Commonly Used Medications and Risk of Colorectal Cancer Recurrence

常用药物和结直肠癌复发的风险

基本信息

批准号：
8893913
负责人：
Jessica Chubak
金额：
$ 54.08万
依托单位：
KAISER FOUNDATION HEALTH PLAN OF WASHINGTON
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-09-19 至 2016-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8893913
关键词：
Acetaminophen Address Adrenergic beta-Antagonists Affect Age American Angiotensin-Converting Enzyme Inhibitors Animals Anti-Inflammatory Agents Anti-inflammatory Antibiotics Antidepressive Agents Apoptosis Aspirin Benefits and Risks Budgets Calcium Channel Blockers Cancer Etiology Cancer Patient Cancer Research Network Cancer Survivor Cell Proliferation Cessation of life Chemopreventive Agent Cholesterol Chronic Cohort Studies Colorectal Cancer Comorbidity Country Data Data Quality Databases Diabetes Mellitus Diagnosis Disease Disease-Free Survival Diuretics Epidemiologic Studies Gastrins Goals Growth Health Health Personnel Health Planning Histamine Hormone replacement therapy Hormones Hyperinsulinism Hypertension In Vitro Incidence Inflammation Insulin Laboratory Animals Life Link Malignant Neoplasms Malignant neoplasm of prostate Medical Mental Depression Metformin Methods National Cancer Institute Non-Steroidal Anti-Inflammatory Agents Opioid Outcome Pathway interactions Patients Pharmaceutical Preparations Preventive Proton Pump Inhibitors Provider Public Health Recording of previous events Recurrence Relative Risks Research Risk Risk Factors Signal Transduction Staging Sulfonylurea Compounds Surveys Survival Analysis System Testing Therapeutic Agents United States Woman age group angiogenesis cancer cell cancer diagnosis cancer recurrence cancer risk clinically relevant cost effective evidence base health care delivery immune function improved malignant breast neoplasm men modifiable risk mortality multiple chronic conditions population based prevent tumor registry

项目摘要

DESCRIPTION (provided by applicant): Currently, more than 1,200,000 people in the United States are colorectal cancer (CRC) survivors; each year, 140,000 more Americans are diagnosed with the disease. Finding cost-effective ways to prevent CRC recurrence is therefore an important public health goal. The long-term objective of our research is to improve the health of cancer survivors in the real world, where people have chronic conditions for which they take prescription and over-the-counter medications. Our objective aligns with the National Cancer Institute's Annual Plan and Budget Proposal for Fiscal Year 2012, which highlights the importance of research on multiple chronic conditions in cancer patients. With a median age at diagnosis of 70 years, CRC tends to occur in an age group burdened with comorbidities. Medications for these conditions are linked to CRC risk in laboratory, animal, and epidemiologic studies. However, surprisingly little is known about how medications commonly used to treat prevalent chronic conditions, such as diabetes and hypertension, affect CRC recurrence risk. Therefore, we seek to evaluate the influence of commonly used medications on CRC recurrence. Our hypothesis is that medications are modifiable risk factors, with some showing promise as chemo preventive agents and some associated with an increased risk of recurrence in CRC survivors. We will test our hypotheses through a retrospective population-based cohort study in two integrated healthcare delivery systems. We will identify approximately 3300 incident stage I-IIIA colorectal cancers diagnosed from 1995- 2014. Cancer recurrence-which is not documented in tumor registries-will be ascertained from targeted medical chart review. By relying on a database of all dispensed medications and reviewing medical charts for over-the-counter medications, the study will avoid selection and recall bias. High-quality information on factors that might confound analyses will be efficiently collected from targeted chart review, complete automated health plan data, and surveys of recently diagnosed patients. A variety of well-established methods will be used to control for confounding in survival analysis to produce estimates of the relative risk of recurrence associated with common medications. Secondary analyses will focus on disease-free survival and all-cause mortality. The results from this clinically relevant, high-impact study will help CRC survivors and their providers make evidence-based decisions about how to manage chronic conditions.

描述（由申请人提供）：目前，美国有超过1,200,000人是大肠癌（CRC）幸存者；每年，有14万名美国人被诊断出患有这种疾病。因此，寻找具有成本效益的方法来预防CRC复发是一个重要的公共卫生目标。我们研究的长期目标是改善现实世界中癌症幸存者的健康状况，在这种情况下，人们患有慢性疾病，他们为此服用处方药和非处方药。我们的目标与美国国家癌症研究所（National Cancer Institute）2012财政年度的年度计划和预算提案保持一致，该计划凸显了研究对癌症患者多种慢性病的重要性。随着诊断为70岁的中位年龄，CRC往往发生在负担合并症的年龄段。这些条件的药物与实验室，动物和流行病学研究中的CRC风险有关。然而，令人惊讶的是，人们对治疗普遍的慢性疾病的常用药物（例如糖尿病和高血压）如何影响CRC复发风险。因此，我们试图评估常用药物对CRC复发的影响。我们的假设是药物是可改变的危险因素，其中一些表现为化学预防剂的希望，有些则与CRC幸存者复发的风险增加有关。我们将通过在两个综合的医疗保健输送系统中进行基于人群的研究研究来检验我们的假设。我们将确定从1995年至2014年诊断出的大约3300阶段的I-IIIA结直肠癌。通过依靠所有分配药物的数据库并审查非处方药的医学图表，该研究将避免选择和回忆偏见。有关可能混淆分析因素的高质量信息将有效地从目标图表审查，完整的自动化健康计划数据以及对最近诊断的患者的调查中收集。各种公认的方法将用于控制生存分析中的混淆，以产生与常见药物相关的相对复发风险的估计。次级分析将集中于无疾病的生存和全因死亡率。这项临床相关，高影响研究的结果将帮助CRC幸存者及其提供者就如何管理慢性病做出基于证据的决定。