Epidemiology of Ovarian Cancer in African-American Women

非裔美国女性卵巢癌的流行病学

基本信息

批准号：
8265223
负责人：
Joellen M. SCHILDKRAUT
金额：
$ 222.63万
依托单位：
DUKE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-06-01 至 2015-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8265223
关键词：
Accounting Address African African American Age Alabama Androgen Receptor Area Breast CAG repeat Cancer Etiology Cancer Patient Case-Control Studies Caucasians Caucasoid Race Cessation of life Characteristics Collaborations Collection Colorectal Consult Data Diagnosis Digit structure Enrollment Epidemiologic Studies Epidemiology Epithelial ovarian cancer Ethnic Origin Etiology Genes Genetic Geographic Locations Gynecologic Health Services Accessibility Illinois Incidence Institution International Knowledge Lung Malignant - descriptor Malignant Neoplasms Malignant neoplasm of ovary New Jersey North Carolina Obesity Ohio Outcome Pattern Patterns of Care Population Population Attributable Risks Population Heterogeneity Positioning Attribute Prevalence Prognostic Factor Publishing Receptor Gene Recruitment Activity Reporting Research Research Infrastructure Research Personnel Risk Factors Sample Size Services South Carolina Staging Survival Rate Symptoms Treatment outcome United States Woman acronyms cancer risk case control child bearing editorial experience follow-up genetic risk factor genome wide association study information gathering insight outcome forecast population based prognostic public health relevance racial difference reproductive

项目摘要

DESCRIPTION (provided by applicant): Ovarian cancer is the most lethal of gynecologic malignancies. Although African-American women have lower incidence rates than white women, their five-year survival rates are lower. To date, there has been little research on ovarian cancer in African-American women. In 1993, an analysis involving 110 cases and 365 controls was the first published report describing ovarian cancer risk factors in African-American women. An editorial accompanying this report called for further research on ovarian cancer in African-Americans, however there has been little progress in this area in the past fifteen years. In the international Ovarian Cancer Association Consortium, women of African descent comprise fewer than 300 of the more than 12,000 cases from 18 case-control studies, including 144 cases from our North Carolina Ovarian Cancer Study (NCOCS). Within the NCOCS, we have found evidence suggesting differences between African-Americans and whites in certain ovarian cancer risk factors including CAG repeats in the androgen receptor (AR) gene and anthropometric characteristics. Although these findings are intriguing, we have been unable to confirm them because of the paucity of data on African-American women in other studies. The purpose of this application is to establish a multi-center case-control study involving nine geographic regions within the United States to study the etiology of ovarian cancer in African Americans. The specific aims are: 1. To establish the infrastructure to recruit 1000 African-American women with invasive epithelial ovarian cancer and an equal number of age-matched controls. 2. To determine how risk factors for ovarian cancer in African-American women are similar or different to established risk factors for white women. We will calculate population attributable fractions to determine if differences in the prevalence of risk factors (e.g. reproductive characteristics or obesity) can account for racial differences in ovarian cancer incidence. 3. To evaluate genetic risk factors for ovarian cancer, focusing on concordance or discordance of results with genes that have been reported to be associated with ovarian cancer in white women in studies from large consortia or genome-wide association studies (GWAS). 4. To obtain information on treatment and outcome for ovarian cancer cases. We will analyze patterns of care and assess factors associated with obtaining treatment consistent with recommended standards for therapy. We also will be positioning ourselves to study predictors of survival among African-American ovarian cancer patients. The proposed study will fill an important gap in research on ovarian cancer in African-American women. Not only will we explore risk factors and prognostic characteristics that have been established as important in white women, we will investigate associations with factors that may be specific to African Americans. The large sample size and the diverse populations represented will provide critical insight into the similarities and differences in ovarian cancer risk factors between African-American and white women and may contribute to a better understanding of the poorer survival experienced by African Americans. PUBLIC HEALTH RELEVANCE: Although the epidemiology of ovarian cancer has been well-studied among Caucasian women there is very little known about risk factors for ovarian cancer among African-Americans. This is largely due to the sparse enrollment of African Americans in existing epidemiologic studies. The purpose of this study is to enroll 1,000 ovarian cancer cases and 1,000 controls of African American ethnicity from 9 geographic regions in the U.S. to comprehensively evaluate known and suspected epidemiologic and genetic factors for ovarian cancer in this population. The collection of treatment and follow-up data will set the stage to address the disparity in ovarian cancer survival among African-American women diagnosed with ovarian cancer compared to whites. This study will provide new insight into both the etiology and prognosis of ovarian cancer in African-American women.

