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Understanding multilevel drivers of gaps in guideline-concordant endometrial cancer treatment in high-risk populations

Award Number: R37CA266204
ORGANIZATION: NATIONAL CANCER INSTITUTE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 07/01/2022
PERIOD OF PERFORMANCE END DATE: 11/30/2025

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Understanding multilevel drivers of gaps in guideline-concordant endometrial cancer treatment in high-risk populations - Endometrial cancer (EC) demonstrates significant variation in outcomes across patient populations. Receipt of treatment in line with national recommendations is an important modifiable factor that influences EC outcomes. The National Comprehensive Cancer Network recommends surgical staging as the first step of guideline-concordant treatment and pathology factors captured from surgery inform adjuvant treatment recommendations. Our prior work demonstrates that receipt of guideline-concordant EC treatment improves survival. Therefore, observed differences in receipt of such treatment across populations is concerning and contributes to suboptimal disease outcomes. We lack a comprehensive understanding of the multilevel determinants that underlie variation in guideline-concordant EC treatment, preventing any meaningful progress in evidence-based intervention development. The extant literature has exclusively focused on individual-level factors as predictors of guideline-concordant EC treatment, which has not led to sustained improvement in care delivery. In addition, even within guideline-concordant paradigms, there can be wide variation in intensity level of recommended treatments, with markedly different impact on quality of life. The factors influencing intensity of treatment within guideline-concordant paradigms are poorly understood. Most important, there are no qualitative data to understand how patients and providers navigate decision-making regarding EC treatment, particularly in populations at increased risk of receiving non-guideline-concordant care. Absent these critical building blocks, we cannot move forward with evidence-based interventions to improve guideline-concordant EC treatment receipt. We propose to identify determinants of variation in guideline-concordant EC treatment by combining analysis of multilevel data from the Surveillance, Epidemiology, and End Results (SEER)-Medicare claims linked dataset (Aims 1-2) with in-depth interviews of women with EC and EC providers (Aim 3). Aim 1: Identify multilevel factors that predict differences in receipt of guideline-concordant EC treatment. Aim 2: Quantify variation and underlying predictors of guideline-concordant EC treatment intensity and examine associations between guideline-concordant EC treatment intensity and survival. Aim 3: Examine the multilevel dynamics that drive and constrain treatment decision-making using qualitative methods. By analyzing a high-quality, multilevel dataset and capturing first-hand accounts of treatment experiences and preferences, our team will uncover actionable factors that can be targeted to improve care delivery and outcomes for all women.


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: 2026 ( Subtotal = $488,515 )
2026	2026	WAKE FOREST UNIVERSITY HEALTH SCIENCES	MEDICAL CENTER BLVD	WINSTON SALEM	NC	27157	FORSYTH	USA	Cancer Cause and Prevention Research	002	5	7/17/2026	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	-$1,008
2026	2026	WAKE FOREST UNIVERSITY HEALTH SCIENCES	MEDICAL CENTER BLVD	WINSTON SALEM	NC	27157	FORSYTH	USA	Cancer Cause and Prevention Research	001	5	6/30/2026	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$489,523
2026	2025	OHIO STATE UNIVERSITY, THE	1960 KENNY RD	COLUMBUS	OH	43210	FRANKLIN	USA	Cancer Cause and Prevention Research	000	4	6/26/2026	NON-COMPETING CONTINUATION	$0
2026	2025	OHIO STATE UNIVERSITY, THE	1960 KENNY RD	COLUMBUS	OH	43210	FRANKLIN	USA	Cancer Cause and Prevention Research	003	4	7/17/2026	NON-COMPETING CONTINUATION	$0
														Subtotal = $488,515

Issue Date FY: 2025 ( Subtotal = $580,415 )
2025	2025	OHIO STATE UNIVERSITY, THE	1960 KENNY RD	COLUMBUS	OH	43210	FRANKLIN	USA	Cancer Cause and Prevention Research	000	4	8/20/2025	NON-COMPETING CONTINUATION	$580,415
														Subtotal = $580,415

Issue Date FY: 2024 ( Subtotal = $365,082 )
2024	2024	OHIO STATE UNIVERSITY, THE	1960 KENNY RD	COLUMBUS	OH	43210	FRANKLIN	USA	Cancer Cause and Prevention Research	000	3	7/30/2024	NON-COMPETING CONTINUATION	$365,082
														Subtotal = $365,082

Issue Date FY: 2023 ( Subtotal = $476,128 )
2023	2023	OHIO STATE UNIVERSITY, THE	1960 KENNY RD	COLUMBUS	OH	43210	FRANKLIN	USA	Cancer Cause and Prevention Research	000	2	6/28/2023	NON-COMPETING CONTINUATION	$476,128
														Subtotal = $476,128

Issue Date FY: 2022 ( Subtotal = $387,070 )
2022	2022	OHIO STATE UNIVERSITY, THE	1960 KENNY RD	COLUMBUS	OH	43210	FRANKLIN	USA	Cancer Cause and Prevention Research	000	1	6/16/2022	NEW	$387,070
														Subtotal = $387,070

Grand Total All Awards = $2,297,210

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Understanding multilevel drivers of gaps in guideline-concordant endometrial cancer treatment in high-risk populations

Award Number: R37CA266204

ORGANIZATION: NATIONAL CANCER INSTITUTE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

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

PERIOD OF PERFORMANCE START DATE: 07/01/2022

PERIOD OF PERFORMANCE END DATE: 11/30/2025

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