Avanzando Caminos (Leading Pathways): The Hispanic/Latino Cancer Survivorship Cohort Study.”

Avanzando Caminos（领先途径）：西班牙裔/拉丁裔癌症幸存者队列研究。 –

• 批准号: 10391549
• 负责人: Frank J Penedo
• 金额: $ 95.59万
• 依托单位: UNIVERSITY OF MIAMI CORAL GABLES
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-05-01 至 2023-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10391549
• 关键词: Acculturation; Address; Admixture; American; Area; Attention; Behavioral; Biological; Biological Assay; Biological Factors; Biological Process; Breast; Cancer Center; Cancer Survivor; Cancer Survivorship; Catchment Area; Cause of Death; Cervix Uteri; Characteristics; Chronic stress; Clinics and Hospitals; Cognition; Cohort Studies; Collaborations; Community Outreach; Comprehensive Cancer Center; Computational Biology; Conflict (Psychology); Country; Cuban; Data; Disease; Education; Emotions; Family; Fatigue; Florida; Gene Expression; Genetic; Geographic Distribution; Geographic Locations; Geography; Health; Health Services Accessibility; High Prevalence; Hispanic; Hispanic Populations; Individual; Inflammation; Inflammatory; Information Systems; Insurance Coverage; Knowledge; Language; Latino; Latino Population; Life Style; Literature; Liver; Malignant Neoplasms; Malignant neoplasm of prostate; Measures; Mediating; Mediator of activation protein; Medical; Mental Depression; Methods; Mexican; Mexican Americans; Minority; Minority Groups; Modeling; NCI-Designated Cancer Center; National origin; Not Hispanic or Latino; Outcome; Outcome Study; Pain; Participant; Pathway interactions; Patient Outcomes Assessments; Phase; Physical Function; Physical activity; Population; Prevalence; Procedures; Productivity; Prostate; Protocols documentation; Puerto Rican; Quality of life; Recurrence; Reporting; Research; Risk; Rural; Sampling; Second Primary Cancers; Secondary Prevention; Signal Transduction; Site; Sleep; Social Functioning; Social support; Socioeconomic Status; South American; South Texas; Stomach; Stress; Survivors; Symptoms; Testing; Texas; Training; Urban Community; Work; advanced disease; cancer genomics; cancer site; cancer therapy; cancer type; cardiometabolism; cohesion; cohort; comorbidity; coping; cultural values; data management; emotional functioning; ethnic minority population; experience; follow-up; health related quality of life; low socioeconomic status; malignant breast neoplasm; metropolitan; mortality; neoplasm registry; nutrition; optimism; perceived discrimination; primary outcome; psychosocial; recruit; resilience; rural residence; satisfaction; sex; social; social culture; survivorship; tertiary prevention; traumatic stress; treatment adherence

Project Summary Cancer is the leading cause of death among Hispanics/Latinos (H/Ls) in the US. H/Ls account for 57.5 million Americans (18%), now the largest minority expected to double over the next four decades. H/Ls have variable SES, nativity, geographic distribution, genetic admixture, and social, psychosocial and behavioral determinants of health. Significant disparities exist in prevalence, invasiveness and mortality in specific cancers (e.g., cervix, liver, stomach) and across multiple patient reported outcomes (PROs) regardless of disease site. H/Ls are more likely to present with advanced disease, greater comorbidities and report greater symptom burden and poorer health-related quality of life (HRQoL). Survivorship in H/Ls is further compromised by low SES, education and insurance coverage, language barriers and limited access to care. Survivorship studies in H/Ls have been limited due to: (a) small samples with short follow-ups; (b) focus on common cancer (e.g., breast or prostate), limiting attention to high-prevalence/mortality sites; restricted H/L origin and SES representation; and (d) lack of guiding models considering multiple determinants (e.g., sociocultural, medical, stress, psychosocial, lifestyle, biological) of survivors’ outcomes. Avanzando Caminos (Leading Pathways): the Hispanic/Latino Cancer Survivorship Cohort Study will involve recruitment, assessment and follow-up of ~3,000 H/Ls who completed primary cancer treatment within the past 2 years and are diverse in H/L background, urban vs. rural residence and cancer site across two major US metropolitan areas—Miami and San Antonio. Both areas have majority H/L populations (~65% of Miami; ~64% of San Antonio), are diverse regarding H/L origin and SES and are served by NCI-designated cancer centers. We will recruit a sample that approximates the diversity of the H/L population in the US (~ 50% Mexican & ~50% other H/L origin). The Florida Cancer Data System and the Texas Cancer Registry will supplement recruitment (~30% of cohort) and serve to establish representativeness. Our primary outcomes are symptom burden (e.g., pain, fatigue, depression, cognition), HRQoL and disease activity (e.g., progression, recurrence, cancer & all-cause mortality). Our transdisciplinary team has a strong and successful record of academic productivity and collaboration across the five targeted domains that will be evaluated as determinants of our outcomes: (1) sociocultural (e.g., SES, acculturation, cultural values); (2) stress and adversity (e.g., chronic and traumatic stress, ethnic-stress); (3) psychosocial (e.g., social support, coping, family cohesion/conflict); (4) lifestyle and behavioral (e.g., physical activity, nutrition, health information seeking); and (5) biological (e.g., inflammatory/pro-metastatic gene expression signaling, cardiometabolic markers, genetic admixture). Participants will be assessed at baseline, 6-months, 12-months and annually thereafter. Methods in multilevel latent longitudinal modeling, cancer genomics and computational biology will be used to test our hypotheses. During the UG3 phase, we will hire and train staff, establish and finalize study protocols, recruit ~18% of the sample and conduct preliminary analyses. During the UH3 phase we will complete recruitment, conduct all remaining assessments, analyze data and disseminate findings to guide and implement secondary and tertiary prevention in H/L survivors.

