Incidence of Malignancies in Californians with Sickle Cell Disease

患有镰状细胞病的加利福尼亚人的恶性肿瘤发病率

• 批准号: 9170720
• 负责人: Theresa H M Keegan
• 金额: $ 12.14万
• 依托单位: UNIVERSITY OF CALIFORNIA AT DAVIS
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-08-06 至 2018-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9170720
• 关键词: Accident and Emergency department; Admission activity; Affect; African American; Age; Algorithms; American; Autoimmune Diseases; Blood Transfusion; California; Cancer Burden; Caring; Case Series; Centers for Disease Control and Prevention (U.S.); Cessation of life; Chronic; Collaborations; Collecting Ducts of Bellini Carcinoma; Comorbidity; Data; Data Set; Databases; Development; Disease; Epidemiology; Florida; Foundations; Frequencies; Funding; Future; Health Planning; Hematological Disease; Hemoglobinopathies; Incidence; Infection; Inflammation; Inherited; Investments; Knowledge; Link; Longevity; Malignant Neoplasms; Measures; Medical Records; Medical Surveillance; Methodology; Michigan; National Heart, Lung, and Blood Institute; New York; North Carolina; Outcome; Pathology; Patient Discharge; Patients; Pennsylvania; Population; Population Control; Recommendation; Registries; Reporting; Risk; Risk Factors; Screening for cancer; Severities; Sickle Cell Anemia; Sickle Cell Trait; Stroke; System; Testing; Thalassemia; Transfusion; United States; United States National Institutes of Health; Universities; base; cancer diagnosis; cancer epidemiology; cancer risk; cancer type; cohort; demographics; disorder prevention; improved; innovation; insight; neoplasm registry; novel; population based; premature; programs; public health research

Small case series have suggested increased incident cancer in patients with sickle cell disease (SCD), which, if confirmed, might affect cancer surveillance recommendations for these patients. Experimental data have linked chronic inflammation and high cellular turnover, both hallmarks of SCD, to increased risk of malignancy. Because increased incident cancer in SCD has important implications for management of these patients, it is necessary to rigorously test this finding in a large patient cohort. We propose to determine the incidence of cancer in Californians with SCD by linking two existing databases created for surveillance purposes—the California Cancer Registry (CCR) and the California Office of Statewide Health Planning and Development (OSHPD) Patient Discharge and Emergency Department Utilization. We estimate between 6,000-8,000 cases with SCD will be found. We will test the hypothesis that cancer risk is increased in the SCD population through the following specific aims. Specific Aim 1: Determine the standardized incidence ratio of cancer amongst Californians with SCD. The SCD cohort will be created using a search algorithm informed by the Registry and Surveillance System for Hemoglobinopathies (RuSH) project, a collaboration between the Centers for Disease Control and Prevention (CDC) and the National Heart Lung and Blood Institute. The algorithm has been validated by the CDC-funded Public Health Research, Surveillance and Epidemiology in Hemoglobinopathies (PHRESH) study. Specific Aim 2: Describe the epidemiology of cancer in patients with SCD, including types of malignancies, demographics, and potential risk factors associated with incident cancer. These data will have significant impact on our knowledge of the complications of SCD, and important implications for cancer screening as survival for patients with SCD improves. It will also provide insight into how SCD affects cancer-specific survival. Assessment of potential risk factors associated with development of malignancy in the SCD population that can be pursued in future, more mechanistic studies. An example might be an association between malignancy and the number of transfusions, severity of SCD as measured by frequency of admissions or other complications, or co-morbidities such as autoimmune disease. These results will also serve as preliminary data for an R01 proposal that would determine the epidemiology of cancer and risk factors for cancer in patients with SCD from the seven states that participated in the RuSH project (California, Georgia, Florida, Michigan, North Carolina, New York, and Pennsylvania).

小病例系列表明镰状细胞病患者的癌症发病率增加 (SCD)，如果得到证实，可能会影响这些癌症监测建议。 患者实验数据表明，慢性炎症和高细胞周转率有关， SCD的标志，增加恶性肿瘤的风险。因为SCD中癌症发病率的增加 对于这些患者的管理具有重要意义，有必要严格测试 这是一个大型患者队列的发现。我们建议确定癌症的发病率， 通过连接两个现有的数据库与SCD创建的监视业务- 加州癌症登记处（CCR）和加州全州健康规划办公室， 发展（OSHPD）患者出院和急诊科利用。我们估计 将发现6000 - 8000例SCD病例。我们将检验癌症风险 通过以下具体目标在SCD人群中增加。具体目标1： 确定加州SCD患者癌症的标准化发病率。的SCD 将使用登记研究和监测所告知的检索算法创建队列 血红蛋白病系统（RuSH）项目，一个由以下中心合作的项目： 疾病控制和预防中心（CDC）和国家心肺和血液研究所。的 该算法已得到CDC资助的公共卫生研究，监测和 血红蛋白病流行病学（PHRESH）研究。具体目标2：描述 SCD患者的癌症流行病学，包括恶性肿瘤类型，人口统计学， 以及与癌症相关的潜在风险因素。这些数据将具有重要意义。 对我们了解SCD并发症的影响，以及对癌症的重要意义 随着SCD患者生存率的提高，它还将提供深入了解SCD如何 影响癌症特异性存活率。评估与下列因素相关的潜在风险因素 SCD人群中恶性肿瘤的发展，可以在未来进行，更多 机械研究。一个例子可能是恶性肿瘤和数量之间的关联 通过入院频率或其他指标衡量的SCD严重程度 并发症或共病如自身免疫性疾病。这些结果也将作为 确定癌症流行病学和风险的R 01提案的初步数据 来自参加RuSH的七个州的SCD患者的癌症因素 项目（加州、格鲁吉亚、佛罗里达、密歇根、北卡罗来纳州、纽约和宾夕法尼亚）。