Examining the Relationship between Residential History at Midlife and Prostate Cancer Outcomes

检查中年居住史与前列腺癌结果之间的关系

基本信息

批准号：
10584259
负责人：
CHARNITA M. ZEIGLER-JOHNSON
金额：
$ 54.26万
依托单位：
RESEARCH INST OF FOX CHASE CAN CTR
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-08-16 至 2028-02-29
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10584259
关键词：
Address Adult Affect Age Aging Black race Cancer Biology Cancer Patient Caring Censuses Characteristics Chronic stress Cities Clinic Communities Community Healthcare Complex Continuity of Patient Care Cost Control Data Diagnosis Disadvantaged Disease Disease Outcome Disparity Environment Ethnic Population Exposure to Goals Health Health Care Costs Hospitals Incidence Income Individual Inequity Inflammation Intervention Investigation Learning Life Life Cycle Stages Link Longevity Longitudinal Studies Malignant Neoplasms Malignant neoplasm of prostate Measures Medicare Modeling Modification Movement Needs Assessment Neighborhoods Outcome Patient-Focused Outcomes Patients Pattern Pennsylvania Persons Philadelphia Physiological Policies Population Poverty Prostate Race Recording of previous events Records Research Resources Risk Risk Factors Role Strategic Planning Structural Racism Suggestion Survival Rate Survivors Time Tissues Tumor Biology Vulnerable Populations Work anticancer research billing data black men cancer care cancer diagnosis cancer health disparity cancer survival community planning critical period data registry disease disparity effective intervention environment related cancer experience future implementation high risk improved innovation men middle age mortality neoplasm registry novel novel strategies older patient outreach patient registry prostate cancer model prostate cancer risk racial disparity racial population socioeconomics survival disparity survivorship trend tumor progression

Address Adult Affect Age Aging Black race Cancer Biology Cancer Patient Caring Censuses Characteristics Chronic stress Cities Clinic Communities Community Healthcare Complex Continuity of Patient Care Cost Control Data Diagnosis Disadvantaged Disease Disease Outcome Disparity Environment Ethnic Population Exposure to Goals Health Health Care Costs Hospitals Incidence Income Individual Inequity Inflammation Intervention Investigation Learning Life Life Cycle Stages Link Longevity Longitudinal Studies Malignant Neoplasms Malignant neoplasm of prostate Measures Medicare Modeling Modification Movement Needs Assessment Neighborhoods Outcome Patient-Focused Outcomes Patients Pattern Pennsylvania Persons Philadelphia Physiological Policies Population Poverty Prostate Race Recording of previous events Records Research Resources Risk Risk Factors Role Strategic Planning Structural Racism Suggestion Survival Rate Survivors Time Tissues Tumor Biology Vulnerable Populations Work anticancer research billing data black men cancer care cancer diagnosis cancer health disparity cancer survival community planning critical period data registry disease disparity effective intervention environment related cancer experience future implementation high risk improved innovation men middle age mortality neoplasm registry novel novel strategies older patient outreach patient registry prostate cancer model prostate cancer risk racial disparity racial population socioeconomics survival disparity survivorship trend tumor progression

