Breast Cancer In Blacks: Impact of Genomics, Healthcare Use and Lifestyle on Outcomes (BRIGHT)

黑人乳腺癌：基因组学、医疗保健使用和生活方式对结果的影响 (BRIGHT)

• 批准号: 10194397
• 负责人: Tuya Pal
• 金额: $ 36.86万
• 依托单位: VANDERBILT UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-07-01 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10194397
• 关键词: Address; Admixture; African; African American; Age; Authorization documentation; Biological; Biological Factors; Body mass index; Cessation of life; Clinical; Clinical Research; Collection; Complement; DNA analysis; Data; Databases; Diabetes Mellitus; Diagnosis; Etiology; Evaluation; Fibrinogen; Florida; Gene Expression Profile; Gene Expression Profiling; Genetic; Genetic Transcription; Genomics; Goals; Health Services Accessibility; Healthcare; Intervention; Life Style; Malignant Neoplasms; Medical Records; Minority Participation; Molecular; Obesity; Outcome; Participant; Patients; Patterns of Care; Population; Population Study; Prevention program; Principal Investigator; Prognosis; Provider; Questionnaires; Recurrence Score; Registries; Reporting; Retrieval; Risk; Risk Factors; Role; Sampling; Secure; Subgroup; System; Time; Underserved Population; Ursidae Family; Woman; aggressive breast cancer; base; black women; breast cancer diagnosis; breast cancer survival; cancer subtypes; cohort; comorbidity; data registry; design; follow-up; genetic variant; health disparity; high risk; improved; improved outcome; lifestyle factors; malignant breast neoplasm; molecular subtypes; mortality; mortality disparity; nano-string; neoplasm registry; older women; population based; primary endpoint; programs; recruit; screening program; sedentary lifestyle; treatment response; triple-negative invasive breast carcinoma; tumor

Abstract Young Black women bear a disproportionate burden of breast cancer (BC) mortality compared to Whites and are underrepresented in clinical studies. It remains critical to understand factors that contribute to the high mortality from BC among young Black women in order to improve outcomes. The higher BC mortality rate among young Blacks with BC is partly attributed to the disproportionately higher proportions who develop the aggressive triple-negative (TN) BC subtype. In addition to biologic factors, timely access to care, and lifestyle factors contribute to this disparity. Consequently, it has become imperative to look in detail within the Black population to evaluate the interplay between biologic and non-biologic contributors to existing disparities, and to better characterize the highly aggressive TNBC among young Black women based on distinct molecular subtypes. Ultimately, it is critical to assess both biologic and non-biologic factors in order to fully understand and address existing health disparities in young Black women. Through leveraging a prior population-based study of 460 young Black women with invasive BC in 2009-2012 (and recruitment of a representative sample of an additional 200 women diagnosed in 2013-2014), we plan to: 1) assess the contribution of biologic and non-biologic factors on high mortality rates observed among young Black women with BC and generate a risk score, to help identify those at risk for poorer outcomes, and 2) investigate molecular features of the subgroup with TNBC. We hypothesize that biologic (including tumor gene expression profiling) and non-biologic factors contribute to existing disparities in BC survival among young Black women. Furthermore, we hypothesize that Blacks have a higher proportion of aggressive subtype of TNBC. To our knowledge, this is among the largest population-based cohorts of young Black women with breast cancer. Ultimately, our study presents a unique opportunity to quantify biological and non-biological factors associated with BC-specific survival, and further characterize TNBC among Black women. Given that prior interventions have too narrowly focused on the patient as the agent of change without meaningfully impacting the BC mortality disparity, it is important to consider patient, provider and system level approaches concurrently to drive system change and close the mortality gap.

抽象的 与白人相比 并且在临床研究中的人为不足。了解有助于高的因素仍然至关重要 年轻的黑人妇女的死亡率是为了改善结果。 BC死亡率较高 在带有卑诗省的年轻黑人中，部分归因于发展不成比例的 侵略性三阴性（TN）BC亚型。除了生物学因素，及时获得护理和生活方式 因素导致这种差异。因此，必须在黑色内详细研究 人口评估生物学和非生物学贡献者之间的相互作用，以及 以不同的分子为基础的年轻黑人女性中高度侵略性的TNBC的表征 亚型。最终，评估生物学和非生物学因素以充分理解至关重要。 并解决年轻黑人妇女的现有健康差异。通过利用先前的人群 研究2009 - 2012年对460名侵入性BC的年轻黑人妇女（以及代表性样本的招募 在2013 - 2014年诊断出的200名妇女中，我们计划：1）评估生物学和 在患有卑诗省的年轻黑人妇女中观察到的高死亡率的非生物因素，并产生风险 得分，帮助识别有较差结果的风险的分数，2）研究亚组的分子特征 与TNBC。我们假设生物学（包括肿瘤基因表达分析）和非生物学因素 在年轻的黑人妇女中有助于卑诗省的现有差异。此外，我们假设 黑人的TNBC侵略性亚型比例更高。据我们所知，这是最大的 基于人群的年轻黑人妇女患有乳腺癌的同类。最终，我们的研究提出了独特的 量化与BC特异性生存相关的生物学和非生物学因素的机会，并进一步 在黑人妇女中的特征是TNBC。鉴于先前的干预措施过于狭窄地关注 患者是变革的推动者，而不会有意义地影响BC死亡率差异，这一点很重要 考虑患者，提供商和系统级别的方法同时推动系统变化并关闭 死亡率差距。