Key Dates

Related Announcements

PAR-20-185 - NIH Research Project Grant (Parent R01 Clinical Trial Not Allowed)

PAR-18-869 - Modular R01 In Cancer Control and Population Sciences (R01 Clinical Trial Optional)

PAR-20-088 - Mechanisms of Disparities in Chronic Liver Diseases and Cancer (R01 Clinical Trial Not Allowed)

PAR-20-081 - Mechanisms of Disparities in Chronic Liver Diseases and Cancer (R21 Clinical Trial Not Allowed)

PAR-20-079 - Surgical Disparities Research (R01 Clinical Trial Optional)

RFA-CA-20-027 - Research to Reduce Morbidity and Improve Care for Pediatric, and Adolescent and Young Adult (AYA) Cancer Survivors (R01 Clinical Trial Optional)

RFA-CA-20-028 - Research to Reduce Morbidity and Improve Care for Pediatric, and Adolescent and Young Adult (AYA) Cancer Survivors (R21 Clinical Trial Optional)

Issued by

National Cancer Institute (NCI)

Purpose

The National Cancer Institute (NCI) is issuing this Notice of Special Interest (NOSI) to encourage applications that efficiently use the existing cancer registry infrastructure by augmenting existing data with additional information not routinely collected by registries to study observed health disparities such as those that exist by race, ethnicity, socioeconomic status, income, insurance status, age, education level, or geographic area. The Surveillance, Epidemiology, and End Results (SEER) Program and the National Program of Cancer Registries (NPCR) are uniquely positioned to support research to assess health disparities in the United States (US) population because they contain information on all cases diagnosed within geographically defined areas. The goal of these hypothesis-driven studies should be to understand why disparities in cancer treatment and outcomes persist by identifying factors contributing to disparities and their relative importance.

Background

Cancer registries represent a sampling frame of cancer patients that contain considerable information on patient demographics, primary tumor site, tumor morphology and stage at diagnosis, first course of treatment, and follow-up for mortality outcomes. Additionally, SEER registries collect information on several key predictive and prognostic factors, such as HER2 for breast cancer, PSA for prostate cancer, and HPV status for some cancers. Many registries can identify cases soon after diagnosis (called rapid case ascertainment) for inclusion in studies.

The US cancer registry system represents a considerable investment toward establishing the infrastructure needed to collect information on individuals diagnosed with cancer. Data from cancer registries are often used to identify observed disparities in treatment and outcomes. These findings lead to hypotheses as to why disparities are occurring.

Research Objectives

NCI is interested in hypothesis-driven research that utilizes the national cancer registry infrastructure to study disparities related to the cancer treatment received and outcomes (such as survival, mortality, quality of life, financial hardship) among different population groups who are diagnosed with cancer. Although existing data sources provide the foundation for population-based research, understanding factors that contribute to health disparities is a complex and multifaceted problem and often requires information beyond that routinely captured. For the projects supported by this NOSI, registry data may be augmented through linkages with other data sources, analysis of biospecimens, or additional data collection such as surveying cancer patients or physicians.

Studies using these data will provide insight into the factors, and their relative importance, that lead to the disparate treatment and outcomes experienced by different population groups. Such studies constitute a necessary first step in designing and implementing effective interventions to eliminate those disparities.

Examples of the types of analyses supported by this NOSI include, but are not limited to:

• Understanding why some populations are less likely to receive recommended treatment:

• The role of patient decision-making process and patient preference;
• Patient/provider communication and cultural competence;
• Prevalence of adverse events related to medication;
• Relationship between physical functioning/severity of comorbidities and appropriateness of treatment and outcomes;
• Utilization of genomic testing for targeting treatment.

• Assessing the prognostic and predictive value of specific biomarkers in cancer incidence, progression and treatment:

• Evaluating differences in molecular subtype of tumors at the time of diagnosis and understanding how they impact outcomes.

• Understanding the role of behavior/lifestyle factors on recurrence and survival after diagnosis:

• Impact of health behaviors (diet and physical activity; tobacco use; stress management) on cancer outcomes for cancer survivors.

• Impact of socioeconomic status and geographic area of residence on treatment received:

• Factors influencing access to care;
• Financial toxicity due to cancer diagnosis and treatment.

• Urban/rural differences:

• Differences in access to health care;
• Characteristics of medical practices/hospitals for treatment in urban and rural areas.

• Role of cultural environment and social support on cancer outcomes:

• Influence of ethnicity and culture on patient health literacy, decision making and preferences;
• Challenges of immigrant populations.

Responsiveness

Applicants submitting applications in response to this NOSI must:

1. Develop a hypothesis-driven study designed to better understand why some groups are less likely to receive recommended treatment and/or are experiencing worse outcomes after a cancer diagnosis
2. Work with population-based cancer registry(ies) to utilize existing infrastructure and data collected by registries to study a targeted sample of cases
3. Augment the data routinely collected by cancer registries with additional information to investigate the causes of observed health disparities

Application and Submission Information

This NOSI applies to Application Due Dates on or after February 5, 2021 and subsequent receipt dates through May 7, 2023.

Submit applications for this initiative using one of the following funding opportunity announcements (FOAs) or any reissues of these FOAs through the expiration date of this Notice.

All instructions in the Application Guide and the funding opportunity announcement used for submission must be followed, with the following additions:

• For funding consideration, applicants must include NOT-CA-21-020 in the Agency Routing Identifier field (box 4B) of the SF424 R&R form. Applications without this information in box 4B will not be considered for this initiative.

Applications nonresponsive to terms of this NOSI will not be considered for the NOSI initiative.

Inquiries

Scientific/Research Contacts:

Kathy Cronin, Ph.D.
National Cancer Institute (NCI)
Telephone: 240-276-6836
Email:[email protected]

Nadia Howlader, Ph.D.
National Cancer Institute (NCI)
Telephone: 240-276-6891
Email:[email protected]