Through this Funding Opportunity Announcement (FOA), the National Cancer Institute (NCI) invites applications describing research focused on improving care and health-related quality of life for childhood, and adolescent and young adult (AYA) cancer survivors. Specifically, this FOA solicits mechanistic, observational, and intervention applications that focus on six key domains: (1) disparities in survivor outcomes; (2) barriers to follow-up care (e.g. access, adherence); (3) impact of familial, socioeconomic, and other environmental factors on survivor outcomes; (4) indicators for long-term follow-up needs related to risk for late effects, recurrence, and subsequent cancers; (5) risk factors and predictors of late/long-term effects of cancer treatment; and (6) development of targeted interventions to reduce the burden of cancer for pediatric/AYA survivors.
Cancer is the leading cause of disease-related death past infancy among children in the United States (U.S.). For 2020, an estimated 11,050 new cases of cancer are expected to be diagnosed among children ages 0 to 14 years and 89,500 among AYAs between ages 15 and 39. Although survival rates vary depending on the type of cancer and other factors (e.g., age at diagnosis, race, socioeconomic status), major treatment advances in recent decades have resulted in more than 80% of children and AYAs with cancer surviving 5 years or more.
The NCI Surveillance, Epidemiology, and End Results Program (SEER) estimates that there are more than 630,000 cancer survivors between the ages 0 to 39 in the United States, and studies suggest that over 60% of these survivors will suffer adverse physical, psychosocial, or behavioral outcomes even months or years after completion of treatment. These disease- and treatment-related adverse outcomes can significantly impair the quality of survival, and therefore, the development of effective strategies to prevent, detect, mitigate, and manage these adverse effects is of high priority. Adverse outcomes can vary in type (physical, behavioral, or psychosocial health effects) and severity (reduced quality of life or lifespan). Common adverse outcomes include premature/accelerated aging, cardiotoxicity, endocrine dysfunction, reproductive health issues, secondary cancers, financial toxicity, neurocognitive deficits, and other psychosocial issues. Barriers to care, especially as survivors transition from pediatric to adult healthcare delivery settings, are also prevalent. Despite a growing awareness of these adverse outcomes, efforts to prevent, mitigate, and manage them are hindered by a variety of factors, including barriers to receiving follow-up care and a paucity of evidence-based tailored interventions to address the burden of morbidity.
Given the increasing number of survivors after cancer diagnosis at young ages (0-39 years of age) and the substantial adverse outcomes associated with cancer and its treatment, the US Congress, recognizing a need for pediatric and/or AYA survivorship research, passed the Childhood Cancer Survivorship, Treatment, Access, and Research (STAR) Act of 2018. The STAR Act was developed in collaboration with many childhood cancer organizations and is a comprehensive, bipartisan childhood cancer bill designed to advance childhood and AYA cancer research and treatments, improve cancer surveillance, and enhance resources for survivors and their families. In addition to supporting improvements in cancer registry infrastructure and biospecimen research, the STAR Act authorizes the NCI to improve the care and quality of life for childhood and AYA cancer survivors by supporting research (including research solicited through this initiative) in six key domains: (1) disparities in survivor outcomes; (2) barriers to follow-up care (e.g. access, adherence); (3) impact of familial, socioeconomic, and other environmental factors on survivor outcomes; (4) indicators for long-term follow-up needs related to risk for late effects, recurrence, and subsequent cancers; (5) risk factors and predictors of late/long-term effects of cancer treatment; and (6) development of targeted interventions to reduce the burden of cancer for pediatric/AYA survivors.
Filed Under: Funding Opportunities