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。其结果是，乳腺癌幸存者的人数不断增加。虽然被诊断患有乳腺癌的女性的很多工作都集中在改善治疗上，但对被诊断为乳腺癌并接受治疗的长期健康后果进行的方法上的严格检查相对较少。 这项建议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，该队列的建立是为了检查与诊断后早期的生活质量和复发有关的行为问题。在2000-2002年间，共有2364名在1996-2000年间被诊断为早期乳腺癌的妇女被登记在队列中。基线数据是在确诊后平均23个月收集的，包括饮食、体力活动、体重、共病状况和生活质量等信息。女性每半年进行一次复发和死亡的跟踪调查。 在拟议的新资助期内，将通过邮寄重新调查队列，以尽可能接近诊断后的五年日期(平均时间为6.0年)更新暴露情况。这项研究建议再跟踪这些女性四年，主要关注行为和医学预测因素，包括永久存活期内的复发、存活率和生活质量，以及癌症治疗的远期和远期健康影响。我们还将研究乳腺癌幸存者的医疗保健利用率和费用，并将其与无癌症的匹配对照组进行比较。 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实现巨大的成本节约，这些人的诊断后行为和医学因素的数据已经可用。此外，由于80%的队列属于北加州凯撒永久医疗保健计划(KPNC)，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果和确定其他结果，计算机化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.