Descriptive Studies and Record Linkage

描述性研究和记录链接

基本信息

批准号：
8763632
负责人：
William Anderson
金额：
$ 16.77万
依托单位：
DIVISION OF CANCER EPIDEMIOLOGY AND GENETICS
依托单位国家：
美国
项目类别：
财政年份：
资助国家：
美国
起止时间：
至
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/8763632
关键词：
Affect Africa South of the Sahara African African Caribbean Agreement American Ampulla of Vater Carcinoma Anatomic Sites Anus Neoplasms Area Attention Behavior Biliary Tract Cancer Birth Brazil Breast Cancer Surveillance Consortium Cancer Etiology Cancer Surveillance Research Caribbean region Cervix Neoplasms Characteristics Communities Country Data Data Linkages Databases Denmark Detection Development Diagnosis Diagnostic Diagnostic Neoplasm Staging Disease Employee Strikes Endometrioid Carcinoma Ethnic Origin Ethnic group Etiology Extrahepatic Bile Ducts Female Follicular thyroid carcinoma Future Gender General Population Generations Gynecologic Head and Neck Neoplasms Healthcare Heterogeneity Hispanics Hormonal Hormone replacement therapy Hormones Human Papillomavirus Hysterectomy Incidence International Agency for Research on Cancer Iodine Link Malignant Neoplasms Malignant neoplasm of gallbladder Malignant neoplasm of ovary Malignant neoplasm of prostate Malignant neoplasm of thyroid Medical Medical Surveillance Menopause Metric Microscopic Modality Neoplasms Nested Case-Control Study Obesity Ovarian Papillary Paraffin Tissue Pathologist Pattern Persons Physicians Population Postmenopause Prevalence Prostate carcinoma Prostatic Neoplasms Public Health Race Reporting Residual state Risk Risk Factors Role Rosa SEER Program Site Staging Subgroup Survivors Testing Thyroid Gland Time Tissues Tumor stage United States Vaccination Vagina Variant Woman Women&apos s Health cancer epidemiology cancer risk cancer type carcinogenesis cohort experience falls geographic difference hormone therapy inflammatory breast cancer male malignant breast neoplasm men middle age mortality neoplasm registry nutrition older women penis population based racial and ethnic repository screening trend tumor young woman

