Optimizing Colorectal Cancer Screening PREcision and Outcomes in CommunIty-baSEd Populations (PRECISE)

优化社区人群的结直肠癌筛查精度和结果 (PRECISE)

基本信息

批准号：
10611337
负责人：
DOUGLAS Allen CORLEY
金额：
$ 56.47万
依托单位：
KAISER FOUNDATION RESEARCH INSTITUTE
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-04-15 至 2025-03-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10611337
关键词：
Address Adherence Adult African American population Age Area Asian Americans Behavioral Sciences Cancer Center Cancer Etiology Cessation of life Clinical Trials Collaborations Colonoscopy Colorectal Colorectal Cancer Communities Consultations Data Data Collection Data Element Data Pooling Data Set Deductibles Detection Diagnosis Disparity Early Diagnosis Effectiveness Eligibility Determination Evaluation Excision Failure Fee-for-Service Plans Geography Goals Guidelines Health system Healthcare Hispanic Populations Impairment Incentives Incidence Insurance Intervention Leadership Malignant Neoplasms Malignant neoplasm of cervix uteri Malignant neoplasm of lung Manuscripts Measures Medicaid Medicare Meta-Analysis Methods Modality Modeling Morbidity - disease rate NCI Center for Cancer Research Observational Study Organ Outcome Patients Pattern Persons Physicians Polypectomy Polyps Population Precancerous Polyp Process Productivity Provider Publications Publishing Recommendation Research Resources Risk Risk Estimate Scientist Screening for cancer Site Surveys System Testing United States Variant adenoma age stratification aged barrier to care cancer diagnosis colon cancer patients colorectal cancer risk colorectal cancer screening demographics design disparity reduction effective intervention effectiveness testing follow-up high risk human very old age (85+)improved mortality older patient personalized screening pilot test population based preventable death public health relevance safety net screening screening guidelines sex symposium theories validation studies

项目摘要

Colorectal cancer (CRC) is the second leading cause of cancer death in the United States. Most deaths are preventable through early detection, but failures of screening completion and quality substantially impair test effectiveness. This proposal unites the productive PROSPR I CRC Centers into a single collaboration to address key questions and pilot interventions to improve CRC screening outcomes. In PROSPR I, we developed a strong transdisciplinary, multisite collaboration. We collected 316 data elements, performed validation studies, created high-quality pooled data sets to identify patient, provider, and system gaps in the CRC screening process factors and published >60 manuscripts. Our unified PROSPR II Research Center (PRC) will use these proven collaborations and >10 years of longitudinal data for >8.9 million screen-eligible people (~ 1 of 40 eligible people in the US), large numbers of screening exposures (>8.4 million fecal immunochemical tests [FIT] and >1.9 million colonoscopies), and outcomes (>28,000 CRCs). Our PRC is geographically, demographically and economically diverse (three states, >800,000 African Americans, 1.6 million Hispanics, and 1 million Asian Americans). The health systems have different CRC screening patterns, different modalities, and include all major insurance/reimbursement methods (safety net, Medicare, Medicaid, high-deductible and pre-paid/fee-for-service, staff-model and incentivized providers). Our PROSPR I research identified major deficiencies in three areas of CRC screening: who should get screening and surveillance and when; why people do not complete recommended screening, surveillance or follow-up of positive tests; and how test quality and accuracy can be improved. Project 1 will identify on whom and when screening should be performed, particularly for those with conflicting recommendations (e.g., African Americans aged 40-49 years, and patients 76-85 years old). Project 2 will evaluate when surveillance should occur after a precancerous polyp diagnosis, using baseline colonoscopy results and precise new 10-year risk estimates for CRC. Project 3 will explore long-term screening patterns and multilevel drivers of why screening and surveillance are not appropriately completed, especially in understudied patients who never screen, fail to re-screen, use surveillance inappropriately or fail to follow up after a positive screening test. Project 4 will evaluate how to increase the effectiveness of FIT and colonoscopy by optimizing age- and sex-stratified quantitative FIT abnormal ranges, establishing precise adenoma detection thresholds for quality improvement and evaluating drivers of adenoma detection. We will use results from these observational studies, behavioral science methods, and stakeholder involvement to develop and pilot test multilevel interventions. Our transdisciplinary team of scientists, physicians, and healthcare experts will also provide leadership and data for trans-PROSPR, multiple-organ collaborations. The proposed research can substantially decrease the burden of CRC by reducing disparities and identifying ways to improve screening completion and effectiveness.

