Long Term Health Outcomes in Breast Cancer Survivors

描述（由申请人提供）： 近年来，乳腺癌幸存者的死亡率一直在下降。因此，乳腺癌幸存者人数不断增加。虽然在被诊断患有乳腺癌的妇女中的许多工作都集中在改善治疗上，但对被诊断患有乳腺癌并接受治疗的长期健康后果的方法学严格检查相对较少。 该提案建立在乳腺癌幸存者的癌症后生活流行病学（LACE）研究队列的基础上，该队列旨在检查诊断后早期与生活质量和复发相关的行为问题。在1996年至2000年期间，共有2 364名妇女被诊断患有早期乳腺癌，并参加了2000年至2002年的队列研究。平均在诊断后23个月收集的基线数据包括饮食、体力活动、体重、共病状况和生活质量等信息。女性每半年随访一次复发和死亡。 在拟议的新资助期内，将通过邮件重新调查队列，以更新尽可能接近诊断后5年的暴露量（平均时间6.0年）。这项研究建议再跟踪这些女性四年，主要关注癌症治疗对永久生存期内复发、生存和生活质量的行为和医学预测因素以及晚期和长期健康影响。我们还将研究乳腺癌幸存者的医疗保健利用和费用，并与无癌症的对照组进行比较。 这项研究将通过检查现有癌症幸存者队列中提出的问题来节省大量成本，这些癌症幸存者已经获得了诊断后行为和医疗因素的数据。此外，由于80%的队列属于北方加州（KPNC）医疗保健计划的Kaiser Permanente，因此可以通过病历审查和与计算机化数据库的链接来验证自我报告的结局，并确定其他结局，这些数据库定期捕获与拟议研究目标相关的医疗保健数据。

DESCRIPTION (provided by applicant): In recent years mortality rates among breast cancer survivors have been declining. As a consequence, there is a growing population of breast cancer survivors. While much work in women diagnosed with breast cancer has focused on improving treatment, there has been relatively little methodologically rigorous examination of the long-term health consequences of having been diagnosed with and treated for breast cancer. This proposal builds on the Life After Cancer Epidemiology (LACE) Study cohort of breast cancer survivors that was established to examine behavioral issues related to quality of life and recurrence in the early years following diagnosis. A total of 2,364 women diagnosed with early stage breast cancer between 1996 and 2000 were enrolled in the cohort from 2000-2002. Baseline data, which was collected on average 23 months post diagnosis included information on diet, physical activity, weight, comorbid conditions and quality of life. Women are followed semiannually for recurrence and death. During the proposed new funding period, the cohort will be re-surveyed by mail to update exposures as close to their five-year post-diagnosis date as possible (mean time 6.0 yr.). This study proposes to follow these women for another four years and will focus primarily on behavioral and medical predictors of recurrence, survival, and quality of life in the permanent survival period and late and long term health effects of cancer therapy. We will also study health care utilization and costs in breast cancer survivors compared to a matched comparison group free of cancer. This study will achieve tremendous cost savings by examining the proposed questions within an existing cohort of cancer survivors for whom data on behavioral and medical factors post-diagnosis are already available. In addition, since 80 percent of the cohort belongs to Kaiser Permanente of Northern California (KPNC) Medical Care Program, self-reported outcomes can be validated and other outcomes ascertained through medical chart review and linkage to computerized databases that routinely capture health care data relevant to the proposed study aims.