项目摘要 癌症是美国西班牙裔/拉丁裔（H/LS）中死亡的主要原因。 H/LS帐户为5750万 美国人（18％），现在是未来四十年中最大的少数民族将翻一番。 H/LS具有可变的SES， 耶稣诞生，地理分布，遗传混合以及健康的社会，社会心理和行为决定者。 特定癌症的患病率，侵袭性和死亡率存在着重要的分布（例如子宫颈，肝脏，胃） 在多个患者中，无论疾病部位如何，都报告了结果（PRO）。 H/LS更有可能与 晚期疾病，合并症更大，并报告症状更大，与健康相关的生活质量较差 （HRQOL）。低SE，教育和保险，语言进一步损害了H/LS的生存 障碍和有限的护理机会。 H/LS的生存研究由于以下原因而受到限制：（a）较短的样本 后续行动； （b）专注于普通癌症（例如乳腺或前列腺），限制了对高价值/死亡部位的关注； 限制H/L起源和SES表示； （d）考虑多个确定词的缺乏指导模型（例如， 生存成果的社会文化，医学，压力，社会心理，生活方式，生物学）。 Avanzando Caminos （领先的途径）：西班牙裔/拉丁裔癌症生存队列研究将涉及招聘，评估和 在过去两年中完成了原发性癌症治疗的约3,000 h/l的随访，在H/L中是潜水员 背景，城市与农村居住和癌症现场，跨越了美国两个主要都会区 - 迈阿密和圣 安东尼奥。这两个地区的大多数H/L人口（占迈阿密的65％；占圣安东尼奥的64％），在H/L方面是潜水员 起源和SES，由NCI指定的癌症中心提供。我们将招募一个近似的样本 美国H/L人口的多样性（墨西哥人约50％，其他H/L起源）。佛罗里达癌症数据系统 得克萨斯州癌症登记处将补充招募（约占队列的30％），并建立 代表性。我们的主要结果是症状伯恩（例如疼痛，疲劳，抑郁，认知），HRQOL 和疾病活动（例如进展，复发，癌症和全因死亡率）。我们的跨学科团队有一个 在五个有针对性领域的学术生产力和协作的强烈成功记录将是 评估为我们的结果的确定因素：（1）社会文化（例如SES，适应，文化价值）； （2）压力和 逆境（例如，慢性和创伤性压力，种族压力）； （3）社会心理（例如，社会支持，应对，家庭 凝聚力/冲突）； （4）生活方式和行为（例如体育锻炼，营养，健康信息寻求）； （5） 生物学（例如，炎症/促抗转移基因表达信号传导，心脏代谢标记，遗传混合物）。 参与者将在基线，6个月，12个月以及此后每年进行评估。多级潜在的方法 纵向建模，癌症基因组学和计算生物学将用于检验我们的假设。在 UG3阶段，我们将雇用和培训员工，建立和最终确定学习方案，招募约18％的样本并进行行为 初步分析。在UH3阶段，我们将完成招聘，进行所有剩余评估， 分析数据并传播发现，以指导和实施H/L表面上的二级和三级预防。