CALIFORNIA TEACHERS STUDY

描述（由申请人提供）：加州教师研究（CTS）是一项前瞻性研究，133,479名加州教师于1995年由加州研究中心联盟发起，具有流行病学和癌症病因学方面的专业知识。该研究旨在更好地了解乳腺癌和其他主要女性健康问题的病因和预防;因此，该队列的启动得到了针对乳腺癌研究的加州烟草税的支持。该队列的成员是通过参加加州州教师退休制度（STRS）来确定的，所有公立学校的教师和管理人员都必须属于该制度。CTS队列的早期观察结果是加州教师患乳腺癌的几率非常高。浸润性乳腺癌的发病率比加州年龄和种族相当的女性的预期发病率高出约51%。此外，我们还报道了CTS组的子宫内膜癌和卵巢癌以及黑色素瘤的发病率非常高。CTS队列的优势在于其规模以及在基线时和随后与队列成员联系时进行的详细暴露和生活方式评估。我们能够从CTS的参与者那里收集到比其他大型健康队列成员通常收集到的更详细的数据，主要是因为CTS成员的教育水平都很高。CTS未来五年的科学具体目标集中在一系列详细的暴露特征上，包括激素治疗（HT）使用的各种模式，异硫氰酸酯的饮食摄入量，酒精消费和身体活动/能量平衡。由于CTS的规模和良好的随访，我们将扩大选定假设的癌症结果，不仅包括乳腺癌，还包括结直肠癌，子宫内膜癌，卵巢癌和肺癌。我们还建议针对2，500例乳腺癌患者和健康CTS参与者的同等样本进行血液采集和DNA提取，以评估一系列关于基于遗传的修饰或与某些暴露/乳腺癌关系的相互作用的假设。最后，我们建议维持现有的先进基础设施，继续与CTS成员进行详细的后续工作和定期重新联系，并处理新数据和继续分析CTS参与者的现有数据。

DESCRIPTION (provided by applicant): The California Teachers Study (CTS) is a prospective study of 133,479 California teachers initiated in 1995 by a consortium of California research centers with expertise in epidemiology and cancer etiology. The study was designed to understand better the etiology and prevention of breast cancer and of other major women's health problems; as such, the initiation of the cohort was supported by California tobacco taxes targeted to breast cancer research. Members of the cohort were identified through their participation in the California State Teachers Retirement System (STRS) to which all public school teachers and administrators must belong. An early observation from the CTS cohort is the extraordinarily high breast cancer rates experienced by California teachers. Incidence rates for invasive breast cancer are approximately 51% higher than those expected among women of comparable age and race in California. Moreover we have reported that the CTS cohort has very high rates of endometrial and ovarian cancers as well as melanoma. Among the strengths of the CTS cohort are its size and the detailed exposure and lifestyle assessment made at baseline and through subsequent contacts with cohort members. We were able to gather more detailed data from participants in the CTS than are typically collected from members of other large healthy cohorts, primarily because of the uniformly high education levels of the CTS membership. The scientific specific aims for the next five years of the CTS are focused around a small series of detailed exposure characteristics, including various patterns of hormone therapy (HT) use, dietary intake of isothiocyanates, alcohol consumption, and physical activity/energy balance. Because of the size and excellent follow-up of the CTS, we will expand the cancer outcomes of interest for selected hypotheses to include not just breast cancer as in the previous funding period, but also colorectal cancer, endometrial cancer, ovarian cancer, and lung cancer. We also propose to target 2,500 incident breast cancer patients and an equal sample of healthy CTS participants for blood collection and DNA extraction to evaluate a series of hypotheses regarding genetically-based modification of or interactions with certain exposure/breast cancer relationships. Finally, we propose to maintain the sophisticated infrastructure already in place, to continue detailed follow-up and periodic recontact of CTS members, and to process new data and continue analysis of existing data on CTS participants.