Avanzando Caminos (Leading Pathways): The Hispanic/Latino Cancer Survivorship Cohort Study.”

Avanzando Caminos（领先途径）：西班牙裔/拉丁裔癌症幸存者队列研究。 –

• 批准号: 10391549
• 负责人: Frank J Penedo
• 金额: $ 95.59万
• 依托单位: UNIVERSITY OF MIAMI CORAL GABLES
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-05-01 至 2023-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10391549
• 关键词: Acculturation; Address; Admixture; American; Area; Attention; Behavioral; Biological; Biological Assay; Biological Factors; Biological Process; Breast; Cancer Center; Cancer Survivor; Cancer Survivorship; Catchment Area; Cause of Death; Cervix Uteri; Characteristics; Chronic stress; Clinics and Hospitals; Cognition; Cohort Studies; Collaborations; Community Outreach; Comprehensive Cancer Center; Computational Biology; Conflict (Psychology); Country; Cuban; Data; Disease; Education; Emotions; Family; Fatigue; Florida; Gene Expression; Genetic; Geographic Distribution; Geographic Locations; Geography; Health; Health Services Accessibility; High Prevalence; Hispanic; Hispanic Populations; Individual; Inflammation; Inflammatory; Information Systems; Insurance Coverage; Knowledge; Language; Latino; Latino Population; Life Style; Literature; Liver; Malignant Neoplasms; Malignant neoplasm of prostate; Measures; Mediating; Mediator of activation protein; Medical; Mental Depression; Methods; Mexican; Mexican Americans; Minority; Minority Groups; Modeling; NCI-Designated Cancer Center; National origin; Not Hispanic or Latino; Outcome; Outcome Study; Pain; Participant; Pathway interactions; Patient Outcomes Assessments; Phase; Physical Function; Physical activity; Population; Prevalence; Procedures; Productivity; Prostate; Protocols documentation; Puerto Rican; Quality of life; Recurrence; Reporting; Research; Risk; Rural; Sampling; Second Primary Cancers; Secondary Prevention; Signal Transduction; Site; Sleep; Social Functioning; Social support; Socioeconomic Status; South American; South Texas; Stomach; Stress; Survivors; Symptoms; Testing; Texas; Training; Urban Community; Work; advanced disease; cancer genomics; cancer site; cancer therapy; cancer type; cardiometabolism; cohesion; cohort; comorbidity; coping; cultural values; data management; emotional functioning; ethnic minority population; experience; follow-up; health related quality of life; low socioeconomic status; malignant breast neoplasm; metropolitan; mortality; neoplasm registry; nutrition; optimism; perceived discrimination; primary outcome; psychosocial; recruit; resilience; rural residence; satisfaction; sex; social; social culture; survivorship; tertiary prevention; traumatic stress; treatment adherence

Project Summary Cancer is the leading cause of death among Hispanics/Latinos (H/Ls) in the US. H/Ls account for 57.5 million Americans (18%), now the largest minority expected to double over the next four decades. H/Ls have variable SES, nativity, geographic distribution, genetic admixture, and social, psychosocial and behavioral determinants of health. Significant disparities exist in prevalence, invasiveness and mortality in specific cancers (e.g., cervix, liver, stomach) and across multiple patient reported outcomes (PROs) regardless of disease site. H/Ls are more likely to present with advanced disease, greater comorbidities and report greater symptom burden and poorer health-related quality of life (HRQoL). Survivorship in H/Ls is further compromised by low SES, education and insurance coverage, language barriers and limited access to care. Survivorship studies in H/Ls have been limited due to: (a) small samples with short follow-ups; (b) focus on common cancer (e.g., breast or prostate), limiting attention to high-prevalence/mortality sites; restricted H/L origin and SES representation; and (d) lack of guiding models considering multiple determinants (e.g., sociocultural, medical, stress, psychosocial, lifestyle, biological) of survivors’ outcomes. Avanzando Caminos (Leading Pathways): the Hispanic/Latino Cancer Survivorship Cohort Study will involve recruitment, assessment and follow-up of ~3,000 H/Ls who completed primary cancer treatment within the past 2 years and are diverse in H/L background, urban vs. rural residence and cancer site across two major US metropolitan areas—Miami and San Antonio. Both areas have majority H/L populations (~65% of Miami; ~64% of San Antonio), are diverse regarding H/L origin and SES and are served by NCI-designated cancer centers. We will recruit a sample that approximates the diversity of the H/L population in the US (~ 50% Mexican & ~50% other H/L origin). The Florida Cancer Data System and the Texas Cancer Registry will supplement recruitment (~30% of cohort) and serve to establish representativeness. Our primary outcomes are symptom burden (e.g., pain, fatigue, depression, cognition), HRQoL and disease activity (e.g., progression, recurrence, cancer & all-cause mortality). Our transdisciplinary team has a strong and successful record of academic productivity and collaboration across the five targeted domains that will be evaluated as determinants of our outcomes: (1) sociocultural (e.g., SES, acculturation, cultural values); (2) stress and adversity (e.g., chronic and traumatic stress, ethnic-stress); (3) psychosocial (e.g., social support, coping, family cohesion/conflict); (4) lifestyle and behavioral (e.g., physical activity, nutrition, health information seeking); and (5) biological (e.g., inflammatory/pro-metastatic gene expression signaling, cardiometabolic markers, genetic admixture). Participants will be assessed at baseline, 6-months, 12-months and annually thereafter. Methods in multilevel latent longitudinal modeling, cancer genomics and computational biology will be used to test our hypotheses. During the UG3 phase, we will hire and train staff, establish and finalize study protocols, recruit ~18% of the sample and conduct preliminary analyses. During the UH3 phase we will complete recruitment, conduct all remaining assessments, analyze data and disseminate findings to guide and implement secondary and tertiary prevention in H/L survivors.

项目总结