Detroit Research on Cancer Survivors (Detroit ROCS)

 描述(申请人提供)：尽管在早期发现和治疗方面取得了进展，但非洲裔美国人的癌症发病率仍然不成比例地高，他们首次被诊断出患有更晚期的疾病，并且比其他人口的死亡率更高。非裔美国癌症幸存者的癌症进展、复发、死亡率和生活质量的决定因素尚未得到很好的研究，生物、遗传、环境、社会和行为因素起作用。底特律大都市居民每年报告的约25,000种癌症为一个独特的非裔美国癌症幸存者队列提供了基础，该队列将包括总体结果较差(肺癌和结肠癌)和总体结果较好(乳腺癌和前列腺癌)的癌症类型，以研究短期和长期生存决定因素。该队列还将包括部分病例的照顾者，以开展家庭支持和经济负担领域的研究。具体目标是：1)将总计5560例以肺癌、前列腺癌、乳腺癌和结肠癌为基础的非裔美国人癌症病例纳入底特律癌症幸存者研究(Detroit ROCs)队列。基线的参与将包括基于网络或电话采访、唾液采集和肿瘤块提取。2)共招募2780名这些病例的照顾者。 对于50%的癌症病例，配偶/照顾者中的一人将被要求参加基于网络或电话的面试。3)对所有癌症病例及其照顾者进行年度随访。4)通过在病程早期收集患者报告的结果数据，评估是否需要更频繁的随访和评估。这将使能够更准确地确定结果的决定因素。大多数队列每年或更少被跟踪。对于这一癌症队列，将在人群中的一个子集中测试更频繁的随访，以评估参与者在治疗后第一年报告生活质量数据的最有效和最轻负担的策略。由此产生的以人群为基础的非裔美国人癌症队列将支持解决癌症预后和进展、生存和癌症指导治疗结果的决定因素的研究。这将是少数几个包括已经积极参与癌症研究的大型少数族裔社区的队列之一，提供大量数据和生物谱系，以促进旨在了解和解决这一人群不良结果的决定因素的研究。这项工作将在我们独特的社区背景下进行：1)社区网络计划中心赠款(U54)支持以社区为基础的参与性研究(CBPR)方法来解决癌症差异；2)NCI资助的SEER癌症登记，用于在一个经济不景气的少数族裔人口众多的地区确定癌症病例；以及3)NCI指定的综合癌症中心，具有强大的癌症健康差异跨学科研究计划。

 DESCRIPTION (provided by applicant): Despite progress made in early detection and treatment, African Americans continue to experience disproportionately higher cancer incidence rates, are first diagnosed with more advanced stage disease, and suffer higher mortality rates than other populations. The determinants of cancer progression, recurrence, mortality and quality of life in African American cancer survivors are not well studied, with biologic, genetic, environmental, social and behavioral factors contributing. The ~25,000 cancers reported annually among residents of metropolitan Detroit provide the basis for a unique cohort of African American cancer survivors that will include cancer types with both poor outcomes overall (lung cancer and colon cancer) and better outcomes overall (breast and prostate cancer) to study both short term and longer term determinants of survival. The cohort will also include caregivers of a subset of the cases to develop research in the areas of family support and economic burden. The specific aims are to: 1) Enroll a total of 5,560 lung, prostate, breast, and colon population-based African American cancer cases into the Detroit Research on Cancer Survivors (Detroit ROCS) cohort. Participation at baseline will include a web-based or telephone interview, saliva collection, and tumor block retrieval. 2) Enroll a total of 2,780 caregivers of these cases. For 50% of the cancer cases, one spouse/caregiver will be asked to participate in a web-based or telephone interview. 3) Conduct yearly follow-up for all cancer cases and their caregivers. 4) Evaluate the need for more frequent follow-up and assessment by collecting patient reported outcome data early in the disease course. This will enable more accurate identification of determinants of outcomes. Most cohorts are followed annually or less often. For this cancer cohort, more frequent follow-up will be tested in a subset of the population to evaluate the most valid and least burdensome strategies for participants to report quality of life data during the fist year post treatment. The resulting population-based, African American cancer cohort will support studies addressing determinants of cancer prognosis and progression, survival, and outcomes of cancer-directed therapies. It will be one of the few cohorts to include a large minority community already actively engaged in cancer research, providing substantial data and biospecimens to facilitate studies aimed at understanding and addressing determinants of poor outcomes in this population. This work will be conducted in the context of a community uniquely engaged through our: 1) Community Network Program Center grant (U54) supporting a community based participatory research (CBPR) approach to addressing cancer disparities; 2) NCI-funded SEER cancer registry for population-based ascertainment of cancer cases in an economically depressed area with a large minority population; and 3) an NCI-designated Comprehensive Cancer Center with a strong transdisciplinary research program in cancer health disparities.