R01CA252182

Identifying Modifiable Factors That Reduce the Burden of Late Stage Melanoma in Hispanics - Project Summary

Hispanics are diagnosed with melanoma at later stages than their non-Hispanic White (NHW) counterparts, leading to increased likelihood of metastasis and worse survival. Hispanics are the largest ethnic group in the United States and have rising rates of melanoma, and in particular, increases in tumors with the worst prognosis.

Hispanics represent an underserved and understudied population when it comes to melanoma occurrence and outcome. In our recent analysis, while the risk of presenting with a late stage melanoma was higher for Hispanics (OR: 1.65 [95% CI: 1.52-1.79]) than NHW, the overall risk of death from melanoma after accounting for stage at diagnosis was similar for Hispanics and NHW (HR: 0.99 [95% CI: 0.94-1.04]), implying that the overall poorer prognosis for Hispanics is due almost entirely to their later stage of disease at diagnosis, rather than response to treatment or other factors (e.g. ability to access treatment) once they are diagnosed.

A later stage of diagnosis among Hispanics could be due to a multitude of factors all of which are modifiable: a lack of access to appropriate screening, lack of adherence to screening recommendations, lack of understanding of appropriate screening approaches in the primary care setting (among both patients and physicians), or a combination of these factors. The key question remaining to be answered is why Hispanics are diagnosed at a later stage: without answering that question, we cannot begin to design, test and implement effective interventions to improve earlier detection and reduce melanoma-related disparities for Hispanics.

We will investigate modifiable factors related to diagnosis at later stage in Hispanics compared to NHW.

Aim 1: Determine the roles of patient-perceived risk and knowledge of melanoma, perceived barriers to melanoma screening and diagnosis, patient access to screening and diagnosis, and cultural factors in determining the later stage at diagnosis of melanoma in Hispanic compared to NHW melanoma patients.

Aim 2: Determine how, when and by whom melanomas are diagnosed (among Hispanics and NHW) and what factors are related to time delays in the diagnosis of melanoma.

Aim 3: Develop, deliver and test a clinic-based health education telenovela intervention designed to achieve earlier diagnosis of melanoma among Hispanics.

We will obtain data from multiple sources for this study in order to minimize the potential impact of selection, response and survival biases all of which would compromise the scientific rigor of our approach. We will identify the key factors resulting in late diagnosis of melanoma among Hispanics to provide truly population-based data on how to develop targeted patient-and-systems level interventions to reduce the melanoma burden among Hispanics. We will then test targeted patient-and-physician level interventions carried out in low-income primary care settings, ensuring that we intervene at the earliest possible stage.

University Of Southern California

TO IDENTIFY CANCER RISKS AND RISK REDUCTION STRATEGIES, TO IDENTIFY FACTORS THAT CAUSE CANCER IN HUMANS, AND TO DISCOVER AND DEVELOP MECHANISMS FOR CANCER PREVENTION AND PREVENTIVE INTERVENTIONS IN HUMANS. RESEARCH PROGRAMS INCLUDE: (1) CHEMICAL, PHYSICAL AND MOLECULAR CARCINOGENESIS, (2) SCREENING, EARLY DETECTION AND RISK ASSESSMENT, INCLUDING BIOMARKER DISCOVERY, DEVELOPMENT AND VALIDATION, (3) EPIDEMIOLOGY, (4) NUTRITION AND BIOACTIVE FOOD COMPONENTS, (5) IMMUNOLOGY AND VACCINES, (6) FIELD STUDIES AND STATISTICS, (7) CANCER CHEMOPREVENTION AND INTERCEPTION, (8) PRE-CLINICAL AND CLINICAL AGENT DEVELOPMENT, (9) ORGAN SITE STUDIES AND CLINICAL TRIALS, (10) HEALTH-RELATED QUALITY OF LIFE AND PATIENT-CENTERED OUTCOMES, AND (11) SUPPORTIVE CARE AND MANAGEMENT OF SYMPTOMS AND TOXICITIES. SMALL BUSINESS INNOVATION RESEARCH (SBIR) PROGRAM: TO EXPAND AND IMPROVE THE SBIR PROGRAM, TO STIMULATE TECHNICAL INNOVATION, TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT FUNDING, TO INCREASE SMALL BUSINESS PARTICIPATION IN FEDERAL RESEARCH AND DEVELOPMENT, AND TO FOSTER AND ENCOURAGE PARTICIPATION IN INNOVATION AND ENTREPRENEURSHIP BY WOMEN AND SOCIALLY/ECONOMICALLY DISADVANTAGED PERSONS. SMALL BUSINESS TECHNOLOGY TRANSFER (STTR) PROGRAM: TO STIMULATE AND FOSTER SCIENTIFIC AND TECHNOLOGICAL INNOVATION THROUGH COOPERATIVE RESEARCH AND DEVELOPMENT CARRIED OUT BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO FOSTER TECHNOLOGY TRANSFER THROUGH COOPERATIVE RESEARCH AND DEVELOPMENT BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT FUNDING, AND FOSTER PARTICIPATION IN INNOVATION AND ENTREPRENEURSHIP BY WOMEN AND SOCIALLY/ECONOMICALLY DISADVANTAGED PERSONS.

93.393 - Cancer Cause and Prevention Research

National Cancer Institute (NCI) [HHS - NIH]

Los Angeles, California 900323649 United States

Single Zip Code

Cancer Prevention and Control Clinical Trials Grant Program (R01 Clinical Trial Required) (PAR-18-559)

Amendment Since initial award the total obligations have increased 387% from $675,213 to $3,286,805.