Evaluating the Effectiveness of Lung Cancer Screening in Patients with COPD

评估慢性阻塞性肺病患者肺癌筛查的有效性

• 批准号: 8881126
• 负责人: Minal S Kale
• 金额: $ 16.93万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-07-01 至 2019-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8881126
• 关键词: Address; Adoption; Advisory Committees; Affect; Age; Attenuated; Award; Cancer Control; Cancer Etiology; Cancer Patient; Cause of Death; Cessation of life; Characteristics; Chronic Obstructive Airway Disease; Computers; Cost Effectiveness Analysis; Cost Measures; Data; Decision Aid; Decision Analysis; Development; Diagnostic; Disease; Disease Progression; Dose; Early Diagnosis; Effectiveness; Equilibrium; Excision; Faculty; Foundations; Frequencies; Funding; Future; Goals; Guidelines; Health; Individual; Insurance Carriers; Intervention; K-Series Research Career Programs; Kale - dietary; Life; Life Expectancy; Lung; Malignant Neoplasms; Malignant neoplasm of lung; Measures; Medicine; Mentors; Mentorship; Modeling; New York; Operative Surgical Procedures; Patients; Persons; Physicians; Population; Populations at Risk; Prevention strategy; Preventive; Preventive Intervention; Primary Health Care; Public Health; Publishing; Quality of life; Quality-Adjusted Life Years; Randomized; Randomized Controlled Trials; Regimen; Research; Research Personnel; Resource Allocation; Resources; Respiratory physiology; Risk; Risk Factors; Role; Screening for cancer; Services; Severity of illness; Smoker; Smoking; Smoking History; Technology; Testing; Training; Translating; Uncertainty; United States; United States National Institutes of Health; Universities; base; cancer prevention; career; career development; cost; cost effective; cost effectiveness; design; economic impact; high risk; improved; innovation; life time cost; lung cancer screening; markov model; medical schools; mortality; patient oriented; patient population; professor; programs; screening; skills; standard of care; tobacco exposure

DESCRIPTION (provided by applicant): This application is for a Cancer Prevention and Control Career Development Award (K07) for Minal Kale, a junior research faculty at Icahn School of Medicine at Mount Sinai. Dr. Kale's career goal is to improve and optimize the use of cancer screening and the delivery of appropriate cancer prevention and early detection services in primary care. The K07 award will provide Dr. Kale with the necessary resources to develop skills to 1) address the benefits and harms of lung cancer screening in individuals with COPD and 2) perform computer simulated decision analyses and cost-effectiveness analyses. Mount Sinai is a national leader in research and is one of the top 20 medical schools in NIH funding. It has one of the largest lung cancer screening research programs in the world. Dr. Kale has a mentorship team of established researchers: Dr. Juan Wisnivesky (primary mentor) is a Professor of Medicine at Icahn School of Medicine and an expert on lung cancer and COPD; Dr. Scott Braithwaite (co-mentor) is a Professor of Medicine at New York University School of Medicine and an expert in computer-simulated modeling and cost- effectiveness analysis. The results of the recently published National Lung Screening Trial demonstrated that low dose CT screening is the cancer screening intervention with the largest mortality benefit ever found. Thus, implementation of lung cancer screening is expected to have a major public health impact. Under the guidance of her mentorship team, Dr. Kale will evaluate whether patients with mild COPD can also benefit or potentially be harmed by this technology (Aim 1), a critical question for this population with an increased risk of lung cancer. She will also determine the best screening regimen (selection of screening candidates based on pack-years of smoking, age of initiation, frequency, and duration) that will be most beneficial for patients with COPD and will identify the subset of COPD patients who are less likely to benefit from screening due to severe disease (i.e., limited airway function) (Aim 2). Furthermore, the economic impact of widespread lung cancer screening is currently unknown. Examining the costs of this cancer prevention strategy in patients with COPD (Aim 3) will be an important advancement in determining the efficient and judicious allocation of this resource. These results will decrease physician and patient uncertainty about the potential role of lung cancer screening and thus, will likely translate into increased adoption of this life saving preventive measure.

描述（由申请人提供）：本申请是为西奈山伊坎医学院的初级研究教师Minal Kale提供的癌症预防和控制职业发展奖（K 07）。Kale博士的职业目标是改善和优化癌症筛查的使用，并在初级保健中提供适当的癌症预防和早期检测服务。K 07奖将为Kale博士提供必要的资源，以发展技能，1）解决COPD患者肺癌筛查的益处和危害，2）进行计算机模拟决策分析和成本效益分析。西奈山是研究的国家领导者，是NIH资助的前20所医学院之一。它拥有世界上最大的肺癌筛查研究项目之一。Kale博士有一个由知名研究人员组成的导师团队：Juan Wisnivesky博士（主要导师）是伊坎医学院的医学教授，也是肺癌和COPD的专家; Scott Braithwaite博士（共同导师）是纽约大学医学院的医学教授，也是计算机模拟建模和成本效益分析的专家。最近发表的国家肺筛查试验的结果表明，低剂量CT筛查是癌症筛查干预措施，有史以来发现的死亡率效益最大。因此，肺癌筛查的实施预计将产生重大的公共卫生影响。在她的导师团队的指导下，Kale博士将评估轻度COPD患者是否也可以受益于这项技术（目标1），这是肺癌风险增加的人群的一个关键问题。她还将确定对COPD患者最有益的最佳筛查方案（根据吸烟包年数、开始吸烟的年龄、频率和持续时间选择筛查候选人）， 将确定由于严重疾病而不太可能从筛选中获益的COPD患者亚组（即，限制气道功能）（目标2）。此外，广泛的肺癌筛查的经济影响目前尚不清楚。检查COPD患者的癌症预防策略的成本（目标3）将是确定这种资源有效和明智分配的重要进展。这些结果将减少医生和患者对肺癌筛查潜在作用的不确定性，因此，可能会转化为增加采用这种挽救生命的预防措施。