持补助金

• 批准号: 10425591
• 负责人: ROBERT H VONDERHEIDE
• 金额: $ 19.94万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2022-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10425591
• 关键词: Acquired Immunodeficiency Syndrome; Address; Adherence; Africa South of the Sahara; African; Aftercare; Botswana; Cancer Center Support Grant; Cancer Survivor; Caring; Cessation of life; Characteristics; Clinic; Clinical; Consolidated Framework for Implementation Research; Country; Data; Developing Countries; Diagnosis; Early Diagnosis; Early treatment; Ensure; Future; Geography; Goals; Grant; Gynecologic Oncology; HIV; HIV Infections; Hospitals; Incidence; Income; Intervention; Interview; Malignant Neoplasms; Malignant neoplasm of cervix uteri; Methods; Morbidity - disease rate; Outcome; Patient-Focused Outcomes; Patients; Pattern; Persons; Prevalence; Private Hospitals; Quality of life; Radiation therapy; Recommendation; Research; Resources; Scientific Advances and Accomplishments; Shapes; Structure; Surveys; Testing; Woman; Work; advanced disease; anticancer research; care delivery; care outcomes; cohort; contextual factors; curative treatments; demographics; experience; falls; improved; infection rate; interest; low and middle-income countries; mortality; multidisciplinary; outreach clinics; psychosocial; response; screening; survivorship; transportation access; tumor; uptake

PROJECT SUMMARY This application is being submitted in response to the Notice of Special Interest (NOSI) identified as NOT-CA- 21-058. The number of cancer survivors living in low- and middle-income countries (LMICs) is expected to grow rapidly over the next decade driven in part by global advances in early detection and treatment, yet very little is known about the long-term needs of cancer survivors or delivery of survivorship care in LMICs. This supplement application will help to fill this critical research gap by quantitatively and qualitatively evaluating care outcomes and contextual determinants of survivorship care among women diagnosed with cervical cancer in Botswana. Cervical cancer is one of the leading cancers among women globally with 600,000 new cases and 340,000 deaths annually per 2020 estimates. Cervical cancer is an acquired immunodeficiency syndrome (AIDS)-defining malignancy, and countries with high rates of human immunodeficiency virus (HIV) have higher incidence of cervical cancer. Due to high HIV-infection rates and suboptimal screening uptake, most of the burden of cervical cancer incidence, morbidity, and mortality falls on LMICs particularly in sub-Saharan Africa, with many women presenting with advanced disease. Botswana, a sub-Saharan African country, has high rates of cervical cancer (incidence rate of 34.4 per 100,000) and HIV (18.5% prevalence), and a high rate of mortality due to cervical cancer (20.1 per 100,000) among women. To date, the majority of cancer research in Botswana and other LMICs has focused on early detection or treatment, with limited research evaluating the long-term physical or psychosocial outcomes in survivorship or how survivorship care may impact these outcomes. Furthermore, even less is known regarding which approaches may be most impactful and sustainable to deliver survivorship care in LMICs. As such, there is a critical need to understand the current state of survivorship in LMICs and to identify effective strategies to ensure that all women receive optimal survivorship care. The objectives of this project are to: 1) quantitatively describe a) patterns in post-treatment survivorship care and b) long-term physical and psychosocial sequelae of cervical cancer using an existing cohort of patients at Princess Marina Hospital in Gaborone, Botswana; and 2) qualitatively assess contextual determinants (e.g., quality of life, access to resources, care delivery strategies) shaping patient experiences and adherence to survivorship care. In combination, these data will be used to develop and/or adapt survivorship care interventions to target the specific contextual determinants in Botswana and other LMICs. The results of this project will advance scientific understanding of survivorship care and sequelae in LMICs and how these experiences may or may not differ from the experiences and needs of cancer survivors in high-income countries. This project will also generate fundamental evidence needed to improve survival and quality of life of cancer survivors globally. The long-term goal of this project is to decrease cervical cancer mortality in Botswana and other LMICs by developing and implementing survivorship care interventions that can be sustained in lower resource settings.

项目概要 本申请是为了响应被识别为 NOT-CA- 的特殊利益通知 (NOSI) 而提交的 21-058。生活在低收入和中等收入国家 (LMIC) 的癌症幸存者数量预计将增加 未来十年迅速发展，部分原因是早期检测和治疗方面的全球进步，但进展甚微。 了解中低收入国家癌症幸存者的长期需求或提供幸存者护理。本补充 应用程序将通过定量和定性评估护理结果来帮助填补这一关键的研究空白 以及博茨瓦纳诊断出宫颈癌的妇女生存护理的背景决定因素。 宫颈癌是全球女性的主要癌症之一，有 60 万新发病例和 34 万例 根据 2020 年估计每年死亡人数。宫颈癌是一种获得性免疫缺陷综合症（艾滋病）的定义 恶性肿瘤的发病率较高，而人类免疫缺陷病毒 (HIV) 发病率较高的国家的发病率也较高 宫颈癌。由于艾滋病毒感染率高和筛查率不高，宫颈癌的大部分负担 中低收入国家的癌症发病率、发病率和死亡率下降，特别是在撒哈拉以南非洲地区，其中许多妇女 表现为晚期疾病。博茨瓦纳是撒哈拉以南非洲国家，宫颈癌发病率很高 （发病率为每 10 万人 34.4 例）和艾滋病毒（患病率 18.5%），以及宫颈癌造成的高死亡率 女性患癌症（每 100,000 人中有 20.1 人患有癌症）。迄今为止，博茨瓦纳和其他中低收入国家的大部分癌症研究 专注于早期检测或治疗，评估长期身体或健康状况的研究有限 幸存者的心理社会结果或幸存者护理如何影响这些结果。此外，甚至 对于哪些方法对于提供幸存者护理最有影响力和可持续性，人们知之甚少 在中低收入国家。因此，迫切需要了解中低收入国家的生存现状并确定 确保所有妇女获得最佳幸存者护理的有效战略。该项目的目标是 目的：1) 定量描述 a) 治疗后生存护理的模式和 b) 长期的身体和健康状况 使用玛丽娜公主医院现有患者队列研究宫颈癌的心理社会后遗症 博茨瓦纳哈博罗内； 2) 定性评估背景决定因素（例如生活质量、获取信息的机会） 资源、护理提供策略）塑造患者体验和对生存护理的依从性。在 结合起来，这些数据将用于制定和/或调整幸存者护理干预措施，以针对具体的 博茨瓦纳和其他中低收入国家的背景决定因素。该项目的成果将推动科学发展 了解中低收入国家的幸存者护理和后遗症以及这些经历可能会或可能不会有什么不同 来自高收入国家癌症幸存者的经历和需求。该项目还将产生 提高全球癌症幸存者的生存率和生活质量需要基本证据。长期来看 该项目的目标是通过开发和降低博茨瓦纳和其他中低收入国家的宫颈癌死亡率 实施可在资源较低的环境中持续的幸存者护理干预措施。