FOUR-CORNERS BREAST AND ENDOMETRIAL CANCER STUDY

描述：(改编自申请者摘要)乳房和乳房发病率 子宫内膜癌在非西班牙裔白人中的差异几乎是三倍 居住在美国的美国原住民和西班牙裔人口 美国四角地区(亚利桑那州、新墨西哥州、科罗拉多州和犹他州)。 有趣的是，尽管美国印第安人和西班牙裔女性的 乳腺癌和子宫内膜癌的多种危险因素的流行 在非西班牙裔白人女性中(例如，肥胖、低水平的剧烈运动 运动，水果和蔬菜的低摄入量，高胰岛素比率 抗药性)他们的癌症发病率较低。在这项研究中， 研究人员关注肥胖/体重变化的代谢因素和 与乳腺癌和子宫内膜癌相关的胰岛素状况的指标。 肥胖与雌激素和胰岛素通过两个相互关联的 疾病途径。胰岛素可能通过其对癌症风险的直接影响 胰岛素样生长因子及其结合蛋白的作用 以及通过其对雌激素水平的影响而间接产生的。调查人员 建议重点关注胰岛素途径，因为胰岛素水平很高 这一人群中的通路功能障碍。一项多中心病例对照研究 建议以居住在四角地区的妇女为目标；该研究将 包括2.5小时的面谈和抽血。超过三年的时间 病例确认期内，这项研究将纳入3000例乳腺癌病例，450例 子宫内膜癌病例和3000名对照组，其中一半将是 西班牙裔/美国原住民，其中一半将是非西班牙裔白人女性 年龄在25岁到79岁之间。影响基因的分子变异 肥胖与胰岛素(雄激素受体基因(AR)、维生素D受体基因(VDR)、 胰岛素受体(ADRB3)将独立和在 结合新陈代谢因素确定遗传差异 人群中的易感性。由于人口的多样性(西班牙裔， 土著美国人和非西班牙裔白人妇女)，调查人员提议 评估种族背景和遗传混合与基因的关系 标志物、环境因素以及乳腺癌和子宫内膜癌的风险。遗传 混合(美国对欧洲的遗传混合)是一种新颖而创新的方式 研究种族多样性的连续体。C-肽，糖化血红蛋白， IGF-1和IGFBP3将根据乳房和子宫内膜进行评估 女性中的一小部分患癌症。

DESCRIPTION: (Adapted from Applicant's Abstract) The incidence of breast and endometrial cancers varies almost three-fold between non-Hispanic white populations and Native American and Hispanic populations living in the 4-Corners area of the United States (Arizona, New Mexico, Colorado, and Utah). Interestingly, although American Indian and Hispanic women have higher prevalences of many risk factors for breast and endometrial cancer identified in non-Hispanic white women (e.g., obesity, low levels of vigorous physical activity, low intakes of fruits and vegetables, high rates of insulin resistance) they have lower cancer incidence rates. In this study the investigators focus on the metabolic factors of obesity/weight changes and indicators of insulin status as they relate to breast and endometrial cancers. Obesity is associated both with estrogen and insulin by two interrelated disease pathways. Insulin may influence cancer risk directly through its effects on insulin-like growth factor (IGF) and its binding proteins (IGFBPs) and well as indirectly through its effect on estrogen levels. The investigators propose focusing on the insulin pathway because of the high levels of insulin pathway dysfunction in this population. A multi-center case-control study is proposed that targets women living in the 4-Corners area; the study will consist of a 2.5 hour in-person interview and a blood draw. Over a three-year case ascertainment period, the study will enroll 3000 breast cancer cases, 450 endometrial cancer cases and 3000 controls, half of whom will be Hispanic/Native American and half of whom will be non-Hispanic white women between the ages of 25 and 79. Molecular variants of genes that influence obesity and insulin (androgen receptor gene (AR), vitamin D receptor gene(VDR), insulin receptor (ADRB3)) will be examined both independently and in conjunction with metabolic factors to determine differences in genetic susceptibility in the population. Because of the diverse population (Hispanics, Native American, and non-Hispanic white women), the investigators propose to evaluate ethnic background and genetic admixture in relationship to gene markers, environmental factors, and breast and endometrial cancer risk. Genetic admixture (Ameridian to European genetic mixture) is a novel and innovative way to study the continuum of ethnic diversity. C-peptide, glycosylated hemoglobin, IGF-1, and IGFBP3 will be evaluated with respect to breast and endometrial cancer in a subset of women.