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项目摘要

ABSTRACT Prostate cancer (PCa) is one of a few cancers with more than double the mortality for black men, making this one of the greatest racial disparities in cancer. Although there are documented disparities in PCa incidence and mortality related to where people live, it is unclear how residential histories of patients contribute to their PCa outcomes. Residential environments vary greatly by race and socioeconomics (SES). Still little is known about how longitudinal exposures to neighborhood risk factors and structural racism captured years before a cancer diagnosis and into survivorship contribute to PCa disparities along the cancer care continuum. Additionally, disease outcomes and disparities in PCa are moderated by patient age. Residential history during midlife is one of the factors that likely influences PCa incidence, progression, mortality, and overall care of survivors. We propose an innovative linkage of PA cancer registry data to hospital billing records from the PA Healthcare Cost Containment Council and ~30 years of LexisNexis address data to provide characteristics of census tracts where patients live. We will use Pennsylvania (PA) Cancer Registry data (N~20,000 patients in Southeastern PA) to determine the relationship between longitudinal neighborhood characteristics (poverty trajectories, historical redlining, lending bias, and gentrification) and PCa outcomes at critical points along the cancer care continuum in a diverse and historic region. These various characteristics will be used to determine best practices to examine residential histories in risk modeling for PCa outcomes. We will take a novel life course approach to addressing the role of residential history on PCa disparities. We hypothesize that cumulative exposures as well as exposures to neighborhood risk factors during critical periods in the PCa care trajectory influence disease characteristics at diagnosis and PCa-mortality. Multilevel regression models will be conducted to evaluate independent associations of multi-level factors with PCa outcomes. We will also examine modification by age. The information that we learn from this study will help us to understand ways to integrate residential history in cancer research and strategize about effective interventions to promote prostate health among high-risk adult populations We propose a longitudinal, ambidirectional study to address the following aims: Aim 1: To examine the relationships between PCa disparities and residential characteristics at diagnosis; Aim 2: To We will employ a life-course framework in this examine relationships between PCa disparities and accumulated cancer disparities research (based on Ory, et al. residential history; Aim 3: To examine how residential exposures 2014, AJPM). Disparities occur within an accumulated specifically during midlife are associated with PCa environmental context. Research focused on disparities; Aim 4: Conduct a community needs assessment in particular life stages provide unique opportunities partnership with expert clinician and community planning stakeholders to inform policy, practice, and the health of the to improve PCa outreach and care community.

抽象的前列腺癌（PCA）是少数癌症的癌症之一癌症中最大的种族差异之一。尽管PCA发病率有记录的差异和与人们居住的地方有关的死亡率，目前尚不清楚患者的住宅历史如何贡献 PCA结果。种族和社会经济学（SES）差异很大。仍然鲜为人知关于在邻里风险因素和结构性种族主义几年之前捕获的纵向暴露于多年的纵向暴露癌症诊断并进入生存，导致沿癌症护理连续体的PCA差异。另外，PCA的疾病结局和差异会因患者年龄而缓和。住宅历史在中年期间，可能会影响PCA发病率，进展，死亡率和整体护理的因素之一幸存者。我们建议将PA癌症注册表数据与医院计费记录进行创新联系 PA医疗保健成本控制委员会和约30年的LexisNexis解决数据，以提供特征患者居住的人口普查区。我们将使用宾夕法尼亚州（PA）癌症注册表数据（N〜20,000名患者在宾夕法尼亚州东南部）确定纵向邻里特征之间的关系（贫困轨迹，历史红线，贷款偏见和高档化）以及沿着关键点的PCA结果癌症护理连续性在一个多样化和历史悠久的地区。这些各种特征将用于确定在PCA结果的风险建模中检查住宅历史的最佳实践。我们将带来新的生活解决住宅历史作用的课程方法 PCA差异。我们假设累积暴露作为关键时期内对邻里风险因素的暴露 PCA护理轨迹影响疾病特征诊断和PCA验证。多级回归模型将是进行评估多层次的独立关联 PCA结果的因素。我们还将通过年龄。我们从这项研究中学到的信息将帮助我们了解整合癌症研究中的住宅历史的方法并制定有效干预措施以促进前列腺高风险的成人人群的健康我们提出了一项纵向的，歧义研究，以解决以下目的：目标1：检查PCA之间的关系诊断时的差异和住宅特征；目标2：我们将在此中采用生命课程框架检查PCA差异与累积的癌症差异研究之间的关系（基于Ory等。住宅历史；目标3：检查2014年住宅暴露方式，AJPM）。差异发生在在中年期间，专门累积与PCA环境环境有关。研究的重点是差异；目标4：在特定的生活阶段进行社区需求评估提供了独特的机会与专业临床医生和社区计划利益相关者的合作关系，以告知政策，实践和健康改善PCA外展和护理社区。