ETIOLOGIC CANCER RESEARCH IN A POPULATION-BASED COHORT

我们建议对一项基于人群的队列研究进行具有成本效益的扩展， 社区动脉粥样硬化风险(ARIC)研究，涵盖 癌症病因学研究。共有15,000名中年成年人，黑人 从美国四个社区抽样的白人首先在 1987年的今天，。许多常见癌症的已知或潜在风险因素是 在基线检查中仔细测量，以及生物标本 (血清、血浆、血细胞和DNA)被储存。三个后续 考试已得到资助：1990-1992年、1993-1995年和1996-1998年。 参与者在每次检查中都报告了癌症的发生，并 每年报告所有住院治疗，包括癌症住院治疗。关于 据估计，到1992年已有450例癌症发生，平均随访时间为 四年了。 ARIC的研究可能会持续很长时间，因此将其扩大到包括 癌症终结点是具有成本效益的。为此有五个具体目标 为期三年的项目。首先，我们建议在公元01年增加以下资料： 常见癌症(乳腺癌、肺癌、结肠癌和 前列腺)通过电话采访的方式。第二，我们建议扩大 ARIC的基本系统，用于通过链接、在 01和03年，癌症登记处的队列识别符，可在 四个来源社区中的三个，并在01年收集 通过03队列成员与癌症相关的住院治疗。第三，a 训练有素的护士抽象员将提取约700人的信息 将在1987年1月至12月期间发生的意外癌症 1994年(平均六年以上的后续行动)。第四，在03年，我们 将测试与1)独立病因学作用相关的特定假设 体脂分布、体质量、内源性胰岛素和血脂水平 2)慢性阻塞性肺疾病是否是一种 独立于吸烟强度的肺癌风险标记物。第五个， 更广泛地说，目标是将癌症确立为ARIC的可靠终点 未来遗传和环境风险因素研究的队列和 他们的互动。 拟议的项目，它利用了已经建立的 以人口为基础的大队列，需要的支持相对较少，但 将对常见癌症的病因学研究做出重大贡献 在这个项目期间，而且远远超出它的范围。

We propose a cost-effective expansion of a population-based cohort study, the Atherosclerosis Risk in Communities (ARIC) Study, to encompass etiologic cancer research. A total of 15,000 middle-aged adults, blacks and whites, sampled from four U.S. communities were first examined in 1987-1989. Many known or potential risk factors for common cancers were carefully measured in the baseline examination, and biologic specimens (sera, plasma, blood cells, and DNA) were stored. Three subsequent examinations have been funded: 1990-1992, 1993-1995, and 1996-1998. Participants have reported cancer occurrence at every examination and have annually reported all hospitalizations, including those for cancer. About 450 cancers are estimated to have occurred by 1992, an average follow-up of four years. The ARIC Study is likely to continue long-term, so expanding it to include cancer endpoints is cost-effective. There are five specific aims for this three-year project. First, we propose in Year 01 to augment information on established risk factors for common cancers (breast, lung, colon, and prostate) by means of a phone interview. Second, we propose to expand ARIC's rudimentary system for finding incident cancer cases by linking, in Years 01 and 03, cohort identifiers to cancer registries, available in three of the four source communities, and by collecting in Years 01 through 03 cancer-related hospitalizations of cohort members. Third, a trained nurse abstractor will abstract information on the estimated 700 incident cancers that will have occurred between January 1987 and December 1994 (an average of follow-up of over six years). Fourth, in Year 03 we will test specific hypotheses related to 1) the independent etiologic role of body fat distribution, body mass, endogenous insulin, and lipid levels in breast cancer, and 2) whether chronic obstructive lung disease is a risk marker for lung cancer independent of smoking intensity. The fifth, and broader, aim is to establish cancer as a reliable endpoint in the ARIC cohort for future studies of genetic and environmental risk factors and their interactions. The proposed project, which takes advantage of an already established large population-based cohort, requires relatively little support and yet will contribute substantially to the etiologic research of common cancers during this project and far beyond it.