Health Behaviors and Mortality in Prostate Cancer Survivors in the Multiethnic Cohort Study

多种族队列研究中前列腺癌幸存者的健康行为和死亡率

• 批准号: 10709584
• 负责人: Stacey Kenfield
• 金额: $ 8.08万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-23 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10709584
• 关键词: Address; Adult; African American; American; American Association of Cancer Research; Animal Feed; Asian Americans; Baseline Surveys; Behavior; Black race; Body Size; Body Weight; Body mass index; California; Cancer Survivor; Caregivers; Centers for Disease Control and Prevention (U.S.); Cessation of life; Chinese; Clinical; Coffee; Cohort Studies; Cox Proportional Hazards Models; Dairying; Data; Diabetes Mellitus; Diagnosis; Diagnostic; Diet; Dietary Component; Dietary Factors; Dietary Fiber; Edible Plants; Enrollment; Ensure; Ethnic Origin; Ethnic Population; Fabaceae; Family; Food; Food Selections; Frequencies; Funding; Hawaii; Health behavior; Heart Diseases; Hispanic; Incidence; Intake; Intervention; Japanese; Knowledge; Latino; Latinx; Latinx population; Malignant neoplasm of prostate; Measures; Meat; Mediating; Medical; Native Hawaiian; Nonmetastatic; Nuts; Outcome; Pacific Islander; Participant; Patients; Persons; Pharmaceutical Preparations; Physical activity; Physicians; Plants; Population; Population Heterogeneity; Processed Meats; Progress Reports; Prospective Studies; Prostate; Public Health; Questionnaires; Race; Recommendation; Recording of previous events; Reporting; Research; Risk; Risk Factors; Risk Reduction; Self Administration; Smoking; Smoking History; Surveys; Tea; United States; Update; Vascular Plant; Vegetable Oils; Vegetables; Weight; Work; advanced disease; anticancer research; cancer diagnosis; cancer health disparity; cancer risk; cohort; demographics; dietary; egg; ethnic disparity; ethnic diversity; follow-up; fruits and vegetables; healthy lifestyle; high risk; improved; indexing; interest; men; modifiable risk; mortality; mortality risk; multi-ethnic; population based; primary outcome; prostate cancer risk; prostate cancer survivors; racial disparity; racial diversity; racial population; research study; saturated fat; secondary outcome; tumor progression

PROJECT ABSTRACT: Large racial/ethnic disparities exist for prostate cancer (PC) incidence and mortality. Between 2001-2017, the 5-year relative survival for Black, Asian American/Pacific Islander, and Latinx groups was lower compared to non-Latinx White men. Progressing to advanced disease is a pivotal concern among patients with non- metastatic PC, their family, caregivers, and physicians. A major gap in current knowledge is the lack of research studies focused on post-diagnostic modifiable factors from racially/ethnically diverse populations. Preliminary data suggest that a Healthful Plant-based Diet Index may be associated with a ~60% lower risk of incident fatal PC among healthy men. In addition, our team recently developed a post-diagnostic Prostate Health Behavior Score (focused on physical activity, weight, and diet) with higher scores associated with a ~55% lower risk of PC-specific mortality among men with PC. Even so, 92% of participants in these two analyses identified as non-Latinx White; thus, the findings may not be generalizable to the racially/ethnically diverse populations of people living with PC. In this R03, we propose to examine whether a Healthful Plant- based Diet Index or composite Prostate Health Behavior Score is associated with survival among men with PC in the population-based Multiethnic Cohort Study (MEC). The MEC is a diverse cohort of over 215,000 adults living predominately in southern California and Hawai’i when enrolled between 1993-1996. For these analyses, we will use data from 2,652 men with PC who have measures of health behaviors before and after diagnosis; 19% identified as African American, 25% identified as non-Latino White, 23% identified as Latino, 28% identified as Asian American, and 5% identified as Native Hawaiian. A comprehensive self-administered questionnaire captured demographics, body size, medical and family histories, medication use, smoking history, and physical activity at enrollment; and a quantitative food frequency questionnaire (FFQ) was also administered. Follow-up surveys have been administered every 4-6 years. Data from the baseline survey will be used to adjust for pre-diagnosis health behaviors and body weight. Using these data, we aim to 1) examine whether the Healthful Plant-based Diet Index, a Prostate Health Behavior Score, and their components, measured after PC diagnosis, are associated with lower risk of all-cause and PC-specific mortality; and 2) explore whether associations between these modifiable risk factors and mortality vary across racial/ethnic groups and the degree to which health behaviors contribute to observed racial/ethnic disparities in PC mortality. This work will be completed in the largest prospective study of racially/ethnically diverse men with PC in the U.S., ensuring the generalizability of our results and directly informing clinical and public health recommendations. In addition, this proposal will strengthen the evidence on the impact of health behaviors on outcomes in cancer survivors and could help reduce racial/ethnic disparities in PC outcomes, and guide interventions to ultimately help people with PC lower their risk of cancer progression and death.