描述（由申请人提供）：卵巢癌是最致命的妇科恶性肿瘤。尽管非洲裔美国女性的发病率低于白人女性，但她们的五年生存率也较低。迄今为止，关于非裔美国女性卵巢癌的研究还很少。 1993 年，第一份发表的报告描述了非洲裔美国女性卵巢癌的危险因素，涉及 110 个病例和 365 个对照。该报告附带的一篇社论呼吁对非裔美国人的卵巢癌进行进一步研究，但在过去十五年里，这一领域几乎没有取得任何进展。在国际卵巢癌协会联盟中，18 项病例对照研究的 12,000 多个病例中，非洲裔女性仅占不到 300 例，其中包括来自我们的北卡罗来纳州卵巢癌研究 (NCOCS) 的 144 例。在 NCOCS 中，我们发现证据表明非裔美国人和白人在某些卵巢癌危险因素上存在差异，包括雄激素受体 (AR) 基因中的 CAG 重复和人体测量特征。尽管这些发现很有趣，但由于其他研究中缺乏关于非裔美国女性的数据，我们无法证实它们。本申请的目的是建立一项涉及美国九个地理区域的多中心病例对照研究，以研究非裔美国人卵巢癌的病因。具体目标是： 1. 建立基础设施，招募 1000 名患有浸润性上皮性卵巢癌的非裔美国女性和同等数量的年龄匹配对照者。 2. 确定非洲裔美国女性卵巢癌的危险因素与已确定的白人女性的危险因素有何相似或不同。我们将计算人口归因分数，以确定危险因素（例如生殖特征或肥胖）患病率的差异是否可以解释卵巢癌发病率的种族差异。 3. 评估卵巢癌的遗传风险因素，重点关注大型联盟或全基因组关联研究 (GWAS) 的研究中与白人女性卵巢癌相关的基因结果的一致性或不一致。 4. 获取卵巢癌病例的治疗和结果信息。我们将分析护理模式并评估与获得符合推荐治疗标准的治疗相关的因素。我们还将致力于研究非裔美国卵巢癌患者的生存预测因素。拟议的研究将填补非裔美国女性卵巢癌研究的重要空白。我们不仅将探索在白人女性中被确定为重要的风险因素和预后特征，还将调查与非裔美国人可能特有的因素的关联。大样本量和所代表的多样化人群将为非裔美国人和白人女性之间卵巢癌危险因素的相似性和差异提供重要的见解，并可能有助于更好地了解非裔美国人所经历的较差的生存状况。公共健康相关性：尽管对白人女性卵巢癌的流行病学进行了深入研究，但对非裔美国人卵巢癌的危险因素却知之甚少。这主要是由于现有流行病学研究中非裔美国人的入组人数很少。本研究的目的是招募来自美国 9 个地理区域的 1,000 名卵巢癌病例和 1,000 名非裔美国人对照者，以全面评估该人群中已知和疑似卵巢癌的流行病学和遗传因素。治疗和随访数据的收集将为解决被诊断患有卵巢癌的非裔美国女性与白人相比卵巢癌生存率的差异奠定基础。这项研究将为非裔美国女性卵巢癌的病因学和预后提供新的见解。