EPIDEMIOLOGY OF CANCER MORTALITY IN CHA

在整个世纪的大部分时间里，癌症死亡率一直在上升 戏剧性地在美国。 然而，最近的数据来自 国家卫生统计中心和国家癌症研究所 表明这一趋势可能正在改变; 1991年至1995年， 死亡率下降了2.6%。 这一下降是 主要归因于肺、结肠/直肠 前列腺癌，乳腺癌和妇科癌症，并可能反映了国家 努力减少吸烟，增加早期发现 开发更好的治疗方法（REF）。 虽然看起来 癌症死亡率已经达到了一个重要的转折点， 一项研究探讨了关于 与癌症风险相关的可改变风险因素的流行病学是 有正当理由 25年前，生理和生活方式信息 由芝加哥心脏协会检测项目评估， 工业，一项前瞻性队列研究，其中数据收集自 39，573名女性和男性，基线时年龄为18岁及以上（即，（1967- 1973） 主要是非裔美国人和白色。 利用现有 从这个庞大的队列中获得了大量高质量的基线信息， 建议检查生理风险因素对研究中心的影响- 在25年的随访中，具体的癌症死亡率。 具体地说， 我们将检验与负荷后血浆葡萄糖水平相关的假设， 静息心率和血清尿酸水平对总癌症风险的影响 死亡率以及胰腺癌、前列腺癌、肺癌和结肠直肠癌 mortality.标准单变量和多变量统计方法 对预期数据的分析（即，考克斯比例风险 回归）将用于研究感兴趣的关联。 来自这个芝加哥队列的数据提供了一个具有成本效益和及时的 研究长期癌症流行病学的机会 mortality.

Throughout much of the century, cancer mortality rates have increased dramatically in the United States. However, recent data from the National Center for Health Statistics and the National Cancer Institute indicate that this trend may be changing; between 1991 and 1995, cancer mortality rates decreased by 2.6 percent. This decrease has been largely attributed to changes in mortality rates of lung, colon/rectum, prostate, breast and gynecologic cancers, and probably reflects national efforts aimed at reducing cigarette smoking, increasing early detection and developing better treatments (REF). Although it appears that the cancer death rate has reached an important turning point, further research examining unique and unanswered hypotheses regarding the epidemiology of modifiable risk factors associated with cancer risk is warranted. Over 25-years ago, physiologic and lifestyle information was assessed from the Chicago Heart Association Detection Project in Industry, a prospective cohort study in which data were collected from 39,573 women and men, aged 18 and older at baseline (i.e., 1967-73), who are primarily African-American and white. Utilizing the available wealth of high-quality, baseline information from this large cohort, we propose to examine the effect of physiologic risk factors for site- specific cancer mortality over the 25 years of follow-up. Specifically, we will test hypotheses related to post-load plasma glucose levels, resting heart rate, and serum uric acid levels on risk of total cancer mortality, as well as pancreatic, prostate, lung and colorectal cancer mortality. Standard univariate and multivariate statistical methods for the analysis of prospective data (i.e., Cox proportional hazards regression) will be used to investigate the associations of interest. Data from this Chicago cohort provide a cost-effective and timely opportunity to investigate the epidemiology of long-term cancer mortality.