Midcareer Mentoring Award for Patient-Oriented Research in Aging

描述(由申请人提供)：这项建议的目的是(1)使候选人能够进一步发展她的研究计划，专注于改善老年人的癌症筛查和预防，以及(2)利用她的研究计划作为一个平台，指导老年医学和医学子专业内对衰老研究感兴趣的初级患者导向型研究人员。候选人是一位老年病学家，他已经建立了一个高影响力的独立临床研究计划，该计划资金充足，有出色的发表记录。在完成老年医学研究后的10年里，她确立了自己作为学生、研究员和初级教员的成功导师的地位，这些学生、研究员和初级教员发表了高影响力的老龄研究成果，获得了成功的资金支持，并继续参与以患者为导向的老龄研究。这位候选人开发了一套广泛的研究组合，专注于老年人癌症筛查的结果，试图通过更好地定义风险和好处，特别是作为预期寿命的函数，来改善癌症筛查的针对性。这项工作影响了美国的筛查指南，后者利用这项研究建议筛查决策更多地关注预期寿命，而不是年龄，并更好地认识到筛查的潜在危害。这项提案将为候选人提供有保护的时间，以将她的研究扩展到一个新的方向，专注于对老年癌症幸存者的癌症复发进行监测测试。对老年癌症幸存者的监测提出了类似于筛查的问题，因为它可以在仍可治疗的情况下发现复发的癌症，从而潜在地使老年人受益，但也可能因过度治疗而导致大量发病率。该提案中的研究将通过更好地确定对老年前列腺癌幸存者进行监测测试的风险和好处，为这一领域的决策提供信息。这一新方向保持了她的研究重点，同时与肿瘤学建立了新的合作关系。候选人还将制定正式的指导计划，包括招募、选拔、发展和评估将成为老龄化研究领导者的指导对象的计划。每个被辅导者都将有一个有重点的职业发展计划，在这个计划中，他们完成研究项目，并发展成为老龄化研究中的独立研究者所需的技能。这项提议将候选人的指导计划整合到加州大学旧金山分校出色的临床研究培训环境中，利用她在老年病学部和临床与翻译科学研究所(CTSI)职业发展计划(KL2学者计划)的领导职位来招募更多对老龄化研究感兴趣的导师。 公共卫生相关性：这项提案将具有独特的公共卫生重要性，因为(1)它将增加对新的临床研究人员的指导，这些新的临床研究人员有兴趣进行研究，以改善对快速增长的老年人口的护理，以及(2)它将通过更好地定义老年前列腺癌幸存者的前列腺特异性抗原(PSA)监测实践的风险和好处，为国家指南和临床决策提供信息。

DESCRIPTION (provided by applicant): The aims of this proposal are to (1) enable the candidate to further develop her research program focused on improving cancer screening and prevention in older adults and (2) use her research program as a platform for mentoring junior patient-oriented investigators interested in aging research, both within Geriatrics and within the medical subspecialties. The candidate is a Geriatrician who has established a high-impact independent clinical research program that is well funded with an outstanding publication record. In the 10 years since completing her Geriatrics fellowship she has established herself as a successful mentor of students, fellows, and junior faculty who have published high-impact aging research, become successfully funded, and continue to participate in patient-oriented research in aging. The candidate has developed an extensive research portfolio focused on the outcomes of cancer screening in elders that has sought to improve the targeting of cancer screening by better defining the risks and benefits, particularly as a function of life expectancy. This work has influenced screening guidelines in the U.S., which have used this research to recommend that screening decisions focus more on life expectancy than chronological age and better recognize the potential harms of screening. This proposal will provide the candidate with protected time to expand her research in a new direction focused on surveillance testing for cancer recurrence in older cancer survivors. Surveillance in older cancer survivors poses similar issues to screening in that it can potentially benefit elders by finding recurrent cancers when still treatable but also may cause substantial morbidity through overtreatment. The research in this proposal will inform decision making in this area by better defining the risks and benefits of surveillance testing in older prostate cancer survivors. This new direction maintains her research focus while building new collaborations with oncology. The candidate will also develop a formal mentoring program with plans for the recruitment, selection, development, and evaluation of mentees who will become leaders in aging research. Each mentee will have a focused career development plan in which they complete research projects and develop the skills needed to become independent investigators in aging research. This proposal integrates the candidate's mentoring program into the outstanding clinical research training environment at UCSF, leveraging her leadership positions in the Division of Geriatrics and the Clinical and Translational Science Institute (CTSI) Career Development (KL2 Scholars) Program to recruit more mentees interested in aging research. PUBLIC HEALTH RELEVANCE: This proposal will have unique public health importance because (1) it will increase mentoring of new clinical investigators interested in conducting research to improve care for the rapidly growing elderly population, and (2) it will inform national guidelines and clinical decision-making by better defining the risks and benefits of prostate-specific antigen (PSA) surveillance practices in elderly prostate cancer survivors.