Comparative Assessment of Screening Strategies for Melanoma

黑色素瘤筛查策略的比较评估

• 批准号: 8757665
• 负责人: Sandra J Lee
• 金额: $ 18.81万
• 依托单位: DANA-FARBER CANCER INST
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-07-01 至 2016-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8757665
• 关键词: Age; American Cancer Society; Applications Grants; Area; Breast Cancer Detection; Characteristics; Clinical; Complement; Consensus; Data; Data Element; Databases; Dermatologist; Diagnosis; Disease; Disease Progression; Disease susceptibility; Dysplastic Nevus; Early Diagnosis; Eastern Cooperative Oncology Group; Elements; Epidemiologist; Epidemiology; Family history of; Foundations; Future; General Population; German population; Grant; Guidelines; Incidence; Individual; Investigation; Lead; Lesion; Malignant Neoplasms; Measures; Medical Surveillance; Methods; Modeling; Natural History; Nevus; Patients; Pattern; Pigments; Population; Prevention; Probability; Process; Public Health; Race; Recording of previous events; Research; Research Personnel; Risk; Risk Factors; Schedule; Screening for Skin Cancer; Skin Carcinoma; Southwest Oncology Group; Stage at Diagnosis; Staging; Susceptibility Gene; TNM; Thick; Time; Woman; Work; base; comparative; compare effectiveness; cost; disease natural history; experience; high risk; innovation; melanoma; member; men; mortality; population based; pre-clinical; programs; public health relevance; randomized trial; screening; sex; tumor; working group

DESCRIPTION (provided by applicant): Comparative Assessments of Screening Strategies for Melanoma Project Summary This grant proposal is centered around research problems arising in the early detection of malignant melanoma with an emphasis on sex-based differences in the early diagnosis of melanoma. The principal research areas include: (i) Investigate the natural history of melanoma and develop stochastic models for early detection of melanoma, (ii) Evaluate the mortality benefit of potential screening programs in the general and high-risk populations, (iii) Establish a pilot database of individuals at high-risk of developing melanoma and evaluate the factors associated with the risk of developing melanoma and of fatal melanoma. The incidence of malignant melanoma in the U.S. has been steadily rising over the last 30 years and there are no population-based guidelines to screen for this relatively common and lethal cancer. The natural history of melanoma is not well-understood although age, sex, and race are risk factors in the general population. Radically different incidence rates and stage at diagnosis patterns between men and women suggest the disease progression process may be sex-specific. Known risk factors for developing the disease include personal history of melanoma, presence of atypical nevi, increased nevus count, presence of large congenital nevi, history of non-melanoma skin cancer, actinic damage and family history of melanoma and disease susceptibility genes. The first main aim of this research is to develop a stochastic model to evaluate the melanoma progression process and the sojourn time distribution in the preclinical disease state. This model will utilize data from the U.S. Surveillace Epidemiology and End Results (SEER) and Eastern Cooperative Oncology Group (ECOG) melanoma studies. The second aim compares the effectiveness of various screening scenarios, using mortality reduction from screening as a measure of benefit. Screening programs defined by starting/stopping ages and screening intervals as well as risk-based schedules will be evaluated. The third aim establishes a database of subjects at high-risk of developing melanoma. This database will utilize de-identified data from patients followed by members of the ECOG/Southwest Oncology Group (SWOG) Melanoma Prevention Working Group (MPWG) and Pigmented Lesion Subcommittee (PLS). Multiple risk factors for developing melanoma will be evaluated. Associations between the risk factors for developing melanoma and for fatal melanoma will also be investigated. Overall, the proposed research provides a foundation that is crucial in order to develop practical guidelines for early detection programs in melanoma. Programs for the general population as well as among individuals at higher risk of developing melanoma will be investigated.

描述（由申请人提供）：黑色素瘤项目筛查策略的比较评估总结本赠款提案的重点是在早期发现恶性黑色素瘤的早期发现中引起的研究问题，重点是对黑色素瘤早期诊断的基于性别的差异。主要研究领域包括：（i）研究黑色素瘤的自然历史并开发了早期发现黑色素瘤的随机模型，（ii）评估一般和高风险人群中潜在筛查计划的死亡率益处，（iii）建立一个在发育中的黑色素瘤高风险中的个体的试验数据库，并评估与疾病质感性黑色素瘤的风险相关的因素。在过去的30年中，美国恶性黑色素瘤的发病率一直在稳步上升，并且没有基于人群的指南来筛查这种相对常见和致命的癌症。尽管年龄，性别和种族是普通人群的危险因素，但黑色素瘤的自然历史并没有得到很好的理解。在男性和女性之间的诊断模式下的发病率和阶段截然不同，这表明疾病进展过程可能是性别特异性的。发展该疾病的已知危险因素包括黑色素瘤的个人病史，非典型NEVI的存在，增加的Nevus计数，存在大型先天性NEVI，非黑色素瘤皮肤癌的史，放光性损害，活化性损害和黑色素瘤家族史以及疾病易感基因。这项研究的第一个主要目的是开发一个随机模型，以评估临床前疾病状态中黑色素瘤进展过程和周时间分布。该模型将利用来自美国监测的流行病学和最终结果（SEER）和东部合作肿瘤学组（ECOG）黑色素瘤研究的数据。第二个目的比较了各种筛查场景的有效性，利用筛查中的死亡率降低作为衡量福利的措施。通过开始/停止年龄和筛选间隔以及基于风险的时间表来定义的筛选程序。第三个目标在发育中的黑色素瘤高风险中建立了受试者的数据库。该数据库将利用来自ECOG/西南肿瘤学组（SWOG）预防性工作组（MPWG）和色素病变小组委员会（PLS）的ECOG/Southwest肿瘤学组（SWOG）的患者的去识别数据。将评估发育黑色素瘤的多种危险因素。还将研究出现黑色素瘤和致命黑色素瘤的危险因素之间的关联。总体而言，拟议的研究为制定黑色素瘤早期检测计划的实用指南提供了至关重要的基础。将研究针对普通人群以及患有较高黑色素瘤风险的个体中的计划。