Characterizing Breast and Cervical Cancer Burden Among Sexual Minority women

性少数女性乳腺癌和宫颈癌负担的特征

基本信息

批准号：
10739450
负责人：
Jenny Spencer
金额：
$ 11.94万
依托单位：
UNIVERSITY OF TEXAS AT AUSTIN
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-07-27 至 2028-02-29
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10739450
关键词：
Address Affect Alcohol consumption Award Behavior Bisexual Breast Cancer Detection Breast Cancer Epidemiology Breast Cancer Risk Factor Calibration Cancer Burden Caring Cervical Cancer Screening Contraceptive Usage Data Decision Modeling Disease Disparity Education Epidemiology Equation Etiology Frequencies Goals Health Health Services Accessibility Heavy Drinking Heterosexuals High Prevalence Human Papilloma Virus Vaccination Human Papillomavirus Human papilloma virus infection Incidence Inequity Insurance Intervention Knowledge Lesbian Lesbian Gay Bisexual Low Prevalence Malignant Neoplasms Malignant neoplasm of cervix uteri Mediating Mediator Mentorship Methodology Methods Modeling National Health Interview Survey Natural History Nulliparity Obesity Oncogenic Outcome Patient Self-Report Pattern Physical activity Population Poverty Prevalence Preventive care Process Recommendation Reporting Research Research Personnel Resources Risk Behaviors Risk Factors Role Screening for cancer Sex Orientation Sexual and Gender Minorities Smoking Source Structure Time Training Underserved Population Update Visit Woman Work cancer care cancer risk care providers care systems career causal model cervical cancer prevention econometrics gender minority group health disparity health equity health inequalities hormonal contraception improved insight large scale data malignant breast neoplasm medical schools models and simulation modifiable risk mortality neoplasm registry parity perceived discrimination queer racial disparity screening screening guidelines sexual disparity sexual identity sexual minority sexual minority group sexual minority health sexual minority men sexual minority women social social determinants tumor progression uptake

项目摘要

Project Summary More than 8 million women in the US identify as a sexual minority- including lesbian, gay, bisexual, or queer, yet the health needs of this population remain understudied. Studies show sexual minority women are less likely to receive routine preventive care, including cancer screening. Studies of breast and cervical cancer risk among sexual minority women are mixed, with higher prevalence of risk factors including smoking, alcohol use, and obesity, but lower prevalence of risk factors such as HPV infection and use of hormonal contraceptives. As no national cancer registries collect information on sexual identity, we have no population-level estimates of cancer burden among sexual minority women and are unable to accurately evaluate disparities or prioritize interventions to improve low screening rates. We propose to first characterize existing sexual identity disparities in cervical cancer screening uptake using a structural equation modeling approach (Aim 1). This approach will evaluate the extent to which previously described disparities in screening uptake are mediated by differences in care access, prevalence of cancer risk factors, or both. We will then incorporate these data into a simulation model of cancer progression to produce feasible estimates of cervical cancer incidence and mortality by stage among sexual minority women (Aim 2). Finally, we will repeat the application of this full framework to assess relevant mediators of breast cancer screening and update the existing model to reflect our understanding of breast cancer natural history to estimate incidence and mortality among sexual minority women (Aim 3). My career to date has focused on using econometric and simulation modeling to better understand and address gaps in cervical cancer prevention among traditionally underserved populations. My ultimate goal is an independent research career focusing on effective strategies to reduce cancer health inequities among sexual and gender minority individuals. This award will allow her to take the next step in her career, building on her background in health equity and decision modeling while facilitating her training in causal epidemiology approaches, breast cancer epidemiology, and the health needs of sexual minority women. Dr. Spencer's training plan draws on the extensive methodological expertise of her mentorship team and the exceptional educational and professional resources at Dell Medical School. The overall goal of this work is to improve the health of sexual minority women through characterizing multilevel sources of inequities in breast and cervical cancer screening, incidence, and mortality.

项目摘要美国有超过800万妇女认为是性少数族裔 - 包括女同性恋，同性恋双性恋或酷儿，但该人群的健康需求仍在研究中。研究表明性少数妇女不太可能接受常规预防保健，包括癌症筛选。性少数妇女乳房和宫颈癌风险的研究混合在一起，危险因素的患病率更高，包括吸烟，饮酒和肥胖症，但较低危险因素的患病率，例如HPV感染和激素避孕药的使用。否国家癌症注册表收集有关性认同的信息，我们没有人口级别估计性少数妇女癌症负担，无法准确评估差异或确定干预措施以提高低筛查率。我们建议先表征宫颈癌中现有的性认同差异，使用结构方程建模方法（AIM 1）。这种方法将评估先前描述的筛查摄取差异是由护理访问差异介导的，癌症危险因素的患病率或两者兼有。然后，我们将这些数据合并到模拟中癌症进展的模型，产生可行的宫颈癌发生率和性少数妇女的阶段死亡率（AIM 2）。最后，我们将重复该应用程序这个完整的框架，以评估乳腺癌筛查的相关介体和更新现有模型以反映我们对乳腺癌自然历史的理解以估计发生率性少数妇女的死亡率（目标3）。我迄今为止的职业专注于使用计量经济学和模拟建模，以更好地理解和解决宫颈癌的差距传统服务不足的人群中的预防。我的最终目标是独立研究职业专注于减少癌症健康不平等的有效策略性和性别少数人。这个奖项将使她能够迈出下一步职业，以她在健康公平和决策建模的背景为基础，同时促进她因果流行病学方法，乳腺癌流行病学和健康需求的培训性少数妇女。斯宾塞博士的培训计划借鉴了广泛的方法论她的指导团队的专业知识以及卓越的教育和专业资源戴尔医学院。这项工作的总体目标是改善性少数群体的健康妇女通过表征乳腺癌和宫颈癌中不平等的多层次来源筛查，发病率和死亡率。