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.

项目摘要 研究：光化性角化病（AKs）是一种癌前皮肤病变，在慢性日光照射下出现 在美国，每年有数千万人受到影响。AK有转化风险 皮肤鳞状细胞癌大多数AK临床护理和研究都集中在个人身上 AK及其恶性转化的风险。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的皮肤癌（黑色素瘤和 基底细胞癌）。虽然他们通常不这样使用，AK可能是一个 皮肤癌风险的重要临床生物标志物，包括黑素瘤、鳞状细胞癌和基底细胞癌 carcinoma.不幸的是，对于皮肤癌，临床医生没有具体的建议可供遵循 监测或早期发现AK患者。该项目将解决关键的知识差距：审查 AK患者发生皮肤癌的绝对风险未知（目标1）;了解护理 目前提供给患有AK的患者，其特征不明（目标2）;以及发展皮肤癌 AK患者的风险预测模型，这是以前没有做过的（目标3）。总体目标 是提供证据来指导临床护理，并为未来皮肤癌的建议奠定基础。 AKS患者是一个庞大的高风险群体，需要进行监测和早期发现。候选人：麦肯齐博士 Wehner，MD MPhil是MD的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她的本科学位， 斯坦福大学流行病学硕士学位，剑桥大学流行病学硕士学位，以及住院医师和博士后研究生学位。 宾夕法尼亚大学的博士研究奖学金。她的职业目标是成为一名独立的， R01资助的医生科学家在面向患者的皮肤癌研究，并通过她的研究，以减少 美国皮肤癌的负担。环境：在此期间，Wehner博士将致力于 至少75%的时间用于研究，20%用于皮肤癌高危患者的临床护理，包括 那些拿着AK的人她的主要导师，博士沙龙佐丹奴，和共同导师，博士大卫马戈利斯，是证明 导师和专家在以病人为导向的癌症研究。癌症的特殊训练环境 MD安德森的研究将为Wehner博士提供一个出色的机会， 独立的物理学家和科学家职业发展：Wehner博士将得到一位经验丰富， 她将把培训的重点放在发展健康服务方面的技能和经验上 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 发展计划将作为一个平台，韦纳博士可以成功地过渡到独立 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。