The aims of this proposal are to (1) enable the candidate to further develop her research program focused on improving cancer screening and prevention in older adults and (2) use her research program as a platform for mentoring junior patient-oriented investigators interested in aging research, both within Geriatrics and within the medical subspecialties. The candidate is a Geriatrician who has established a high-impact independent clinical research program that is well funded with an outstanding publication record. In the 10 years since completing her Geriatrics fellowship she has established herself as a successful mentor of students, fellows, and junior faculty who have published high-impact aging research, become successfully funded, and continue to participate in patient-oriented research in aging. The candidate has developed an extensive research portfolio focused on the outcomes of cancer screening in elders that has sought to improve the targeting of cancer screening by better defining the risks and benefits, particularly as a function of life expectancy. This work has influenced screening guidelines in the U.S., which have used this research to recommend that screening decisions focus more on life expectancy than chronological age and better recognize the potential harms of screening. This proposal will provide the candidate with protected time to expand her research in a new direction focused on surveillance testing for cancer recurrence in older cancer survivors. Surveillance in older cancer survivors poses similar issues to screening in that it can potentially benefit elders by finding recurrent cancers when still treatable but also may cause substantial morbidity through overtreatment. The research in this proposal will inform decision making in this area by better defining the risks and benefits of surveillance testing in older prostate cancer survivors. This new direction maintains her research focus while building new collaborations with oncology. The candidate will also develop a formal mentoring program with plans for the recruitment, selection, development, and evaluation of mentees who will become leaders in aging research. Each mentee will have a focused career development plan in which they complete research projects and develop the skills needed to become independent investigators in aging research. This proposal integrates the candidate's mentoring program into the outstanding clinical research training environment at UCSF, leveraging her leadership positions in the Division of Geriatrics and the Clinical and Translational Science Institute (CTSI) Career Development (KL2 Scholars) Program to recruit more mentees interested in aging research.
This proposal will have unique public health importance because (1) it will increase mentoring of new clinical investigators interested in conducting research to improve care for the rapidly growing elderly population, and (2) it will inform national guidelines and clinical decision-making by better defining the risks and benefits of prostate-specific antigen (PSA) surveillance practices in elderly prostate cancer survivors.
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