Epidemiologic Field Studies

生物统计处既进行自己的实地研究，也就由生物统计组其他部门领导的实地研究提供咨询和合作。BCDDP：乳腺癌检测示范项目随访研究（1030）本研究跟踪了约6万名乳腺癌示范项目（BCDDP）的前参与者。目前的分析包括：1)乳腺癌和卵巢癌风险家族史；2)生殖因素、口服避孕药和激素治疗与膀胱癌风险的关系；3)体重、身高、体质指数与卵巢癌风险的关系；4)预测白人女性浸润性癌症的绝对风险：包括乳房x线摄影密度的模型；5) BMI与乳腺癌风险；6)乳腺癌组织学类型的危险因素；7)根据乳腺癌ER/PR状态分析危险因素；8) BMI与死亡率；9)饮食模式与结直肠癌风险；10)涉及乳腺癌、结肠癌、卵巢癌和肾癌的饮食汇总项目分析。黑人/白人PHS研究（430）食管癌和胰腺癌的发病率黑人比白人高得多。我们正在进行一项基于人群的病例对照研究，调查在易感性的遗传和分子标记方面的种族差异及其与环境因素的相互作用。这些标记物可能有助于预防和早期发现策略。乳腺癌：SEER特别研究（10316）我们的长期目标是通过与爱荷华州、洛杉矶和夏威夷的SEER组织丢弃登记处合作，获得以人群为基础的带标注的美国乳腺癌组织样本，并使用这些材料构建组织微阵列（tma），以验证不同乳腺癌亚型（如luminal、basal和HER2表型）的基于发现的分子特征；为乳腺癌的病因、监测、预防和治疗提供见解。我们启动了一个示范项目，使用SEERs夏威夷肿瘤登记处收集的乳腺tma；包括1995年确诊的原位及浸润性乳腺癌病例n=432例。获得三组TMA用于免疫组化（IHC）染色：1)标准IHC， 2) Q-Dot技术和3)由HistoRx公司开发的所谓AQUA方法。到目前为止，已收到标准染色的载玻片，并将进行评分。Q-Dot和AQUA染色待处理；这些污渍将不会被人工标记。针对急性淋巴细胞白血病（ALL）患儿的母亲和脑肿瘤患儿的母亲分别进行了两次焦点小组访谈，以探讨访谈的最佳时间、给药方法和地点；替代性数据来源的可用性；儿童癌症诊断与流行病学访谈的间隔时间以及其他可能影响母亲访谈反应的特征。患有这两种癌症的孩子的母亲更喜欢晚上在家接受采访，并愿意提供他们孩子的完整医疗记录。与患有脑肿瘤的儿童的母亲相比，患有ALL儿童的母亲更愿意在儿童治疗过程中更早地参与流行病学访谈，并提供更多的产妇生殖史记录，这体现了母亲群体之间的情感、社会经济和文化差异。父母对脑癌的担忧和治疗过程的困难是他们决定推迟参加流行病学访谈的关键因素，因为他们的孩子被诊断出癌症。我们的结论是，焦点小组方法可以为改进儿童癌症流行病学研究的问卷调查和方法提供广泛的策略。

The Biostatistics Branch both conducts its own field studies as well as consults and collaborates on field studies lead by other DCEG branches.Field Studies Lead by the Biostatistics BranchBCDDP: Breast cancer detection demonstration project follow-up study (1030) This study follows about 60,000 former participants in the Breast Cancer Demonstration Project (BCDDP). Current analyses include: 1) family history of breast cancer and ovarian cancer risk; 2) reproductive factors, oral contraceptive and hormone therapy use and bladder cancer risk; 3) weight, height, and body mass index and ovarian cancer risk; 4) projecting absolute invasive cancer risk in white women: a model that includes mammographic density; 5) BMI and breast cancer risk; 6) risk factors for histologic types of breast cancer; 7) risk factors according to breast cancer ER/PR status; 8) BMI and mortality; 9) dietary patterns and colorectal cancer risk; 10) dietary pooling project analyses involving cancers of the breast, colon, ovary, and kidney. Black/white PHS study (430)Rates of esophageal and pancreatic cancer are much higher in blacks than whites. We are conducting a study to investigate racial differences with respect to genetic and molecular markers of susceptibility and their interaction with environmental factors among cases from a population-based case-control study. Such markers might be useful for prevention and early detection strategies. Breast cancer: SEER special study (10316)Our long-term objective is to obtain a population-based sample of annotated U.S. breast cancer tissues through collaboration with the SEER Tissue Discard Registries in Iowa, Los Angeles, and Hawaii, and to use these materials to build tissue microarrays (TMAs) to validate discovery-based molecular signatures for different breast cancer subtypes such as luminal, basal, and HER2 phenotypes; providing insights for breast cancer etiology, surveillance, prevention, and treatment. We initiated a demonstration project, using a collection of prepared breast TMAs from SEERs Hawaii Tumor Registry; including n=432 in-situ and invasive breast cancer cases, diagnosed in 1995. Three sets of TMA were obtained for immunohistochemical (IHC) staining: 1) standard IHC 2) Q-Dot technology and 3) the so-called AQUA method, developed by HistoRx Inc. To date, the slides with standard stain have been received and will be scored. Q-Dot and AQUA stains are pending; these stains will not be scored manually. Feasibility study for reducing response bias in studies of childhood cancer research (443)Two focus group sessions with mothers of children with acute lymphoblastic leukemia (ALL) and two with mothers of children with brain tumors were conducted to explore: the optimal time of day, method of administration, and location for the interview; the availability of alternative data sources; the interval between pediatric cancer diagnosis and epidemiological interview; and other features which may affect maternal interview responses. Mothers of children with both types of cancer preferred being interviewed at home during the evening and were willing to provide complete access to their offsprings medical records. Emotional, socioeconomic, and perhaps cultural differences between the groups of mothers were exemplified by the willingness of mothers of children with ALL to participate in epidemiological interviews earlier in their childs treatment course and to provide greater access to maternal reproductive history records compared with mothers of children with brain tumors. Parental concerns about the brain cancer and the difficult treatment course were a key element in their decision to defer participating in epidemiologic interviews for many months after their childs cancer diagnosis. We conclude that the focus group approach can contribute to a broad strategy for improving questionnaires and methods for conducting pediatric cancer epidemiological research.