African Breast Cancer - Disparities in Outcomes - Plus (ABC-DO Plus)

非洲乳腺癌 - 结果差异 - Plus (ABC-DO Plus)

• 批准号: 10416101
• 负责人: Isabel Dos Santos Silva
• 金额: $ 32.89万
• 依托单位: INTERNATIONAL AGENCY FOR RES ON CANCER
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-01 至 2024-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10416101
• 关键词: Address; Affect; Africa South of the Sahara; African; Aftercare; Biological; Breast Cancer Patient; Breast Cancer Prevention; Breast Cancer survivor; Breast Cancer survivorship; Cancer Etiology; Cancer Survivor; Cessation of life; Characteristics; Clinical; Collaborations; Collection; Complement; Country; Cultural Diversity; Data; Diagnosis; Diagnostic; Disease; Early Diagnosis; Economics; Ensure; Epidemiology; Ethics; Gene Expression Profile; Goals; Guidelines; HIV; Healthcare Systems; Hospitals; Hygiene; Income; Individual; Institution; International; International Agency for Research on Cancer; Intervention; Investigation; Legal; London; Malignant Neoplasms; Mammary Neoplasms; Molecular; Molecular Profiling; Namibia; Nigeria; Obesity; Outcome; Pathologic; Patients; Politics; Prevalence; Prognostic Factor; Prospective Studies; Quality of life; Reporting; Reproduction; Research; Research Infrastructure; Schools; Severities; South Africa; Standardization; Survival Rate; Survivors; Therapeutic; Time; Treatment Side Effects; Tropical Medicine; Tumor Subtype; Uganda; Woman; Women' s Health; Zambia; base; black women; breast cancer diagnosis; breast cancer survival; cancer care; cancer diagnosis; cancer health disparity; cancer subtypes; cancer therapy; cancer type; cohesion; cohort; comorbidity; evidence base; experience; follow-up; health related quality of life; high body mass index; improved; insight; mHealth; malignant breast neoplasm; molecular subtypes; neglect; novel; oncology service; prospective; recruit; social culture; social inequality; socioeconomic disparity; socioeconomic diversity; socioeconomics; success; survival disparity; survival prediction; survivorship; treatment duration; tumor; tumor heterogeneity

Project Summary Breast cancer is the most common type of cancer diagnosed and the second cause of cancer death in sub-Saharan African women. The few studies on breast cancer survival in this region reported low short-term survival rates, but none were able to comprehensively address reasons for low survival, how to improve survival, nor assess five-year and longer-term survival and survivorship. Further, the impact of more aggressive molecular subtypes, common in women of African-descent, on breast cancer survival in sub-Saharan Africa has not yet been investigated. The African Breast Cancer-Disparities in Outcomes (ABC-DO) study is a five-country sub-Saharan African breast cancer cohort initiated in 2014. During 3 years of recruitment, over 2100 women were recruited in Uganda, Nigeria, Zambia, Namibia, and South Africa. In the proposed project, ABC-DO-Plus, we will build on ABC-DO – namely the established collaborations, research staff, tumor collections, ethical and legal permissions; and novel and successful mobile-Health (mHealth)-implemented follow-up – to actively follow-up women for a further 2 years to 5 years post-diagnosis, examine for the first time 5-year survival overall and by key prognostic factors, molecular subtypes, treatment availability, affordability and compliance, socioeconomic determinants and comorbidities present in this setting, particularly high BMI and HIV. Breast cancer survivorship research, i.e. the health of women with breast cancer post- treatment, has largely been neglected in sub-Saharan Africa. ABC-DO-Plus will examine, for the first time, longitudinal changes in health-related quality of life up to 5 years after a woman’s breast cancer diagnosis. ABC-DO-Plus will inform interventions needed to mitigate the excessive number of deaths of women with the disease, and improve the quality-of-life of survivors. Utilizing a within-African framework of five countries with different cancer care politics, but also representing individual socioeconomic and cultural diversity, will enable comparisons across settings and hereby identification of modifiable factors influencing BC survival. Furthermore, its findings on the proportions of more aggressive tumor molecular subtypes, and how these may affect survival, as well as on the impact on survival of comorbidities such as HIV, will be of relevance to other black women in the US and elsewhere. The success of the proposed ABC-DO-Plus, and its manifold goals, will be ensured through continuity of the experience of the previous 4+ years’ ABC-DO fieldwork, its established research infrastructure, and the efficient mHealth follow-up approach of this unique cohort.

项目概要 乳腺癌是最常见的癌症类型，也是导致乳腺癌的第二大原因 撒哈拉以南非洲妇女癌症死亡。关于乳腺癌生存的少数研究 该地区报告短期生存率较低，但没有一个地区能够全面解决 生存率低的原因，如何提高生存率，也不评估五年和更长期的生存率 和生存。此外，女性中常见的更具攻击性的分子亚型的影响 非洲人后裔对撒哈拉以南非洲乳腺癌生存率的影响尚未得到调查。 非洲乳腺癌结果差异 (ABC-DO) 研究是一项针对五个国家的研究 撒哈拉以南非洲乳腺癌队列于 2014 年启动。在 3 年的招募过程中，超过 乌干达、尼日利亚、赞比亚、纳米比亚和南非招募了 2100 名女性。在 拟议的项目 ABC-DO-Plus，我们将建立在 ABC-DO 的基础上——即已建立的 合作、研究人员、肿瘤收集、道德和法律许可；和小说和 成功的移动医疗 (mHealth) 实施的随访 – 积极跟踪女性 诊断后 2 年至 5 年，首次检查 5 年总体生存率并通过 关键预后因素、分子亚型、治疗可用性、负担能力和依从性， 这种情况下存在的社会经济决定因素和合并症，特别是高体重指数和 艾滋病病毒。 乳腺癌生存研究，即乳腺癌女性术后的健康状况 撒哈拉以南非洲地区的治疗在很大程度上被忽视了。 ABC-DO-Plus 将检查 女性乳房发育后 5 年内健康相关生活质量的首次纵向变化 癌症诊断。 ABC-DO-Plus 将告知减少死亡人数过多所需的干预措施 减少患有该病的妇女，并提高幸存者的生活质量。利用非洲内部 具有不同癌症护理政治的五个国家的框架，但也代表个人 社会经济和文化多样性，将能够进行跨环境的比较，特此 确定影响 BC 存活的可改变因素。 此外，其关于更具侵袭性的肿瘤分子亚型比例的发现， 以及这些可能如何影响生存，以及合并症对生存的影响，例如 艾滋病毒将与美国和其他地方的其他黑人女性相关。 将确保拟议的 ABC-DO-Plus 及其多重目标的成功 通过延续过去 4 年多的 ABC-DO 实地工作经验，建立了 研究基础设施，以及这个独特群体的高效移动医疗后续方法。