The Center for Innovation and Translation of Point of Care Technologies for Equitable Cancer Care (CITEC)

摘要： 在183个国家中的134个国家中，癌症是导致过早死亡的第一或第二大原因，据估计，全球 从2018年到2040年，癌症发病率将增加50%。预计病例数量将在以下国家翻一番 人类发展指数低；这些国家拥有最少的资源和基础设施来充分照顾癌症 病人。国家内部存在差异；在美国，种族和少数民族以及其他医疗服务不足 人们在许多类型的癌症中分担了不成比例的负担。如果及早发现并及时治疗，大多数癌症是可以治愈的 治疗有效。为了减少过早死亡，世界卫生组织建议实施早期癌症 初级保健一级的检测和预防方案。然而，现有的癌症早期检测方法过于复杂。 和/或在初级保健环境中实施，特别是在医疗服务不足的地区。我们将建立 用于公平癌症护理的护理点技术创新和转换中心(CITEC)，以确定高 POC癌症技术的优先临床需求；加速开发有效、负担得起的技术以 满足这些需求；评估和改善POC技术在不同环境中对临床和公共健康的影响； 并培训开发人员和用户创建和传播更公平的PoC技术。CITEC将确定优先顺序 开发POC测试以检测发生在上皮表面的癌症。最初，我们将重点关注可访问的站点 及早发现，因为这是PoC技术可以产生最直接影响的地方。目标器官部位包括 子宫颈、胃肠道(食道、胃、结肠、直肠、肛门)和口腔；这些部位的癌症 占全球癌症病例的26%和全球癌症死亡的29%。CITEC以15年的高生产率为基础 莱斯大学、德克萨斯大学MD安德森癌症中心、贝勒医学院、 和位于休斯顿的德克萨斯大学健康科学中心合作开发和翻译新的POC技术，以改善 低资源和高资源环境下的癌症护理。与巴西圣保罗大学的合作者和 巴雷托斯肿瘤医院和合作伙伴在莫桑比克的爱德华多·蒙德兰大学和卫生部，我们 将创建一个协作中心来支持技术开发，并参与和支持全球社区 研究人员致力于创建和扩展POC技术，以实现公平的癌症筛查和诊断，以促进 早期治疗。CITEC将支持POC技术的发展，以促进NIH癌症的高优先级主题 研究，包括预防、筛查和早期发现的精确方法，减少癌症差异 成果，并建立一支能够将PoC技术从研发转化为 公平执行。CITEC将在公平预防、诊断和早期治疗方面产生重大影响 癌症，并将与POCTRN网络合作，建立一支强大的全球合作伙伴团队，以 加强和支持PoC技术发展。

Abstract: Cancer is the first or second leading cause of premature death in 134 of 183 countries, and it is estimated that global incidence of cancer will increase by 50% from 2018 to 2040. The number of cases is projected to double in countries with low Human Development Index; these countries have the least resources and infrastructure to adequately care for cancer patients. Disparities exist within countries; in the US, racial and ethnic minorities and other medically underserved populations share a disproportionate burden for many types of cancer. Most cancers can be cured if detected early and treated effectively. To reduce premature death, the World Health Organization recommends implementing early cancer detection and prevention programs at the primary care level. Yet, existing tests for early cancer detection are too complex and/or expensive to implement in primary care settings, particularly in medically underserved areas. We will establish the Center for Innovation and Translation of Point-of-Care Technologies for Equitable Cancer Care (CITEC) to identify high- priority clinical needs for POC cancer technologies; to accelerate development of effective, affordable technologies to meet these needs; to evaluate and improve the clinical and public health impact of POC technologies in diverse settings; and to train developers and users to create and disseminate more equitable POC technologies. CITEC will prioritize development of POC tests to detect cancers that arise in epithelial surfaces. Initially, we will focus on sites accessible for early detection because this is where POC technologies can have the most immediate impact. Targeted organ sites include the uterine cervix, gastro-intestinal tract (esophagus, stomach, colon, rectum, anus), and oral cavity; cancers in these sites account for 26% of global cases and 29% of global cancer deaths. CITEC builds on the highly productive 15-year collaboration between Rice University, The University of Texas MD Anderson Cancer Center, Baylor College of Medicine, and The University of Texas Health Science Center at Houston to develop and translate novel POC technologies to improve cancer care in both low- and high-resource settings. Joining with collaborators in Brazil at The University of Sao Paulo and Barretos Cancer Hospital and partners in Mozambique at The Universidade Eduardo Mondlane and Ministry of Health, we will create a collaborative center to support technology development and engage and support a global community of investigators dedicated to creating and scaling POC technologies for equitable cancer screening and diagnosis to facilitate early treatment. CITEC will support development of POC technologies to promote high priority topics of NIH cancer research, including precision approaches to prevention, screening and early detection, reducing disparities in cancer outcomes, and building a diverse workforce able to translate POC technologies from research and development to equitable implementation. CITEC will have a major impact on equitable prevention, diagnosis and early treatment of cancer in the US and worldwide, and will work with the POCTRN network to build a strong team of global partners to strengthen and sustain POC technology development.