项目摘要： 前列腺癌(PC)的发病率和死亡率存在很大的种族/民族差异。2001-2017年间， 黑人、亚裔美国人/太平洋岛民和拉丁裔群体的5年相对存活率低于 非拉丁裔白人男性。进展到晚期疾病是非霍奇金淋巴瘤患者的关键担忧 转移性PC、他们的家人、照顾者和医生。当前知识中的一个主要差距是缺乏 研究研究的重点是种族/民族多样化人群的诊断后可修改因素。 初步数据表明，健康的植物性饮食指数可能与患心脏病的风险降低约60%相关 健康男性中发生致命PC事件。此外，我们的团队最近开发了一种诊断后前列腺癌 健康行为得分(重点关注体力活动、体重和饮食)，得分较高的人 在患有PC的男性中，PC特有的死亡率降低约55%。即便如此，这两个项目中92%的参与者 被确认为非拉丁裔白人的分析；因此，这些发现可能不能推广到种族/民族 与PC生活在一起的不同人群。在本R03中，我们建议研究一种健康的植物- 基于饮食指数或综合前列腺健康行为评分的前列腺癌男性患者的存活率 在基于人口的多种族队列研究(MEC)中。MEC是一个由超过215,000名成年人组成的多样化队列 1993-1996年间入学时主要居住在加利福尼亚州南部和夏威夷。对于这些分析， 我们将使用2652名患有PC的男性的数据，他们在诊断前和诊断后都有健康行为的测量； 19%的人认定为非裔美国人，25%的人认定为非拉丁裔白人，23%的人认定为拉丁裔，28%的人认定为拉美裔 被确认为亚裔美国人，5%被确认为夏威夷土著人。一个全面的自我管理 调查问卷收集了人口统计数据、体型、病史和家族史、用药情况、吸烟情况 登记时的病史和体力活动；以及定量食物频率问卷(FFQ) 管理。每4-6年进行一次跟踪调查。基线调查的数据将 用于调整诊断前的健康行为和体重。利用这些数据，我们的目标是1)检查 无论是健康植物性饮食指数，前列腺健康行为评分，以及它们的组成部分， 在PC诊断后进行测量，与全原因和特定于PC的死亡率的风险较低相关；以及2) 探讨这些可改变的危险因素与死亡率之间的关联是否因种族/民族而异 群体和健康行为对观察到的PC种族/民族差异的影响程度 死亡率。这项工作将在对不同种族的患有PC的男性进行的最大规模的前瞻性研究中完成 在美国，确保我们结果的普适性，并直接告知临床和公共卫生 建议。此外，这项建议将加强关于健康行为对健康影响的证据 癌症幸存者的结局，并可帮助减少PC结局中的种族/民族差异，并指导 最终帮助PC患者降低癌症进展和死亡风险的干预措施。