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Evaluation of genetic, clinical and environmental risk factors to establish effective screening strategies for second primary lung cancer

Award Number: R37CA226081
ORGANIZATION: NATIONAL CANCER INSTITUTE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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Lung cancer (LC) is a leading cause of cancer deaths in the U.S. The widespread adoption of computed tomography (CT) screening enables the early detection of lung cancer and is expected to increase the number of long-term LC survivors. The estimated number of LC survivors is approximately 412,230 as of 2012 and is projected to be over a half million in 2022. Recent studies show that LC survivors have a high risk of developing second primary lung cancer (SPLC), the incidence of which is around 4-6 times higher than that of initial primary lung cancer (IPLC) in the general population. While national lung screening guidelines have been established for IPLC by the U.S. Preventive Services Task Force (USPSTF), no such consensus guidelines exist for LC survivors who are exposed to a high risk of SPLC. Furthermore, the factors that contribute to the development of SPLC have not yet been established. Our long-term goal is to reduce the overall LC mortality in the U.S. population by focusing on SPLC. The overall objectives of this application are to identify the genetic, clinical, and environmental determinants for SPLC, to assess an individual’s risk of developing SPLC, and to evaluate efficient lung screening strategies for SPLC to help inform the development of consensus screening guidelines for LC survivors. Our aims are: (AIM 1) To identify the genetic, environmental, clinical, and demographic risk factors for SPLC and to develop a risk prediction model for SPLC. We will use cohort data from the Transdisciplinary Research in Cancer of the Lung (TRICL) and the International Lung Cancer Consortium (ILCCO) to evaluate risk factors for SPLC; (AIM 2) To evaluate optimal CT screening strategies for SPLC by estimating the population-level harms and benefits of CT screening under various selection criteria. We will develop a stochastic simulation model for SPLC that integrates the incidence, progression, and survival of SPLC to quantify the population-level harms and benefits of screening for SPLC under various risk- based selection criteria; (AIM 3) To estimate the lifetime costs and to assess the cost-effectiveness of CT screening strategies for SPLC in the general U.S. population. The contribution of our research will be significant because it will provide a better understanding of the etiology of SPLC by identifying various risk factors for SPLC using comprehensive population-based data. Second, the completion of our research will provide a valuable decision tool for evaluating an individual’s risk of developing SPLC, which can help identify high-risk individuals for screening. Finally, by evaluating the potential harms and benefits of lung cancer screening for SPLC under various criteria, our research will provide a set of optimal CT screening strategies, the results of which will reduce clinicians’ uncertainty on how to best guide LC survivors for CT screening.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2023 ( Subtotal = $648,460 )
2023	2023	THE LELAND STANFORD JUNIOR UNIVERSITY	450 JANE STANFORD WAY	STANFORD	CA	94305	SANTA CLARA	USA	Cancer Cause and Prevention Research	000	6	4/18/2023	EXTENSION WITH OR WITHOUT FUNDS	$648,460
														Subtotal = $648,460

Issue Date FY: 2022 ( Subtotal = $574,350 )
2022	2022	LELAND STANFORD JUNIOR UNIVERSITY, THE	450 JANE STANFORD WAY	STANFORD	CA	94305	SANTA CLARA	USA	Cancer Cause and Prevention Research	000	5	5/17/2022	NON-COMPETING CONTINUATION	$574,350
														Subtotal = $574,350

Issue Date FY: 2021 ( Subtotal = $589,771 )
2021	2021	LELAND STANFORD JUNIOR UNIVERSITY, THE	450 JANE STANFORD WAY	STANFORD	CA	94305	SANTA CLARA	USA	Cancer Cause and Prevention Research	000	4	4/16/2021	NON-COMPETING CONTINUATION	$589,771
														Subtotal = $589,771

Issue Date FY: 2020 ( Subtotal = $605,892 )
2020	2020	LELAND STANFORD JUNIOR UNIVERSITY, THE	450 JANE STANFORD WAY	STANFORD	CA	94305	SANTA CLARA	USA	Cancer Cause and Prevention Research	000	3	3/25/2020	NON-COMPETING CONTINUATION	$605,892
														Subtotal = $605,892

Issue Date FY: 2019 ( Subtotal = $602,532 )
2019	2019	LELAND STANFORD JUNIOR UNIVERSITY, THE	450 SERRA MALL	STANFORD	CA	94305	SANTA CLARA	USA	Cancer Cause and Prevention Research	000	2	4/10/2019	NON-COMPETING CONTINUATION	$602,532
														Subtotal = $602,532

Issue Date FY: 2018 ( Subtotal = $692,450 )
2018	2018	LELAND STANFORD JUNIOR UNIVERSITY, THE	450 SERRA MALL	STANFORD	CA	94305	SANTA CLARA	USA	Cancer Cause and Prevention Research	000	1	4/25/2018	NEW	$692,450
														Subtotal = $692,450

Grand Total All Awards = $3,713,455

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Evaluation of genetic, clinical and environmental risk factors to establish effective screening strategies for second primary lung cancer

Award Number: R37CA226081

ORGANIZATION: NATIONAL CANCER INSTITUTE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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