The Impact of Comorbidity on Older Cancer Patients

合并症对老年癌症患者的影响

• 批准号: 7079301
• 负责人: Cary P. Gross
• 金额: $ 19.03万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-07-15 至 2008-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7079301
• 关键词: Medicare /Medicaid; cancer registry /resource; chronic obstructive pulmonary disease; colorectal neoplasms; comorbidity; decision making; diabetes mellitus; endoscopy; gastrointestinal imaging /visualization; heart disorder; hospital utilization; human data; human mortality; human old age (65+); human therapy evaluation; neoplasm /cancer chemotherapy; neoplasm /cancer classification /staging; neoplasm /cancer surgery; patient care management; quality of life; Medicare /Medicaid; cancer registry /resource; chronic obstructive pulmonary disease; colorectal neoplasms; comorbidity; decision making; diabetes mellitus; endoscopy; gastrointestinal imaging /visualization; heart disorder; hospital utilization; human data; human mortality; human old age (65+); human therapy evaluation; neoplasm /cancer chemotherapy; neoplasm /cancer classification /staging; neoplasm /cancer surgery; patient care management; quality of life

DESCRIPTION (provided by applicant): BACKGROUND: Cancer is commonly a disease of the elderly, and elderly cancer patients tend to have worse outcomes than their younger counterparts. This is likely due, at least in part, to the myriad of noncancer problems that tend to accrue with age. SPECIFIC AIMS: Among elderly patients with colorectal cancer, we will identify the relation between comorbid conditions (heart disease, chronic obstructive pulmonary disease (COPD), and diabetes) and: Cancer stage at the time of initial diagnosis; 1. Use of surgical resection, adjuvant therapy, and surveillance colonoscopy; 2. Effectiveness of surgical resection and adjuvant therapy; 3. Probability of death, hospitalization, or diminished quality of life; and, 4. Patient and physician treatment preferences and goals of therapy. RESEARCH PLAN: Initially, we will use the population-based SEER-Medicare linked database, which combines tumor registry information with Medicare administrative data. We will explore how heart disease, COPD, and diabetes impact patterns of care, treatment effectiveness and outcomes of elderly colorectal cancer patients. We will then conduct a qualitative study of patients who have colorectal cancer as well as one of the three comorbid conditions of interest. We will identify how physicians and patients incorporate comorbid conditions into their treatment preferences and goals. This will be followed by additional exploratory analyses and grant-writing . CAREER DEVELOPMENT PLAN: My career goal is to become an independent investigator, applying rigorous clinical research methods that incorporate the principles of geriatrics into the study of elderly patients with cancer - specifically on how non-cancer conditions affect elderly patients. I will work closely with my mentors and a skilled multi-disciplinary team, completing a rigorous program of research, coursework, and independent study. SIGNIFICANCE: This work will generate clinically relevant new insights about the impact of comorbid illness on elderly patients with colorectal cancer, and guide future efforts to enhance communication of treatment preferences and goals in this vulnerable population .

描述（由申请人提供）：背景：癌症通常是老年人的疾病，老年癌症患者的预后往往比年轻的疾病。这至少部分归因于往往随着年龄的增长而产生的无数非癌症问题。 具体目的：在结直肠癌的老年患者中，我们将确定合并症（心脏病，慢性阻塞性肺部疾病（COPD）和糖尿病）之间的关系。 初始诊断时的癌症阶段； 1。使用手术切除，辅助治疗和监测结肠镜检查； 2。手术切除和辅助治疗的有效性； 3。死亡，住院或生活质量降低的可能性；和， 4。患者和医师的治疗偏好和治疗目标。 研究计划：最初，我们将使用基于人群的Seer-Medicare链接数据库，该数据库将肿瘤注册表与Medicare行政数据结合在一起。我们将探讨心脏病，COPD和糖尿病如何影响老年大肠癌患者的护理，治疗效果和结果。然后，我们将对患有大肠癌的患者以及感兴趣的三个合并症之一进行定性研究。我们将确定医生和患者如何将合并症纳入他们的治疗偏好和目标。随后将进行其他探索性分析和赠款写作。 职业发展计划：我的职业目标是成为一名独立研究者，采用严格的临床研究方法，将老年医学原理纳入老年癌症患者的研究 - 特别是关于非癌症状况如何影响老年患者的研究。我将与我的导师和熟练的多学科团队紧密合作，完成严格的研究，课程和独立研究计划。 意义：这项工作将产生有关合并症对结直肠癌老年患者的影响的临床相关新见解，并指导未来的努力，以加强这种脆弱人群的治疗偏好和目标的交流。