结直肠癌（CRC）是美国癌症死亡的第二大原因。大多数死亡是通过早期检测可以预防，但筛查完成和质量的失败会严重影响测试效力。该提案将富有成效的 PROSPR I CRC 中心联合起来进行单一合作，以解决关键问题和试点干预措施，以改善结直肠癌筛查结果。在 PROSPR I 中，我们建立了强大的跨学科、多地点合作。我们收集了 316 个数据元素，执行验证研究，创建了高质量的汇总数据集，以确定患者、提供者和系统中的差距 CRC 筛选过程因素并发表超过 60 篇手稿。我们统一的 PROSPR II 研究中心 (PRC) 将使用这些经过验证的合作和超过 10 年的纵向数据来处理超过 890 万个符合银幕资格的内容人（~美国 40 名符合条件的人中的 1 人），大量筛查暴露（> 840 万粪便免疫化学测试 [FIT] 和 >190 万次结肠镜检查）和结果（>28,000 个 CRC）。我们的中华人民共和国是地理、人口和经济多样化（三个州，>800,000 非裔美国人，1.6 100 万西班牙裔美国人和 100 万亚裔美国人）。卫生系统有不同的结直肠癌筛查模式，不同的方式，并包括所有主要的保险/报销方法（安全网、医疗保险、医疗补助、高免赔额和预付费/按服务收费、员工模式和激励提供者）。我们的 PROSPR I 研究发现了 CRC 筛查三个领域的主要缺陷：谁应该接受筛查和监测以及何时进行；为什么人们不完成建议的筛查、监测或阳性检测结果的跟进；以及如何提高测试质量和准确性。项目 1 将确定针对谁以及何时应该进行筛查，特别是对于那些有相互冲突的建议的人（例如，非洲美国人年龄为 40-49 岁，患者年龄为 76-85 岁）。项目 2 将评估何时应进行监测使用基线结肠镜检查结果和精确的新 10 年风险诊断出癌前息肉后发生 CRC 的估计。项目 3 将探索长期筛查模式和筛查原因的多层次驱动因素和监测没有适当完成，特别是在从未进行过筛查、未能进行充分研究的患者中重新筛查、不恰当地使用监测或在筛查测试呈阳性后未能跟进。项目4将评估如何通过优化年龄和性别分层来提高 FIT 和结肠镜检查的有效性定量FIT异常范围，建立精确的腺瘤检测阈值以提高质量并评估腺瘤检测的驱动因素。我们将使用这些观察性研究、行为学研究的结果科学方法和利益相关者参与制定和试点多层次干预措施。我们的由科学家、医生和医疗保健专家组成的跨学科团队也将为 trans-PROSPR，多器官协作。拟议的研究可以大大减轻负担通过减少差异并确定提高筛查完成度和有效性的方法来提高 CRC 的水平。

项目成果

期刊论文数量（23）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Natural Language Processing for the Accurate Identification of Colorectal Cancer Mismatch Repair Status in Lynch Syndrome Screening.

自然语言处理在林奇综合征筛查中准确识别结直肠癌错配修复状态。

DOI：
发表时间：
2021
期刊：
影响因子：
0
作者：
Li, Dan;Udaltsova, Natalia;Layefsky, Evan;Doan, Cecilia;Corley, Douglas A
通讯作者：
Corley, Douglas A

Predicting Risk of Colorectal Cancer After Adenoma Removal in a Large Community-Based Setting.

在大型社区环境中预测腺瘤切除后患结直肠癌的风险。

DOI：
发表时间：
2024-04-11
期刊：
影响因子：
0
作者：
Lee, Jeffrey K;Jensen, Christopher D;Udaltsova, Natalia;Zheng, Yingye;Levin, Theodore R;Chubak, Jessica;Kamineni, Aruna;Halm, Ethan A;Skinner, Celette S;Schottinger, Joanne E;Ghai, Nirupa R;Burnett;Issaka, Rachel;Corley, Dougl
通讯作者：
Corley, Dougl

Early Screening of African Americans (45-50 Years Old) in a Fecal Immunochemical Test-Based Colorectal Cancer Screening Program.

基于粪便免疫化学测试的结直肠癌筛查计划对非裔美国人（45-50 岁）进行早期筛查。

DOI：
发表时间：
2020
期刊：
影响因子：
29.4
作者：
Levin, Theodore R;Jensen, Christopher D;Chawla, Neetu M;Sakoda, Lori C;Lee, Jeffrey K;Zhao, Wei K;Landau, Molly A;Herm, Ariel;Eby, Eryn;Quesenberry, Charles P;Corley, Douglas A
通讯作者：
Corley, Douglas A

Early assessment of the first wave of the COVID-19 pandemic on cancer screening services: The International Cancer Screening Network COVID-19 survey.

第一波 COVID-19 大流行对癌症筛查服务的早期评估：国际癌症筛查网络 COVID-19 调查。

DOI：
发表时间：
2021-10
期刊：
影响因子：
5.1
作者：
Puricelli Perin, Douglas M;Elfström, K Miriam;Bulliard, Jean;Burón, Andrea;Campbell, Christine;Flugelman, Anath A;Giordano, Livia;Kamineni, Aruna;Ponti, Antonio;Rabeneck, Linda;Saraiya, Mona;Smith, Robert A;Broeders, Mireille J M;Internat
通讯作者：
Internat

Impact of a scalable training program on the quality of colonoscopy performance and risk of postcolonoscopy colorectal cancer.

可扩展的培训计划对结肠镜检查表现质量和结肠镜检查后结直肠癌风险的影响。

DOI：
发表时间：
2023-10
期刊：
影响因子：
7.7
作者：
Corley, Douglas A;Jensen, Christopher D;Lee, Jeffrey K;Levin, Theodore R;Zhao, Wei K;Schottinger, Joanne E;Ghai, Nirupa R;Doubeni, Chyke A;Halm, Ethan A;Sugg Skinner, Celette;Udaltsova, Natalia;Contreras, Richard;Fireman, Bruce H;Quesenberry
通讯作者：
Quesenberry