Vermont PROSPR Research Center (VPRC)

描述：佛蒙特州PROSPR研究中心(VPRC)：在过去的30年里，乳腺癌筛查使美国乳腺癌死亡率大幅下降，但并非没有意想不到的危害和缺点。关于整个筛查过程的全面的、以人群为基础的纵向数据可以评估当前的筛查做法并提出改进建议。佛蒙特州繁荣研究中心(VPRC)建议继续和扩大佛蒙特州乳腺癌监测系统(VBCS)的工作，该系统在收集患者风险因素、乳房成像、病理、治疗、癌症结局和生命状态数据方面拥有16年的经验。我们的第一个目标是在佛蒙特州的社区实践中记录整个乳腺癌筛查过程。收集的新数据将增加我们16年的纵向数据，这些数据为我们提议的研究计划、与统计协调中心的数据共享以及与PROSPR其他网站的合作提供了基础。其次，我们将开展一项研究计划，通过开发可用于制定导管原位癌(DCIS)个性化管理策略的预后标记物来改进筛查过程。利用来自VBCS的约1400例DCLS病例的纵向数据，我们将寻求识别新的分子、形态、放射学和肿瘤微环境标记物，这些标记物可以根据进展为侵袭性疾病的风险对DCLS患者进行分层。我们的比较有效性分析将提供一个框架，通过该框架可以评估新的DCLS预后标记物对筛查的益处和危害的潜在影响。第三，我们将与其他PROSPR研究中心、PROSPR统计协调中心、国家癌症研究所和更大的研究社区开展合作研究。我们由经验丰富的基础、临床和人口科学家组成的多学科团队将领导和参与跨网络计划，并确保我们的数据和研究结果的传播。这些目标的实现将为评估和改进目前的乳腺癌筛查过程提供丰富的数据来源。我们研究项目的成功将填补识别DCLS预后标志物的迫切需求，使个性化管理策略成为可能。

DESCRIPTION: Vermont PROSPR Research Center (VPRC): Breast cancer screening has led to substantial reductions in breast cancer mortality in the United States over the past 30 years, but not without unintended harms and shortcomings. Comprehensive, population-based, longitudinal data on the entire screening process can evaluate current screening practices and recommend improvements. The Vermont Prosper Research Center (VPRC) proposes to continue and extend the work of the Vermont Breast Cancer Surveillance System (VBCSS), which has 16 years of experience in collecting integrated patient risk factor, breast imaging, pathology, treatment, cancer outcome and vital status data. Our first aim is to document the entire breast cancer screening process in community practice across the state of Vermont. The new data collected will add to our 16 years of longitudinal data, which provide the foundation for our proposed research program, data sharing with the Statistical Coordination Center, and collaborations with other PROSPR sites. Second, we will pursue a research program that improves the screening process by developing prognostic markers that can be used to develop personalized management strategies for ductal carcinoma in situ (DCIS). Using longitudinal data on approximately 1400 DClS cases from the VBCSS, we will seek to identify novel molecular, morphologic, radiologic, and tumor microenvironment markers that can stratify DClS patients by risk of progression to invasive disease. Our comparative effectiveness analyses will provide a framework by which new DClS prognostic markers can be evaluated for their potential impacts on the benefits and harms of screening. Third, we will conduct collaborative research with other PROSPR Research Centers, the PROSPR Statistical Coordination Center, the National Cancer Institute, and the larger research community. Our multidisciplinary team of experienced basic, clinical, and population scientists will lead and participate in trans-Network initiatives and ensure the dissemination of our data and study findings. Accomplishment of these aims will provide a rich source of data for use in evaluating and improving current breast cancer screening processes. Success in our research program will fill an urgent need for identification of DClS prognostic markers that could enable personalized management strategies.