EPIDEMIOLOGY OF CANCER MORTALITY IN CHA

在本世纪的大部分时间里，癌症死亡率一直在上升。 在美国戏剧性地。然而，最近来自 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至1995年间，癌症 死亡率下降了2.6%。这一下降一直是 主要归因于肺、结肠/直肠死亡率的变化， 前列腺癌、乳腺癌和妇科癌症，可能反映了全国 旨在减少吸烟、增加早期发现的努力 和开发更好的治疗方法(参考文献)。尽管看起来 癌症死亡率已经达到一个重要的转折点，进一步 这项研究检验了关于人类的独特且未被回答的假设 与癌症风险相关的可改变风险因素的流行病学是 这是正当的。25年前，生理和生活方式的信息 来自芝加哥心脏协会检测项目的评估 行业，一项前瞻性队列研究，其中数据收集自 39,573名男女，基线年龄为18岁及以上(即1967-73年)， 主要是非裔美国人和白人。利用现有的 来自这一大群人的高质量、基线信息的财富，我们 建议研究生理风险因素对场地的影响- 在25年的随访中发现了特定的癌症死亡率。具体来说， 我们将测试与负荷后血糖水平相关的假设， 静息心率和血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、肺癌和结直肠癌 死亡率。标准单变量和多变量统计方法 前瞻性数据的分析(即COX比例风险 回归)将被用来调查感兴趣的关联。 来自芝加哥队列的数据提供了具有成本效益和及时的 研究长期癌症流行病学的机会 死亡率。

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.