Optimizing the Impact of Aspirin for Chemoprevention

优化阿司匹林对化学预防的影响

• 批准号: 10212338
• 负责人: Yin Cao
• 金额: $ 10.87万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-07-06 至 2022-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10212338
• 关键词: Address; Adherence; Adult; Adverse effects; Advisory Committees; Age; Area; Aspirin; Award; Cancer Burden; Cancer Intervention; Cardiovascular Diseases; Chemoprevention; Chronic Disease; Clinical; Clinical Trials; Collaborations; Colorectal Cancer; Data; Decision Analysis; Decision Modeling; Development; Dose; Elderly; Epidemiology; Equilibrium; Event; Future; Gastrointestinal Hemorrhage; Genetic Predisposition to Disease; Goals; Grant; Guidelines; Health; Health behavior; Incidence; Individual; Intake; International; Intervention; Interview; Intracranial Hemorrhages; Iris; Journals; Knowledge; Life; Link; Malignant Neoplasms; Medical; Medical Genetics; Mentors; Mentorship; Nutritional; Older Population; Patients; Peer Review; Physicians; Policies; Policy Making; Population; Prevention strategy; Preventive service; Primary Prevention; Provider; Publications; Quality-Adjusted Life Years; Randomized Controlled Trials; Recommendation; Recording of previous events; Reporting; Research; Research Personnel; Research Project Grants; Resources; Risk; Risk Factors; Role; Science; Structure; Surveys; Training; Translational Research; Uncertainty; Universities; Work; aged; aging population; base; cancer epidemiology; cancer prevention; cardiovascular disorder prevention; cardiovascular disorder risk; career; clinical predictors; clinical risk; colorectal cancer prevention; colorectal cancer risk; colorectal cancer screening; compliance behavior; experience; genetic risk factor; high risk population; implementation barriers; implementation facilitators; implementation research; implementation science; implementation tool; improved; individualized prevention; innovation; meetings; models and simulation; molecular marker; mortality; multidisciplinary; novel; precision cancer prevention; predictive modeling; prevent; screening; skills; surveillance network; translational impact; willingness

PROJECT SUMMARY / ABSTRACT The candidate's long-term career goal is to become an academic leader in “precision cancer prevention”, by linking clinical and epidemiological risk factors with novel molecular markers, and applying decision and implementation tools to direct heathcare resources to the most effective and practical prevention strategies in the appropriate risk groups. The U.S. Preventive Services Task Force (USPSTF) recently released new recommendations supporting the use of low-dose aspirin for the primary prevention of CRC and CVD in adults aged 50-59 with certain CVD risk profiles. However, evidence for the efficacy of daily low-dose aspirin use among older people are lacking, and net benefits were not considered in the context of baseline CRC risk. In addition, impact and challenges in implementing the 2016 USPSTF guideline, and potential more refined precision-based recommendations have not been investigated. Building on the candidate's passion to bridge evidence with policy to improve practice in real world settings, as well as her prior research experience in cancer epidemiology and aspirin chemoprevention, the candidate seeks to fill these knowledge gaps through this novel and high impact research project to 1) examine the overall benefits and harms of low-dose daily aspirin use in a large randomized controlled trial among adults aged 65 and above, and estimate aspirin's efficacy on CRC according to CRC screening and baseline CRC risk predicted by clinical and genetic susceptibility (Aim 1); 2) refine the net benefits of low-dose aspirin use among adults aged 50 and above according to both CRC and CVD risk integrating findings from the RCT and stratified analyses using decision modeling (Aim 2); 3) examine the impact of 2016 USPSTF recommendations using national survey, and identify the barriers and facilitators for implementation at provider and patient level through interviews (Aim 3). The candidate will develop the necessary skills to conduct this work through a multidisciplinary mentoring committee, consisting of internationally recognized experts in cancer prevention and implementation science (Dr. Graham Colditz), aspirin chemoprevention (Dr. Andrew Chan), decision modeling (Dr. Ann Zauber), and health behaviors (Dr. Aimee James). The candidate will also receive committed mentorship from Dr. John McNeil at Monash University and Dr. Iris Lansdorp-Vogelaar from Erasmus MC, and collaborate with Dr. Nathan Moore from BJC Medical Group. In addition to mentored research, the candidate will also benefit from formal training through didactic coursework, attendance at scientific meetings, publication in peer-reviewed journals, and submission of an R01 grant. This mentoring and in-depth training in decision science and implementation science as well as national and international collaborations, will be critical for the candidate to develop new, interdisciplinary, and unique areas of expertise, and establish a strong research network that expands from cancer epidemiology to policy making to implementation, which will be instrumental for her transition to an independent investigator and as an emerging leader in cancer prevention.

