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

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.