Case-Control Study of Pancreas Cancer Etiologic Factors

胰腺癌病因的病例对照研究

• 批准号: 6945854
• 负责人: Harvey A Risch
• 金额: $ 11.21万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-09-01 至 2009-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6945854
• 关键词: Helicobacter; acidity /alkalinity; adenocarcinoma; cadmium; cancer risk; case history; clinical research; diet; disease /disorder etiology; duodenum; epidemiology; genetic polymorphism; genetic screening; genetic susceptibility; human middle age (35-64); human old age (65+); human subject; infection related neoplasm /cancer; lifestyle; nitroso compounds; nutrition related neoplasm /cancer; nutrition related tag; occupational hazard; pancreas neoplasms; serology /serodiagnosis; stomach

DESCRIPTION (provided by applicant): In the US in 2001, there were about 29,000 new cases of cancer of the pancreas, and nearly that number died from it, making it the 4th most frequent cause of cancer death, after lung, breast/prostate and colorectal cancer. Over the lifetime, more than 1% of the population is affected, with blacks having a bit higher rates than whites. Survival with this cancer is dismal: one year about 20-30%, and 5-year, about 5%. Most patients present with advanced disease, and the standard treatments do not much alter the progressive, fatal course. Aside from major-gene causes underlying perhaps 5% of cases, the one known risk factor for pancreatic cancer is cigarette smoking, which doubles the risk. Studies of dietary factors have not been entirely consistent but do suggest associations of higher risk with animal product intake and lower risk with consumption of fruits or vegetables. This application describes a new hypothesis on the etiology of pancreatic cancer, and provides a substantial body of laboratory and epidemiologic evidence in support of it. To examine this hypothesis, we will conduct, in the state of CT, a population-based case-control study to examine infectious, genetic, dietary, lifestyle and medical history factors. In total, 600 pancreas-cancer cases aged 35-79 years will be identified prospectively via the ultra-rapid program of the Rapid Case Ascertainment Shared Resource at Yale. About 600 randomly selected population controls will be frequency matched to the cases by age and gender. Controls will be identified using enhanced random-digit dialing methods. All subjects will be interviewed in person by trained interviewers using a standardized, structured questionnaire that will include sections on tobacco use and medical history, a standard food frequency/supplements questionnaire, and questions about other factors specific to our hypothesis. A small blood sample will be drawn for use in testing for exposure to certain infections, and for four DNA polymorphisms relevant to our hypothesis. Average daily intake of dietary nutrients will be calculated from the diet histories, and uni- and multivariate analyses will be used to estimate relative risks for comparison of the cases with the controls. The factors to be examined here have received little attention with respect to pancreas cancer, and the proposed study will evaluate them systematically in a vigorous, large-scale and integrated project.

描述（由申请人提供）： 2001 年，美国大约有 29,000 例新发胰腺癌病例，几乎这个数字因此而死亡，使其成为继肺癌、乳腺癌/前列腺癌之后的第四大癌症死亡原因和结直肠癌。在一生中，超过 1% 的人口受到影响，黑人的患病率略高于白人。这种癌症的生存率很低：一年的生存率约为 20-30%，五年的生存率约为 5%。大多数患者都患有晚期疾病，标准治疗并不能太大改变进行性、致命性的病程。除了大约 5% 的病例的主基因原因外，已知的胰腺癌危险因素之一是吸烟，这会使风险增加一倍。对饮食因素的研究并不完全一致，但确实表明较高的风险与动物产品的摄入有关，而较低的风险与食用水果或蔬菜有关。该申请描述了关于胰腺癌病因学的新假设，并提供了大量的实验室和流行病学证据来支持它。为了验证这一假设，我们将在 CT 状态下进行一项基于人群的病例对照研究，以检查传染性、遗传、饮食、生活方式和病史因素。耶鲁大学快速病例查明共享资源的超快速项目将总共前瞻性地识别出 600 例年龄在 35-79 岁的胰腺癌病例。大约 600 个随机选择的人群对照将按年龄和性别与病例进行频率匹配。 将使用增强的随机数字拨号方法来识别控件。所有受试者都将由训练有素的采访员使用标准化的结构化调查问卷进行亲自采访，其中包括烟草使用和病史部分、标准食物频率/补充剂调查问卷以及有关我们假设的其他特定因素的问题。将抽取少量血液样本用于测试是否接触过某些感染以及与我们的假设相关的四种 DNA 多态性。膳食营养素的平均每日摄入量将根据饮食历史计算，并将使用单变量和多变量分析来估计病例与对照组比较的相对风险。这里要检查的因素在胰腺癌方面很少受到关注，拟议的研究将在一个充满活力的、大规模的综合项目中系统地评估它们。