项目概要/摘要 候选人的长期职业目标是成为“精准癌症预防”领域的学术带头人，通过 将临床和流行病学危险因素与新型分子标志物联系起来，并应用决策和 实施工具，将医疗保健资源引导至最有效、最实用的预防策略 美国预防服务工作组 (USPSTF) 最近发布了新的风险群体。 支持使用小剂量阿司匹林作为成人 CRC 和 CVD 一级预防的建议 50-59 岁，有一定的 CVD 风险。但是，有证据表明每日使用小剂量阿司匹林的有效性。 老年人中的研究缺乏，并且没有在基线 CRC 风险的背景下考虑净收益。 此外，实施 2016 年 USPSTF 指南的影响和挑战，以及进一步细化的潜力 尚未对以候选人的热情为基础的建议进行调查。 改善现实世界环境中的实践的政策证据，以及她之前的研究经验 癌症流行病学和阿司匹林化学预防，候选人试图通过以下方式填补这些知识空白 这个新颖且具有高影响力的研究项目旨在 1）检查每日低剂量的总体益处和危害 一项针对 65 岁及以上成年人的大型随机对照试验中阿司匹林的使用情况，并估计阿司匹林的疗效 根据 CRC 筛查和临床和遗传预测的基线 CRC 风险对 CRC 的疗效 易感性（目标 1）；2）完善 50 岁及以上成年人使用低剂量阿司匹林的净效益 根据 CRC 和 CVD 风险整合 RCT 的结果以及使用决策的分层分析 建模（目标 2）；3) 使用全国调查检验 2016 年 USPSTF 建议的影响，以及 通过访谈确定在提供者和患者层面实施的障碍和促进因素（目标 3）。 候选人将通过多学科指导培养开展这项工作所需的技能 委员会由国际公认的癌症预防和实施科学专家组成 （Graham Colditz 博士）、阿司匹林化学预防（Andrew Chan 博士）、决策建模（Ann Zauber 博士）和 健康行为（艾米·詹姆斯博士）。候选人还将获得约翰博士的坚定指导。 莫纳什大学的 McNeil 和伊拉斯谟 MC 的 Iris Lansdorp-Vogelaar 博士，并与 Dr. Iris Lansdorp-Vogelaar 合作。 来自 BJC 医疗集团的 Nathan Moore 除了指导研究外，候选人还将受益于 通过教学课程、参加科学会议、同行评审出版物进行正式培训 期刊，并提交 R01 补助金，以进行决策科学和深度培训。 实施科学以及国家和国际合作对于候选人来说至关重要 开发新的、跨学科的、独特的专业领域，并建立强大的研究网络 从癌症流行病学扩展到政策制定再到实施，这对她很有帮助 转变为独立研究者并成为癌症预防领域的新兴领导者。

项目成果

Dairy intake during adolescence and risk of colorectal adenoma later in life.

青春期的乳制品摄入量和晚年患结直肠腺瘤的风险。

• 发表时间: 2021-03
• 影响因子: 8.8
• 作者: Nimptsch, Katharina;Lee, Dong Hoon;Zhang, Xuehong;Song, Mingyang;Farvid, Maryam S;Rezende, Leandro F M;Cao, Yin;Chan, Andrew T;Fuchs, Charles;Meyerhardt, Jeffrey;Nowak, Jonathan A;Willett, Walter C;Ogino, Shuji;Giovannucci, Edward;Pischon, T
• 通讯作者: Pischon, T

Glucosamine and Chondroitin Use in Relation to C-Reactive Protein Concentration: Results by Supplement Form, Formulation, and Dose.

葡萄糖胺和软骨素的使用与 C 反应蛋白浓度的关系：补充剂形式、配方和剂量的结果。

• 发表时间: 2021-02
• 作者: Kantor, Elizabeth D;O'Connell, Kelli;Du, Mengmeng;Cao, Chao;Zhang, Xuehong;Lee, Dong Hoon;Cao, Yin;Giovannucci, Edward L
• 通讯作者: Giovannucci, Edward L

Association Between Aspirin Use and Gastric Adenocarcinoma: A Prospective Cohort Study.

阿司匹林使用与胃腺癌之间的关联：一项前瞻性队列研究。

• 发表时间: 2022-04-01
• 作者: Kwon, Sohee;Ma, Wenjie;Drew, David A;Klempner, Samuel J;Leonardo, Brianna M;Flynn, Jacqueline J;Cao, Yin;Giovannucci, Edward L;Bao, Ying;Fuchs, Charles S;Song, Mingyang;Chan, Andrew T
• 通讯作者: Chan, Andrew T

Association of Aspirin Use With Mortality Risk Among Older Adult Participants in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial.

阿司匹林使用与前列腺癌、肺癌、结直肠癌和卵巢癌筛查试验中老年人死亡风险的关联。

• 发表时间: 2019
• 影响因子: 13.8
• 作者: Loomans;Pinsky, Paul;Cao, Yin;Chan, Andrew T;Umar, Asad
• 通讯作者: Umar, Asad

Genomic Risk Score for Melanoma in a Prospective Study of Older Individuals.

对老年人的前瞻性研究中黑色素瘤的基因组风险评分。

• 发表时间: 2021-10-01
• 作者: Bakshi, Andrew;Yan, Mabel;Riaz, Moeen;Polekhina, Galina;Orchard, Suzanne G;Tiller, Jane;Wolfe, Rory;Joshi, Amit;Cao, Yin;McInerney;Yanes, Tatiane;Janda, Monika;Soyer, H Peter;Cust, Anne E;Law, Matthew H;Gibbs, Peter;McLean, C
• 通讯作者: McLean, C