项目摘要

General descriptive studies (00350): Following decades of rising breast cancer incidence in the U.S. there were abrupt declines circa 2000 that stabilized during 2003-2004. The fall in breast cancer rates occurred mostly among older women with ER positive cancers, following the Womens Health Initiative announcement that reported statistically significant breast cancer risks among women using hormone replacement therapy. Much less attention was given to falling ER negative cancer rates, especially since hormonal exposures were not expected to affect ER negative tumors. Subsequent studies in the U.S., however, confirmed that ER negative breast cancers had declined while ER positive cancers were rising over the long-term; consistent with etiologic heterogeneity due to secular changes in different risk factor profiles for ER positive and ER negative cancers. The observation of similar trends in other countries with similar risk factor patterns would support the view that US trends reflect changes in the prevalence of exposures linked to different breast cancer subtypes. Denmark was an excellent test case. Subsequent results showed that trends in breast cancer incidence rates in Demark and U.S. were similar and consistent with dynamic changes in etiologically distinct breast cancer subtypes over time. ER positive cancers had increased among middle-aged and older Danish women in earlier birth-cohorts (or generations), implying a confluence of risk factor exposures during the peri-menopausal through the post-menopausal periods. On the other hand, ER negative cancers had decreased among younger women in more recent cohorts. The Danish and US experience may foreshadow a common pattern worldwide. Emerging data suggest that ovarian cancers differ by tumor grade. However, the reliability of microscopic grade from paraffin tissue in the general medical community and as reflected in population-based cancer registries is unknown. We examined grade agreement between two gynecologic pathologists and the NCIs Surveillance Epidemiology and End Results (SEER) Residual Tissue Repository (SEER). Grade agreement was fair at best between the study pathologists and SEER; and therefore, recorded grade in SEER should be used with caution and is probably not a reliable metric for ovarian cancer epidemiology in the general population. We investigated risk factors for inflammatory breast cancer in a nested case-control study in the Breast Cancer Surveillance Consortium database (1994-2009). Associations between high BMI and inflammatory breast cancer were particularly striking and suggest a different etiology for this clinically distinct breast cancer. After a report from the Womens Health Initiative (WHI) in 2002, a precipitous decline in menopausal hormonal therapy (MHT) use in the United States was linked to a decline in breast cancer incidence rates. Given that MHT use is also associated with increased ovarian cancer risk, we tested whether ovarian cancer incidence rates changed after 2002 using the North American Association of Central Cancer Registries (NAACCR) database. After a marked reduction in MHT use around 2002, ovarian cancer incidence rates demonstrated an accelerated decline, with the largest changes for endometrioid carcinomas. This strong temporal association, although not proving a causal role of hormones in ovarian carcinogenesis, suggests a role for hormonal exposures on the development and behavior of certain ovarian cancer subtypes. Although ovarian cancer incidence rates have declined in the United States, less is known of ovarian cancer trends among survivors of breast cancer. Therefore, we examined second primary ovarian cancers after first primary breast cancer in SEER. Persistently elevated SIRs along with decreasing absolute rates over the entire study period suggest that ovarian cancers in both the general population and survivors of breast cancer are declining in parallel, possibly because of common risk factor exposures. The SEER program incidence data were utilized in several additional projects. In a study of biliary tract cancers, a female excess of gallbladder cancer was apparent among all racial/ethnic groups, in contrast to a male excess for extrahepatic bile duct and ampulla of Vater cancers. The temporal trends differed by site, with rates for gallbladder cancer declining and those for extrahepatic bile duct rising in many of the gender/racial/ethnic groups. These findings indicate that these cancers likely are etiologically distinct. The incidence of potentially HPV-related preinvasive and invasive neoplasms in the US was investigated to document the patterns before widespread HPV vaccination. Incidence of preinvasive squamous tumors of the cervix, vagina, and penis rose rapidly over time and decreased for invasive neoplasms. The most rapid increases occurred for both preinvasive and invasive anal tumors. Patterns were generally similar among the various racial/ethnic groups, with the exception of invasive head and neck tumor rates which increased exclusively among white males. The rising rates support an urgent need for vaccination given the absence of effective screening modalities for tumors at these sites. The increases in thyroid cancer overall and in the predominant papillary type have been well-documented, but trends for follicular thyroid cancer, a less common but more aggressive variant, have not been as well characterized. Follicular thyroid cancer rates among both women and men rose more rapidly for regional than localized stage disease; rates increased for all tumor sizes among women but primarily for smaller size tumors among men. These results add to the evidence that rising thyroid cancer rates are not only due to improvements in detection and that the thyroid types should be evaluated separately in future studies. The thyroid cancer incidence rates in Sao Paulo, Brazil, known to be among the highest in the world, were compared with those in the U.S. SEER program. Overall incidence rates increased over time in both populations and were higher in Sao Paulo than in the US among both females and males, by 65% and 23%, respectively. The female/male incidence rate ratio was higher in Sao Paulo (4.17) than in SEER (3.10), and it did not change over time. Both diagnostic activity and iodine nutrition status may be contributing to these patterns. Both the SEER and NAACCR data were used to assess state-level uterine corpus cancer incidence rates by race/ethnicity corrected for hysterectomy prevalence and to identify potential correlation with state-level obesity prevalence. Corpus cancer rates rose 30%-100% with correction for hysterectomy, and a modest association with obesity became apparent. For most states, hysterectomy correction diminished or reversed the black/white deficit and accentuated the Hispanic/white deficit. Global patterns of prostate cancer incidence, aggressiveness, and mortality in men of African descent were assessed using publicly available IARC data and collected data from the Men of African Descent and Carcinoma of the Prostate (MADCaP) Consortium and the African Caribbean Cancer Consortium. Prostate cancer incidence and mortality are highest in men of African descent in the USA and the Caribbean. Tumor stage and grade were highest in sub-Saharan Africa. The proportion of prostate tumors that were stage T1 was higher in countries with greater percent gross domestic product spent on health care and physicians per 100,000 persons. Although cancer of the prostate appears to be under diagnosed and/or under reported in sub-Saharan men, prostate cancer incidence and mortality represent a significant public health problem in men of African descent around the world.

