A Prospective Study of the Impact of Breast Cancer on Symptoms and Functioning

乳腺癌对症状和功能影响的前瞻性研究

• 批准号: 9513487
• 负责人: NANCY E AVIS
• 金额: $ 5.54万
• 依托单位: WAKE FOREST UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-07-01 至 2020-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9513487
• 关键词: Adverse effects; Age; Anxiety; Biological Assay; Body mass index; Breast Cancer survivor; C-reactive protein; Cancer Survivor; Characteristics; Cognition; Cognitive; Data; Diagnosis; Diagnostic; Early identification; Fatigue; Frequencies; Growth; Health; Impairment; Inflammation; Intervention; Knowledge; Malignant Neoplasms; Measures; Mediating; Menopause; Mental Depression; Mental Health; Outcome; Outcome Measure; Outcome Study; Pain; Participant; Perimenopause; Physical Function; Physical activity; Play; Prospective Studies; Psychosocial Factor; Quality of life; Radiation; Radiosurgery; Recording of previous events; Reporting; Research; Risk; Role; Running; Sampling; Sex Functioning; Sleep; Sleep Disorders; Smoking; Social support; Specific qualifier value; Stage at Diagnosis; Study of Women' s Health Across the Nation; Survivors; Symptoms; Techniques; Time; Vasomotor; Visit; Weight; Woman; Women' s Group; Work; aging population; breast cancer diagnosis; cancer diagnosis; cancer therapy; chemotherapy; cognitive function; cohort; comparison group; cost; depressive symptoms; design; experience; follow-up; improved; inflammatory marker; innovation; malignant breast neoplasm; member; mortality; older women; physical conditioning; public health relevance; racial and ethnic; repository; screening

 DESCRIPTION (provided by applicant): Breast cancer is the most frequently occurring cancer among US women. Largely due to improvements in screening and treatment, breast cancer mortality rates in the US have declined significantly since 1975. In combination with an aging population, the number of breast cancer survivors has grown and is projected to continue increasing. Currently, an estimated 2.7 million breast cancer survivors are alive in the US, and nearly 90% of the estimated 232,340 women diagnosed with breast cancer this year will be alive 5 years after diagnosis. Breast cancer survivors may experience short- and long-term adverse effects, including reduced quality of life, sexual, and cognitive functioning; and increased fatigue, depression, and vasomotor symptoms (VMS). Existing research has studied these outcomes following a cancer diagnosis, but to our knowledge, none has compared cancer survivors to appropriate controls, had lengthy pre-and post-diagnosis data, and examined multiple relevant outcomes over time in a single cohort with longitudinal data. The proposed research capitalizes on existing data from a multiethnic/racial cohort of 3302 women who were pre- and early peri-menopausal at baseline and have been followed through the menopausal transition in the Study of Women's Health Across the Nation (SWAN) with 15 visits over nearly 20 years. The proposed research will use innovative statistical techniques to provide a comprehensive view of the impact of breast cancer on a range of outcomes and begin to explore the role that inflammation plays in these outcomes. Specifically, we aim to: 1) compare women who develop incident breast cancer in the SWAN cohort to those who have not developed cancer to determine the impact of breast cancer diagnosis and treatment on symptoms (fatigue, depression, VMS, sleep problems), functioning (sexual, cognitive), and quality of life; 2) among women with breast cancer only, examine the impact of cancer treatment (chemotherapy, radiation), age at diagnosis, time since diagnosis, menopausal stage at diagnosis, and psychosocial factors on the above outcomes, as well as on newly acquired in-depth measures of fatigue, illness intrusiveness, and cancer-related quality of life, and consider outcomes jointly to identify different "states" or profiles of women; and 3) as an exploratory aim, we will compare breast cancer survivors and age-matched controls to examine the impact of cancer and/or treatment on hs-CRP, examining the time course of inflammation between the two groups and whether this inflammatory marker is associated with the impact of cancer on fatigue, depression, sleep, and/or cognition. The proposed research capitalizes on an existing comparison group within the SWAN cohort, detailed pre-and post-diagnostic information already available in SWAN, and use of analytic approaches, such as latent growth analysis to identify different trajectories of outcomes. Our results will also further advance our knowledge of the relationships between inflammation and symptoms of fatigue, depression, sleep, and cognition. The proposed work will allow for improved risk profiles to accelerate interventions specific to cancer survivors.

 描述（由申请人提供）：乳腺癌是美国女性中最常见的癌症，这在很大程度上得益于筛查和治疗的改进，自 1975 年以来，美国乳腺癌死亡率已显着下降。加上人口老龄化，乳腺癌死亡率大幅下降。目前，美国估计有 270 万乳腺癌幸存者，其中近 90% 的患者今年被诊断患有乳腺癌，估计有 232,340 名女性。诊断后 5 年内，乳腺癌幸存者可能会经历短期和长期的不良影响，包括生活质量、性功能和认知功能下降；以及疲劳、抑郁和血管舒缩症状 (VMS) 增加。研究了癌症诊断后的这些结果，但据我们所知，没有人将癌症幸存者与适当的对照进行比较，拥有冗长的诊断前和诊断后数据，并在单个队列中用纵向数据检查多个提出的相关结果。利用现有数据全国妇女健康研究 (SWAN) 对 3302 名基线处于绝经前和围绝经早期妇女的多民族/种族队列进行了跟踪，在近 20 年的时间里进行了 15 次访问。使用创新的统计技术来全面了解乳腺癌对一系列结果的影响，并开始探索炎症在这些结果中所扮演的角色，具体来说，我们的目标是：1）比较女性。将 SWAN 队列中发生乳腺癌的患者与未患癌症的患者进行比较，以确定乳腺癌诊断和治疗对症状（疲劳、抑郁、VMS、睡眠问题）、功能（性、认知）和生活质量的影响； 2) 仅在患有乳腺癌的女性中，检查癌症治疗（化疗、放疗）、诊断时的年龄、诊断后的时间、诊断时的绝经期和社会心理因素对上述结果以及新获得的疾病的影响。疲劳、疾病的深度测量侵入性和癌症相关的生活质量，并共同考虑结果以确定女性的不同“状态”或概况；3）作为探索性目标， 我们将比较乳腺癌幸存者和年龄匹配的对照组，以检查癌症和/或治疗对 hs-CRP 的影响，检查两组之间炎症的时间进程以及该炎症标志物是否与癌症对疲劳的影响相关拟议的研究利用了 SWAN 队列中现有的比较组、SWAN 中已有的详细诊断前和诊断后信息，以及使用分析方法（例如潜在生长分析）来识别。不同的轨迹我们的研究结果还将进一步增进我们对炎症与疲劳、抑郁、睡眠和认知症状之间关系的认识。拟议的工作将有助于改善风险状况，从而加快针对癌症幸存者的干预措施。