Skin Cancer Risks and Risk Prediction in Patients with Actinic Keratosis

光化性角化病患者的皮肤癌风险和风险预测

• 批准号: 10448977
• 负责人: Mackenzie Rachel Wehner
• 金额: $ 26.04万
• 依托单位: UNIVERSITY OF TX MD ANDERSON CAN CTR
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-04-18 至 2027-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10448977
• 关键词: Actinic keratosis; Address; Adopted; Advisory Committees; Affect; Award; Bachelor' s Degree; Basal cell carcinoma; Behavioral; Biological; Cancer Center; Caring; Chronic; Clinical; Clinical Research; Cutaneous Precancerous Condition; Data; Data Set; Data Sources; Dermatology; Development Plans; Diagnosis; Early Diagnosis; Environment; Epidemiology; Fellowship; Foundations; Frequencies; Funding; Future; Genetic; Goals; Guidelines; Health Services Research; Individual; Investigation; Knowledge; Lesion; Malignant - descriptor; Malignant Epithelial Cell; Malignant Neoplasms; Measures; Medicare; Medicare claim; Melanoma Cell; Mentors; Mentorship; Modeling; Oncology; Patient Care; Patients; Pattern; Pennsylvania; Performance; Persons; Phenotype; Physicians; Positioning Attribute; Postdoctoral Fellow; Provider; Recommendation; Relative Risks; Reporting; Research; Research Project Summaries; Residencies; Risk; Scientist; Skin Cancer; Squamous cell carcinoma; Sun Exposure; Time; Training; UV Radiation Exposure; United States; United States National Institutes of Health; Universities; Visit; Work; anticancer research; base; beneficiary; biobank; cancer epidemiology; cancer risk; career; career development; clinical biomarkers; clinical care; clinical decision-making; clinical practice; evidence base; experience; follow-up; genetic epidemiology; genetic information; high risk; high risk population; individual patient; medical schools; melanoma; melanoma biomarkers; model development; patient oriented; patient oriented research; professor; research and development; risk prediction; risk prediction model; skills; skin squamous cell carcinoma; tool; tool development

PROJECT SUMMARY Research: Actinic keratoses (AKs) are pre-cancerous skin lesions that arise in the setting of chronic sun exposure and affect tens of millions of people in the United States each year. AKs have a risk of transformation to cutaneous squamous cell carcinoma. The majority of AK clinical care and research focuses on the individual AK and its risk of malignant transformation. However, there is evidence that the presence of AKs may be associated with increased risk of squamous cell carcinoma and other types of skin cancer (melanoma and basal cell carcinoma) for the patient as a whole. Though they are not typically used this way, AKs may be an important clinical biomarker of skin cancer risk, including melanoma, squamous cell carcinoma, and basal cell carcinoma. Unfortunately, there are no specific recommendations for clinicians to follow for skin cancer surveillance or early detection in patients with AKs. This project will address key knowledge gaps: to examine the absolute risks of skin cancer in patients with AKs, which are unknown (Aim 1); to understand the care currently being provided to patients with AKs, which is uncharacterized (Aim 2); and to develop a skin cancer risk prediction model for patients with AKs, which has not previously been done (Aim 3). The overarching goal is to provide evidence to guide clinical care and form the foundation for future recommendations on skin cancer surveillance and early detection in patients with AKs, a large and high-risk group. Candidate: Dr. Mackenzie Wehner, MD MPhil is an Assistant Professor of Health Services Research and of Dermatology at MD Anderson Cancer Center. She completed her undergraduate degree at Yale University, medical school at Stanford University, a Master's in Epidemiology at the University of Cambridge, and residency and post- doctoral research fellowship at the University of Pennsylvania. Her career goal is to become an independent, R01-funded physician scientist in patient-oriented skin cancer research and through her research to decrease the burden of skin cancer in the United States. Environment: During this award period Dr. Wehner will devote at least 75% of her time to research and 20% to clinical care of patients at high risk of skin cancer, including those with AKs. Her primary mentor, Dr. Sharon Giordano, and co-mentor, Dr. David Margolis, are proven mentors and experts in patient-oriented research in cancer. The exceptional training environment in cancer research at MD Anderson will offer Dr. Wehner an outstanding opportunity to launch her career as an independent physician-scientist. Career Development: Dr. Wehner will have support from an experienced and diverse advisory committee and will focus her training on developing skills and experience in 1) health services research and large administrative datasets, 2) risk prediction modeling and tools development, and 3) incorporating genetic data in epidemiologic analyses. Completion of the proposed research and career development plan will serve as a platform upon which Dr. Wehner can successfully transition to independence and pursue an impactful career focused on patient-oriented skin cancer research.

项目概要 研究：光化性角化病 (AK) 是在长期阳光照射下出现的癌前皮肤病变 每年有数千万美国民众受到影响。 AK有转型风险 皮肤鳞状细胞癌。 AK 的大部分临床护理和研究都集中于个人 AK及其恶变风险。然而，有证据表明 AK 的存在可能是 与鳞状细胞癌和其他类型皮肤癌（黑色素瘤和 基底细胞癌）对于整个患者来说。尽管 AK 通常不以这种方式使用，但它们可能是一种 皮肤癌风险的重要临床生物标志物，包括黑色素瘤、鳞状细胞癌和基底细胞癌 癌。不幸的是，对于皮肤癌，临床医生没有可遵循的具体建议 AK 患者的监测或早期检测。该项目将解决关键的知识差距： AK 患者患皮肤癌的绝对风险尚不清楚（目标 1）；去了解护理 目前正在向 AK 患者提供，但其特征尚不明确（目标 2）；并发展为皮肤癌 AK 患者的风险预测模型，此前尚未完成（目标 3）。总体目标 旨在提供指导临床护理的证据，并为未来皮肤癌的建议奠定基础 对 AK 患者（一个庞大的高危群体）进行监测和早期发现。候选人：麦肯齐博士 Wehner，医学博士 哲学硕士是医学博士健康服务研究和皮肤病学助理教授 安德森癌症中心。她在耶鲁大学医学院完成了本科学位 斯坦福大学、剑桥大学流行病学硕士学位、住院医师实习期和毕业后 宾夕法尼亚大学博士研究奖学金。她的职业目标是成为一个独立的、 R01 资助的医师科学家从事以患者为导向的皮肤癌研究，并通过她的研究减少 美国皮肤癌的负担。环境：在此颁奖期间，Wehner 博士将致力于 她至少 75% 的时间用于研究，20% 的时间用于对皮肤癌高风险患者进行临床护理，包括 那些有 AK 的人。她的主要导师 Sharon Giordano 博士和共同导师 David Margolis 博士已被证明 以患者为导向的癌症研究的导师和专家。癌症方面的特殊培训环境 MD 安德森的研究将为 Wehner 博士提供一个绝佳的机会来开启她的职业生涯 独立医师科学家。职业发展：Wehner 博士将得到经验丰富且专业的人士的支持 多元化的咨询委员会，并将重点培训她在 1) 卫生服务方面的技能和经验 研究和大型管理数据集，2) 风险预测建模和工具开发，以及 3) 将遗传数据纳入流行病学分析。完成拟议的研究和职业生涯 发展计划将成为韦纳博士成功过渡到独立的平台 并追求有影响力的职业生涯，专注于以患者为导向的皮肤癌研究。