一般描述性研究（00350）：在美国，乳腺癌发病率数十年后，大约在2003 - 2004年稳定下来的乳腺癌发病率下降。乳腺癌率下降大部分发生在具有ER阳性癌症的老年妇女中，此后，《女子健康计划》宣布了使用激素替代疗法的妇女中统计学意义的乳腺癌风险。对ER负面癌症率下降的关注要少得多，尤其是因为预计激素暴露不会影响ER负肿瘤。然而，随后在美国进行的研究证实，ER负面乳腺癌在长期内呈阳性癌的增长而下降。与ER阳性和ER负癌的不同风险因素谱的世俗变化导致的病因异质性一致。观察到其他具有相似风险因素模式的国家类似趋势的观察将支持美国趋势反映与不同乳腺癌亚型相关的暴露率的变化。丹麦是一个很好的测试用例。随后的结果表明，Demark和美国乳腺癌发病率的趋势相似，并且随着时间的流逝，病因学上不同的乳腺癌亚型的动态变化是一致的。 ER阳性癌症在较早的出生科（或世代）中的中年和老年妇女中有所增加，这意味着在绝经后通过绝经后期，危险因素暴露于危险因素。另一方面，在最近的队列中，年轻女性的ER负癌减少了。丹麦人和美国的经验可能会预示着全球常见的模式。新兴数据表明，卵巢癌因肿瘤等级而有所不同。然而，普通医学界的石蜡组织以及基于人群的癌症登记册的可靠性尚不清楚。我们研究了两名妇科病理学家与NCIS监测流行病学和最终结果（SEER）残留组织存储库（SEER）之间的等级一致性。年级协议充其量是研究病理学家和SEER之间的公平。因此，应谨慎使用记录的SEER等级，并且可能不是普通人群卵巢癌流行病学的可靠度量。我们在乳腺癌监测财团数据库中的一项嵌套病例对照研究中研究了炎症性乳腺癌的危险因素（1994-2009）。高BMI和炎性乳腺癌之间的关联特别引人注目，并为这种临床上不同的乳腺癌提出了不同的病因。在2002年《妇女健康计划》（WHI）的报告后，美国更年期荷尔蒙治疗（MHT）使用急剧下降与乳腺癌发病率下降有关。鉴于MHT的使用也与卵巢癌风险增加有关，我们使用北美中央癌症注册表（NAACCR）数据库测试了卵巢癌的发病率是否发生了变化。在2002年左右的MHT使用显着降低后，卵巢癌的发病率显示出加速下降，子宫内膜类癌的变化最大。这种强大的时间关联虽然没有证明激素在卵巢癌发生中的因果作用，但表明激素暴露在某些卵巢癌亚型的发育和行为上起着作用。尽管美国的卵巢癌发病率下降，但乳腺癌幸存者的卵巢癌趋势却鲜为人知。因此，我们检查了SEER第一次原发性乳腺癌后的第二次原发性卵巢癌。在整个研究期间，SIRS的持续升高以及绝对率降低表明，乳腺癌的普通人群和幸存者的卵巢癌在并行下降，这可能是由于常见的危险因素暴露。 SEER计划的发病率数据用于其他几个项目。在一项胆道癌的研究中，在所有种族/族裔群体中，胆囊癌的过量过量是显而易见的，与男性过量的肝外胆管和Vater癌的ampulla相反。时间趋势因站点而异，胆囊癌的发生率下降，肝外胆管导管的发生率在许多性别/种族/族裔群体中增加。这些发现表明，这些癌症可能在病因上是不同的。研究了美国可能与HPV相关的前侵入性和浸润性肿瘤的发生率，以记录在广泛的HPV疫苗接种之前的模式。随着时间的流逝，子宫颈，阴道和阴茎的浸润前鳞状肿瘤的发生率迅速上升，侵入性肿瘤的发生率降低。前侵入性和侵入性肛门肿瘤均发生最快的增加。在各个种族/族裔群体中，模式通常相似，除了侵入性的头颈部肿瘤率外，白人男性中只有增加。鉴于这些部位的肿瘤缺乏有效的筛查方式，上升的速率支持迫切需要疫苗接种。甲状腺癌的总体和主要乳头类型的增加已经有据可查，但是卵泡甲状腺癌的趋势（一种较不常见但更具侵略性的变体）并没有得到很好的特征。男女卵泡甲状腺癌的发生率比局部舞台疾病更快地升高。女性所有肿瘤大小的发生率都会增加，但主要是男性大小较小的肿瘤。这些结果增加了证据表明，甲状腺癌率上升不仅是由于检测的提高，而且甲状腺类型应在以后的研究中分别评估。巴西圣保罗的甲状腺癌发病率是世界上最高的甲状腺癌发病率，与美国先知计划中的甲状腺癌发病率相提并论。随着时间的流逝，圣保罗的总体发病率随着时间的流逝而增加，在女性和男性中，总体发病率分别高于美国的总体发病率，分别为65％和23％。圣保罗（4.17）的女性/男性发病率比率高于SEER（3.10），并且随着时间的流逝没有变化。诊断活动和碘营养状况都可能导致这些模式。 SEER和NAACCR数据均用于通过种族/种族校正子宫切除术患病率来评估状态级子宫癌的发病率，并确定与州级肥胖症患病率的潜在相关性。子宫癌率上升了30％-100％，并进行了子宫切除术的矫正，并且与肥胖症的谦虚关联变得显而易见。对于大多数州而言，子宫切除术矫正减少或逆转了黑色/白色赤字，并突出了西班牙裔/白人缺陷。使用公开可用的IARC数据评估了非洲血统男性的前列腺癌发病率，侵略性和死亡率的全球模式，并收集了来自非洲血统和前列腺癌（MADCAP）财团和非洲加勒比海癌症联盟的数据。在美国和加勒比海的非洲人中，前列腺癌的发病率和死亡率最高。在撒哈拉以南非洲，肿瘤阶段和等级最高。在T1阶段的前列腺肿瘤的比例较高，在国内生产总值中，国内生产总值较高，每10万人都花在医疗保健和医生上。尽管前列腺癌似乎未被诊断出和/或在撒哈拉以南男性中报道，但前列腺癌的发病率和死亡率代表了世界各地非洲人血统的一个重大公共卫生问题。