The Prevalence of Dissemination and Implementation Research and Training Grants at National Cancer Institute-Designated Cancer Centers.

Background: Dissemination and implementation (D&I) research is a key factor in the uptake and use of evidence-based cancer control interventions. National Cancer Institute (NCI)-designated cancer centers are ideal settings in which to further D&I knowledge. The purpose of this study was to summarize the characteristics of NCI-funded D&I science grants in the nation's cancer centers to understand the nature, extent, and opportunity for this key type of translational work. Methods: We used the National Institutes of Health Research Portfolio Online Reporting Tool to identify active NCI-funded grants in D&I science at NCI clinical cancer centers (n = 13) and comprehensive cancer centers (n = 51) as well as their academic affiliates. Active projects were eligible for inclusion if they 1) were awarded directly to an NCI cancer center or an academic or research affiliate, and 2) identified D&I content in the abstract. Portfolio data were collected in February 2021. Results: We identified 104 active NCI-funded D&I research or training grants across the 64 cancer centers; 57.8% of cancer centers had at least 1 NCI-funded D&I grant. Most awards (71.1%) were for research grants. Training grants constituted 29.1% of D&I-focused grants. Overall, 50.0% of grants (n = 52) concentrated on specific cancers. Almost two-thirds of grants (n = 68, 65.4%) had a stated health equity focus. Conclusions: More than one-half of NCI-designated cancer centers have active funding in D&I science, reflecting a substantial investment by NCI. There remains considerable room for further development, which would further support NCI's translational mission.

Preeclampsia and Long-term Risk of Maternal Retinal Disorders.

OBJECTIVE: To evaluate whether preeclampsia is associated with risk of maternal retinal disease in the decades after pregnancy. METHODS: We carried out a longitudinal cohort study of 1,108,541 women who delivered neonates in any hospital in Quebec, Canada, between 1989 and 2013. We tracked women for later hospitalizations until March 31, 2014. Preeclampsia was measured at delivery categorized by severity (mild or severe) and onset (before or at 34 weeks or more of gestation). Main outcomes were hospitalizations and inpatient procedures for retinal detachment, retinopathy, or other retinal disorders. We used Cox regression models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) comparing preeclampsia with no preeclampsia adjusting for diabetes and hypertension. RESULTS: Compared with no preeclampsia, women with preeclampsia had a higher incidence of hospitalization for retinal detachment (52.9 compared with 23.9/10,000), retinopathy (60.5 compared with 8.0/10,000), and other retinal disorders (13.3 compared with 7.3/10,000). Preeclampsia was most strongly associated with traction detachments (HR 2.39, 95% CI 1.52-3.74), retinal breaks (HR 2.48, 95% CI 1.40-4.41), and diabetic retinopathy (HR 4.13, 95% CI 3.39-5.04). Severe and early-onset preeclampsia was associated with even higher risk compared with mild or late-onset preeclampsia. CONCLUSION: Preeclampsia, particularly severe or early-onset preeclampsia, is associated with an increased risk of maternal retinal disease in the decades after pregnancy.

Preeclampsia and the risk of cataract extraction in life.

BACKGROUND: Pregnancy-related risk factors for cataract are understudied, including the possibility that preeclampsia increases the risk of cataract later in life. OBJECTIVE: We sought to evaluate the long-term risk of cataract extraction following a preeclamptic pregnancy. STUDY DESIGN: We carried out a historic cohort study of 1,108,541 women who delivered at least 1 infant in any hospital in the province of Quebec, Canada, from 1989 through 2013, including 64,350 with preeclampsia and 5732 with cataract extractions. We categorized preeclampsia by onset time and severity, and followed up women for up to 25 years after delivery. We calculated the incidence of inpatient cataract extraction for women with and without preeclampsia, and used Cox proportional hazard models to estimate hazard ratios and 95% confidence intervals for later risk of cataract extraction, adjusting for age at first delivery, total parity, metabolic disease, asthma, socioeconomic deprivation, and time period. RESULTS: Women with preeclampsia had a higher incidence of cataract extraction compared with no preeclampsia (21.0 vs 15.9/1000) and 1.20 times the risk (95% confidence interval, 1.08-1.34). Women with early-onset preeclampsia had 1.51 times the risk of cataract extraction compared with no preeclampsia (95% confidence interval, 1.14-2.00), whereas women with late-onset preeclampsia had 1.16 times the risk (95% confidence interval, 1.04-1.30). Risk was elevated by about 20% for both severe and mild preeclampsia. Preeclampsia with diabetes was associated with significantly greater risk (hazard ratio, 4.32; 95% confidence interval, 3.60-5.19). CONCLUSION: Women with preeclampsia, particularly preeclampsia of early onset or with diabetes, may have greater risk of cataract later in life. The underlying pathways linking preeclampsia with cataract require further investigation.