Social genomic mechanisms of health disparities among Adolescent and Young Adult (AYA) cancer survivors

青少年和青年（AYA）癌症幸存者健康差异的社会基因组机制

• 批准号: 10272690
• 负责人: Bradley Jay Zebrack
• 金额: $ 98.01万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-10 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10272690
• 关键词: Address; Adolescence; Adolescent and Young Adult; Adult Lymphoma; Affect; Aftercare; Age; American College of Radiology Imaging Network; Antiviral Agents; Antiviral resistance; Biological; Biological Assay; Biology; Blood; Blood specimen; Cancer Model; Cancer Survivor; Cancer Survivorship; Caring; Cells; Childhood; Chronic Disease; Collaborations; Community Clinical Oncology Program; Coping Behavior; Data; Data Set; Development; Discrimination; Disease Progression; Eastern Cooperative Oncology Group; Endocrine; Environmental Risk Factor; Ethnic Origin; Exposure to; Fibrinogen; Future; Gender; Gender Identity; Gene Expression; Gene Expression Regulation; Genes; Genetic Transcription; Geographic Locations; Geography; Goals; Health; Heterogeneity; Hodgkin Disease; Human; Immune; Individual; Inflammation; Inflammatory; Interferon Type I; Intervention; Investigation; Late Effects; Life; Literature; Long-Term Effects; Longitudinal cohort study; Malignant Neoplasms; Maps; Measures; Medical; Mental Health; Molecular; Molecular Target; Morbidity - disease rate; National Cancer Institute; Neoplasm Metastasis; Non-Hodgkin' s Lymphoma; Oncology; Outcome; Pathway interactions; Patients; Personal Satisfaction; Population; Positioning Attribute; Poverty; Process; Prospective cohort study; Psychological Factors; Quality of life; Race; Reporting; Research; Research Infrastructure; Risk; Risk Factors; Role; Rural; Self Efficacy; Social Conditions; Social Environment; Social Functioning; Social isolation; Social support; Structure; Supportive care; Survivors; Symptoms; Treatment/Psychosocial Effects; Tumor Tissue; Vulnerable Populations; Work; adolescent health outcomes; base; cancer diagnosis; cancer recurrence; cancer therapy; childhood adversity; early childhood; experience; functional genomics; genome-wide; genomic profiles; health disparity; immune function; improved; knowledge base; mortality; novel; pediatric trauma; physical conditioning; population health; programs; psychologic; psychosocial; psychosocial stressors; recruit; relating to nervous system; resilience; response; sex; social; social engagement; social factors; social genomics; social health determinants; socioeconomic disadvantage; socioeconomics; survivorship; therapy resistant; transcriptome; trauma exposure; treatment effect; tumor progression; young adult

Social genomic mechanisms of health disparities among Adolescent and Young Adult (AYA) cancer survivors. Survivors of cancer diagnosed in adolescence or young adulthood have an elevated risk of multiple health problems. They also experience specific and unique psychosocial stressors and life disruptions having ramifications for their health, mental health, and quality of life (QOL). These outcomes, and disparities in these outcomes (by race/ethnicity, sex and gender, geographic location), may be partially a function of social determinants of health, including socioeconomic gradients, exposures to early childhood traumas or adversity, and accumulated experiences of discrimination. Yet, little is known about these effects including the biological pathways through which the known effects of social-environmental risk factors on population health and well- being influence outcomes in post-treatment AYA cancer survivors, particularly with regard to morbidity, mortality, and QOL. Therefore, the research proposed here is intended to identify and define functional genomic pathways through which current and past psychosocial and social environmental risk and resilience factors influence gene regulation in AYAs, and thus contribute to a greater understanding of health disparities in post-treatment survivorship. We propose a 5-year longitudinal prospective cohort study of 2000 AYA cancer survivors recruited within one year following completion of treatment for Hodgkin or non-Hodgkin lymphomas. Using repeated measures of risk and resilience factors and blood assays, we will evaluate the extent to which biological, psychological and social indicators are associated with, and potentially predict, mortality and morbidity in AYA cancer survivors within two years following completion of therapy. In collaboration with the Eastern Cooperative Oncology Group-American College of Radiology Imaging Network (ECOG-ACRIN) research infrastructure and the National Cancer Institute Community Oncology Research Program (NCORP), this study will 1) identify the genome-wide transcriptional impact of social-environmental RISK factors (i.e., adverse living conditions/poverty, childhood trauma exposure, social isolation, and discrimination) and define the relationships of those genomic profiles to AYA survivor mortality, morbidity, and QOL; 2) identify the genome-wide transcriptional impact of individual RESILIENCE factors (i.e., social support, sense of purpose/meaning-making, self-efficacy) and define the relationships of those genomic profiles to AYA mortality, morbidity, and QOL; and, 3) identify the genome- wide molecular correlates of vulnerable populations, as structured by race/ethnicity, sexual/gender identity, and geography (e.g., rural vs. urban), and define the relationships of those genomic profiles to AYA survivor mortality, morbidity, and QOL. The study results may inform the conceptualization and development of new biological / molecular targets for future interventions to reduce risks for long-term and late effects of treatment and maximize likelihood of long-term health and QOL for AYA cancer survivors.

青少年和年轻成人（AYA）癌症健康差异的社会基因组机制