Towards a Transdisciplinary Understanding of Breast Cancer Survival Disparities

对乳腺癌生存差异的跨学科理解

• 批准号: 8403651
• 负责人: Deirdre Hill
• 金额: $ 49.54万
• 依托单位: UNIVERSITY OF NEW MEXICO HEALTH SCIS CTR
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-03-01 至 2014-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8403651
• 关键词: Accounting; Address; Area; Caring; Cessation of life; Cohort Studies; Commit; Communities; Community based prevention; Complex; County; Data; Diagnosis; Diagnostic; Discipline; Early Diagnosis; Education; Ethnic group; Genetic; Goals; Healthcare; Hispanics; Income; Inherited; Insurance Coverage; Intervention; Investigation; Joints; Link; Literature; Mammography; Measures; Medical; New Mexico; Not Hispanic or Latino; Outcome; Pilot Projects; Population Group; Prevention strategy; Prognostic Marker; Registries; Relative (related person); Research; Research Personnel; Risk; Role; Sampling; Tumor Biology; Tumor Tissue; United States; Woman; Work; cohort; cost effectiveness; forging; malignant breast neoplasm; mortality; population based; prevention service; public health relevance; racial and ethnic disparities; research study; socioeconomics; tumor

DESCRIPTION (provided by applicant): Racial and ethnic disparities in breast cancer survival remain one of the most prominent and tangible manifestations of the gaps in health care outcomes in the United States, yet they have not yielded to easy analysis or amelioration. Much of the research in this area has arisen from within the confines of specific disciplines that address only a piece of the problem, and as a result it is difficult to perceive the overall picture. We propose to evaluate the persistent breast cancer survival disparity among Hispanic women in New Mexico by integrating the understanding derived across a continuum of potential determinants, beginning with community-based prevention/ early detection and continuing through diagnostic and prognostic indicators to clinically-related contributors. We will investigate the 1.6-fold increased risk of breast cancer death in Hispanic as compared with non-Hispanic white women in a population-based case-cohort study of women diagnosed with invasive breast cancer in six New Mexico counties from 1997 to 2011. Almost 1000 deaths and a 20% sample of the cohort (~1450 women) will be included. We will draw on population-based mammography data, the New Mexico SEER registry, medical chart reviews, and tumor tissue to investigate a full spectrum of potential contributors to the disparate breast cancer survival. Understanding the joint contributions from these areas to breast cancer survival differences should address important gaps in survival disparity research. Relatively few studies measure variables in more than one of these areas. Those attempting to address survival disparities have contended with isolated findings from these disciplines, with few ways to determine the relative impact of prevention strategies directed to a particular contributor. Without that data, it is difficult to effectively target interventions to the crucial link or links in the temporal sequence. Our comprehensive approach will allow us to identify factors amenable to intervention, and those that will have the strongest impact. The task of eradicating disparities is a complex one, and one that may be strengthened by working across disciplines to develop an integrated, comprehensive assessment of factors that then can readily be applied to eliminate disparities in our communities.

描述（由申请人提供）：乳腺癌生存率的种族和民族差异仍然是美国医疗保健结果差距的最突出和最明显的表现之一，但尚未易于分析或改善。该领域的许多研究都是在特定学科的范围内产生的，只解决了问题的一部分，因此很难了解整体情况。我们建议通过整合对一系列潜在决定因素的理解来评估新墨西哥州西班牙裔妇女中持续存在的乳腺癌生存差异，从基于社区的预防/早期检测开始，并继续通过临床相关因素的诊断和预后指标。我们将在一项基于人口的病例队列研究中，对 1997 年至 2011 年新墨西哥州六个县被诊断患有浸润性乳腺癌的女性进行一项基于人群的病例队列研究，调查与非西班牙裔白人女性相比，西班牙裔女性乳腺癌死亡风险增加 1.6 倍。将包括 1000 例死亡病例和 20% 的队列样本（约 1450 名女性）。我们将利用基于人群的乳房X光检查数据、新墨西哥州SEER登记、医学图表审查和肿瘤组织来调查影响不同乳腺癌生存的各种潜在因素。了解这些领域对乳腺癌生存差异的共同贡献应该可以弥补生存差异研究中的重要空白。相对较少的研究测量了其中一个以上领域的变量。那些试图解决生存差异的人一直在与这些学科的孤立发现作斗争，几乎没有方法可以确定针对特定贡献者的预防策略的相对影响。如果没有这些数据，就很难有效地针对时间序列中的一个或多个关键环节进行干预。我们的综合方法将使我们能够确定适合干预的因素以及那些将产生最强影响的因素。消除不平等的任务是一项复杂的任务，可以通过跨学科合作对因素进行综合、全面的评估来加强这一任务，然后可以轻松地将其应用于消除我们社区中的不平等。