Abramson Cancer Center Support Grant

艾布拉姆森癌症中心支持补助金

• 批准号: 10425591
• 负责人: ROBERT H VONDERHEIDE
• 金额: $ 19.94万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2022-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10425591
• 关键词: Acquired Immunodeficiency Syndrome; Address; Adherence; Africa South of the Sahara; African; Aftercare; Botswana; Cancer Center Support Grant; Cancer Survivor; Caring; Cessation of life; Characteristics; Clinic; Clinical; Consolidated Framework for Implementation Research; Country; Data; Developing Countries; Diagnosis; Early Diagnosis; Early treatment; Ensure; Future; Geography; Goals; Grant; Gynecologic Oncology; HIV; HIV Infections; Hospitals; Incidence; Income; Intervention; Interview; Malignant Neoplasms; Malignant neoplasm of cervix uteri; Methods; Morbidity - disease rate; Outcome; Patient-Focused Outcomes; Patients; Pattern; Persons; Prevalence; Private Hospitals; Quality of life; Radiation therapy; Recommendation; Research; Resources; Scientific Advances and Accomplishments; Shapes; Structure; Surveys; Testing; Woman; Work; advanced disease; anticancer research; care delivery; care outcomes; cohort; contextual factors; curative treatments; demographics; experience; falls; improved; infection rate; interest; low and middle-income countries; mortality; multidisciplinary; outreach clinics; psychosocial; response; screening; survivorship; transportation access; tumor; uptake

PROJECT SUMMARY This application is being submitted in response to the Notice of Special Interest (NOSI) identified as NOT-CA- 21-058. The number of cancer survivors living in low- and middle-income countries (LMICs) is expected to grow rapidly over the next decade driven in part by global advances in early detection and treatment, yet very little is known about the long-term needs of cancer survivors or delivery of survivorship care in LMICs. This supplement application will help to fill this critical research gap by quantitatively and qualitatively evaluating care outcomes and contextual determinants of survivorship care among women diagnosed with cervical cancer in Botswana. Cervical cancer is one of the leading cancers among women globally with 600,000 new cases and 340,000 deaths annually per 2020 estimates. Cervical cancer is an acquired immunodeficiency syndrome (AIDS)-defining malignancy, and countries with high rates of human immunodeficiency virus (HIV) have higher incidence of cervical cancer. Due to high HIV-infection rates and suboptimal screening uptake, most of the burden of cervical cancer incidence, morbidity, and mortality falls on LMICs particularly in sub-Saharan Africa, with many women presenting with advanced disease. Botswana, a sub-Saharan African country, has high rates of cervical cancer (incidence rate of 34.4 per 100,000) and HIV (18.5% prevalence), and a high rate of mortality due to cervical cancer (20.1 per 100,000) among women. To date, the majority of cancer research in Botswana and other LMICs has focused on early detection or treatment, with limited research evaluating the long-term physical or psychosocial outcomes in survivorship or how survivorship care may impact these outcomes. Furthermore, even less is known regarding which approaches may be most impactful and sustainable to deliver survivorship care in LMICs. As such, there is a critical need to understand the current state of survivorship in LMICs and to identify effective strategies to ensure that all women receive optimal survivorship care. The objectives of this project are to: 1) quantitatively describe a) patterns in post-treatment survivorship care and b) long-term physical and psychosocial sequelae of cervical cancer using an existing cohort of patients at Princess Marina Hospital in Gaborone, Botswana; and 2) qualitatively assess contextual determinants (e.g., quality of life, access to resources, care delivery strategies) shaping patient experiences and adherence to survivorship care. In combination, these data will be used to develop and/or adapt survivorship care interventions to target the specific contextual determinants in Botswana and other LMICs. The results of this project will advance scientific understanding of survivorship care and sequelae in LMICs and how these experiences may or may not differ from the experiences and needs of cancer survivors in high-income countries. This project will also generate fundamental evidence needed to improve survival and quality of life of cancer survivors globally. The long-term goal of this project is to decrease cervical cancer mortality in Botswana and other LMICs by developing and implementing survivorship care interventions that can be sustained in lower resource settings.

项目摘要 该申请是为了响应特殊利益通知（NOSI）而提交 21-058。居住在低收入和中等收入国家（LMIC）的癌症幸存者的数量将增长 在接下来的十年中，迅速在全球检测和治疗方面的一部分驱动中，但几乎没有 知道癌症幸存者的长期需求或在LMIC中提供生存护理。此补充 申请将通过定量和定性评估护理结果来帮助填补这一重要的研究差距 在博茨瓦纳诊断出患有宫颈癌的妇女中生存护理的情境决定因素。 宫颈癌是全球妇女中的主要癌症之一，有60万例新病例和340,000例 每2020年估计每年死亡。宫颈癌是一种获得的免疫缺陷综合征（AIDS）定义 恶性肿瘤和人类免疫缺陷病毒率高的国家（HIV）的发生率更高 宫颈癌。由于艾滋病毒感染率高和次优筛查吸收，大部分宫颈负担 癌症的发病率，发病率和死亡率属于LMIC，特别是在撒哈拉以南非洲，许多妇女 出现晚期疾病。博茨瓦纳（Botswana （每100,000每100,000的发病率为34.4）和艾滋病毒（患病率为18.5％），宫颈造成的死亡率很高 妇女中的癌症（每100,000每100,000）。迄今为止，博茨瓦纳和其他LMIC的大多数癌症研究 研究的重点是早期检测或治疗，有限的研究评估了长期物理或 生存期或生存护理如何影响这些结果的社会心理成果。此外，甚至 关于哪种方法可能最有影响力和可持续来提供生存护理，鲜为人知 在LMIC中。因此，迫切需要了解LMICS中的生存状况并确定 确保所有妇女获得最佳生存护理的有效策略。这个项目的目标是 至：1）定量描述a）治疗后生存护理中的模式和b）长期身体和 宫颈癌的心理社会后遗症，使用现有的患者玛丽娜公主医院的患者队列 Gaborone，博茨瓦纳； 2）定性评估上下文决定因素（例如，生活质量，访问权限 资源，护理交付策略）塑造患者经验并遵守生存护理。在 组合这些数据将用于开发和/或适应生存护理干预措施以针对特定 博茨瓦纳和其他LMIC的上下文决定因素。该项目的结果将提高科学 了解LMIC中的生存护理和后遗症，以及这些经历如何有所不同 根据高收入国家的癌症幸存者的经验和需求。这个项目也将产生 在全球范围内改善癌症幸存者的生存和生活质量所需的基本证据。长期 该项目的目标是通过开发和开发和 实施在较低资源环境中可以维持的生存护理干预措施。