UChicago Interdisciplinary Cancer Health Disparities SPORE

本申请是根据特别关注通知（NOSI）（编号为NOTCA-20-042）提交的。持续的2019冠状病毒病（COVID-19）大流行是一种公共卫生和经济紧急情况，扰乱了乳腺癌患者的生活。不幸的是，它严重打击了美国，迄今已有170多万人感染，10多万人丧生。虽然年老和患有合并症是死于COVID-19的风险因素，但COVID-19的严重程度也存在种族差异，城市中心的黑人和拉丁裔患者死于COVID-19的比例不成比例。乳腺癌是女性中最常见的恶性肿瘤，在美国有超过380万女性患有浸润性乳腺癌。患有乳腺癌的非裔美国人的全因死亡率和乳腺癌特异性死亡率风险升高。在COVID-19大流行期间，重要的是要了解SARS-CoV-2感染和COVID-19对乳腺癌疾病进展、护理提供和生存率（包括COVID-19爆发期间和之后的生活质量）的影响。为了满足参与我们的P20资助的U芝加哥跨学科健康差异SPORE的患者的需求，并解决这些知识差距，我们建议通过进行在线调查，审查电子健康记录，并搜索国家死亡指数，以确定芝加哥多种族流行病学乳腺癌队列中3，059名乳腺癌患者的状态，与社区合作。该项目有三个具体目标：首先，我们将评估因COVID-19爆发而中断治疗的程度，并了解远程医疗的使用情况和满意度。第二，我们将对COVID-19进行全面评估，并对乳腺癌患者的孤独、焦虑、压力、经济影响和资源缺乏进行缓解。第三，我们将估计COVID-19的冠状病毒感染率、严重程度及病死率，并识别与COVID-19严重程度及病死率相关的因素。对于每个目标，我们将检查种族差异，以了解COVID-19是否加剧了队列中先前确定的死亡率差距。该补充项目将通过支持对癌症队列成员的额外访谈和随访，大大增强我们的SPORE P20计划，并将生成有关COVID-19疫情和封锁对转化研究的影响的必要数据，以缩小我们建议的完整SPORE应用中的死亡率差距。这些数据对于指导社区层面的干预措施和卫生系统的适应性至关重要，以在COVID-19时代支持高风险患者。

This application is being submitted in response to the Notice of Special Interest (NOSI) identified as NOTCA-20-042. The ongoing pandemic of the coronavirus disease 2019 (COVID-19) is a public health and economic emergency that has disrupted the lives of breast cancer patients. Unfortunately, it has hit the United States heavily with more than 1.7 million people having been infected and more than 100,000 lives lost to date. While old age and having comorbidities are risk factors for dying from COVID-19, there is also a racial disparity in COVID-19 severity, with black and Latino patients in urban centers dying disproportionately from COVID-19. Breast cancer is the most common malignancy in women, with over 3.8 million women living in the United States with a history of invasive breast cancer. African Americans with breast cancer have an elevated risk of all-cause mortality and breast cancer-specific mortality. During the COVID-19 pandemic, it is important to understand the impact of SARS-CoV-2 infection and COVID-19 on breast cancer disease progression, care delivery, and survivorship including quality of life during and after the COVID-19 outbreak. In response to the needs of patients participating in our P20 funded UChicago Interdisciplinary Health Disparities SPORE and to address these knowledge gaps, we propose to engage with the Community by conducting an online survey, reviewing electronic health records, and searching the National Death Index to determine status of 3,059 breast cancer patients in the Chicago Multiethnic Epidemiologic Breast Cancer Cohort. The project has three specific aims: First, we will evaluate the extent of treatment interruption because of COVID-19 outbreak, and understand the utilization and satisfaction with Telehealth. Second, we will conduct a holistic evaluation of COVID-19 and mitigation efforts on loneliness, anxiety, stress, economic impact, and lack of resources among breast cancer patients. Third, we will estimate the coronavirus infection rate, severity and case-fatality rate of COVID-19, and identify factors associated with severity and case-fatality rate of COVID-19. For each aim, we will examine racial differences to understand whether COVID-19 has worsened previously identified mortality gap in the Cohort. The Supplementary Project will greatly enhance our SPORE P20 program by supporting additional interviews and follow-up of the cancer cohort members, and will generate necessary data regarding the impact of COVID-19 epidemic and lockdown on translational research to close the mortality gap in our proposed full SPORE application. These data are critical for guiding both community level interventions and health systems adaptation to support high-risk patients in the era of COVID-19.