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，癌症是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%。在有艾滋病毒/艾滋病的国家， 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 患者国家内部存在差异;在美国，种族和少数民族以及其他医疗服务不足的国家， 人口对许多类型的癌症分担不成比例的负担。如果早期发现，大多数癌症是可以治愈的， 有效治疗。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，现有的早期癌症检测测试过于复杂 和/或在初级保健环境中，特别是在医疗服务不足的地区，实施起来昂贵。我们将建立 公平癌症护理护理点技术创新和转化中心（CITEC），以确定高 优先考虑POC癌症技术的临床需求;加速开发有效、负担得起的技术， 满足这些需求;评估和改善POC技术在不同环境中的临床和公共卫生影响; 并培训开发人员和用户创建和传播更公平的POC技术。CITEC将优先考虑 开发POC测试以检测上皮表面出现的癌症。首先，我们将专注于可访问的网站， 早期检测，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建立在高效的15年 莱斯大学、德克萨斯大学MD安德森癌症中心、贝勒医学院、 和德克萨斯大学休斯顿健康科学中心开发和翻译新的POC技术， 在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一起， Barretos癌症医院与莫桑比克Eduardo Mondlane大学和卫生部的合作伙伴， 将创建一个协作中心，以支持技术开发，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， 早期治疗。CITEC将支持POC技术的开发，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，减少癌症的差异 成果，并建立一支能够将POC技术从研究和开发转化为 公平执行。CITEC将对公平预防、诊断和早期治疗 癌症在美国和世界范围内，并将与POCTRN网络合作，建立一个强大的全球合作伙伴团队， 加强和维持POC技术开发。

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.