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: 7787606
• 负责人: Deirdre Hill
• 金额: $ 60.15万
• 依托单位: UNIVERSITY OF NEW MEXICO
• 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/7787606
• 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; 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; prognostic indicator; 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. PUBLIC HEALTH RELEVANCE: Racial and ethnic disparities in breast cancer survival persist as one of the most visible indicators of gaps in health care outcomes in the United States. Many research studies have identified factors that influence differences in survival, but an overall picture is lacking. Our goal is to develop a comprehensive understanding of contributors to the disparity in breast cancer survival in Hispanic women in New Mexico, and to determine the relative contributions of each, so that interventions can be directed most effectively to eradicate disparities.

描述（由申请人提供）：乳腺癌生存中的种族和种族差异仍然是美国医疗保健结果中最突出和最有形的表现之一，但它们并未屈服于简单的分析或减轻。该领域的大部分研究都来自仅解决问题的特定学科的范围内，因此很难感知整体情况。我们建议通过整合在潜在决定因素的连续体中得出的理解，从基于社区的预防/早期检测开始，并通过诊断和预后指标继续进行临床相关的贡献者，从而评估新墨西哥州西班牙裔妇女持续的乳腺癌生存差异。与非西班牙裔白人妇女相比，我们将在1997年至2011年的六个新墨西哥州六个新墨西哥州诊断出患有侵入性乳腺癌的妇女中，研究西班牙裔乳腺癌死亡的风险增加了1.6倍。将包括1000名新墨西哥县的侵入性乳腺癌。我们将借鉴基于人群的乳房X线摄影数据，新墨西哥州SEER登记册，医学图表评论和肿瘤组织，以研究各种潜在的乳腺癌生存的潜在贡献者。了解这些地区对乳腺癌生存差异的共同贡献应解决生存差异研究中的重要差距。相对较少的研究测量了这些领域中的一个以上的变量。那些试图解决生存差异的人与这些学科的孤立发现有关，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。没有这些数据，很难有效地将干预措施靶向至关重要的链接或时间序列中的链接。我们的全面方法将使我们能够确定可及其干预的因素，以及那些影响最大的因素。消除差异的任务是一个复杂的任务，并且可以通过跨学科的工作来加强一项综合的，全面的评估，以便对当时可以轻松地应用来消除我们社区的差异。 公共卫生相关性：乳腺癌生存中的种族和种族差异一直是美国医疗保健结果中最明显的差距指标之一。许多研究已经确定了影响生存差异的因素，但缺乏整体情况。我们的目标是对新墨西哥州西班牙裔妇女乳腺癌生存差异的贡献进行全面了解，并确定每种妇女的相对贡献，以便可以最有效地指导干预措施以消除差异。