DESCRIPTION (provided by applicant): Despite progress made in early detection and treatment, African Americans continue to experience disproportionately higher cancer incidence rates, are first diagnosed with more advanced stage disease, and suffer higher mortality rates than other populations. The determinants of cancer progression, recurrence, mortality and quality of life in African American cancer survivors are not well studied, with biologic, genetic, environmental, social and behavioral factors contributing. The ~25,000 cancers reported annually among residents of metropolitan Detroit provide the basis for a unique cohort of African American cancer survivors that will include cancer types with both poor outcomes overall (lung cancer and colon cancer) and better outcomes overall (breast and prostate cancer) to study both short term and longer term determinants of survival. The cohort will also include caregivers of a subset of the cases to develop research in the areas of family support and economic burden. The specific aims are to: 1) Enroll a total of 5,560 lung, prostate, breast, and colon population-based African American cancer cases into the Detroit Research on Cancer Survivors (Detroit ROCS) cohort. Participation at baseline will include a web-based or telephone interview, saliva collection, and tumor block retrieval. 2) Enroll a total of 2,780 caregivers of these cases.
For 50% of the cancer cases, one spouse/caregiver will be asked to participate in a web-based or telephone interview. 3) Conduct yearly follow-up for all cancer cases and their caregivers. 4) Evaluate the need for more frequent follow-up and assessment by collecting patient reported outcome data early in the disease course. This will enable more accurate identification of determinants of outcomes. Most cohorts are followed annually or less often. For this cancer cohort, more frequent follow-up will be tested in a subset of the population to evaluate the most valid and least burdensome strategies for participants to report quality of life data during the fist year post treatment. The resulting population-based, African American cancer cohort will support studies addressing determinants of cancer prognosis and progression, survival, and outcomes of cancer-directed therapies. It will be one of the few cohorts to include a large minority community already actively engaged in cancer research, providing substantial data and biospecimens to facilitate studies aimed at understanding and addressing determinants of poor outcomes in this population. This work will be conducted in the context of a community uniquely engaged through our: 1) Community Network Program Center grant (U54) supporting a community based participatory research (CBPR) approach to addressing cancer disparities; 2) NCI-funded SEER cancer registry for population-based ascertainment of cancer cases in an economically depressed area with a large minority population; and 3) an NCI-designated Comprehensive Cancer Center with a strong transdisciplinary research program in cancer health disparities.
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