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Oral contraceptive use by formulation and breast cancer risk by subtype

按配方划分的口服避孕药使用情况和按亚型划分的乳腺癌风险

基本信息

批准号：
7885296
负责人：
DIANA SM BUIST
金额：
$ 8万
依托单位：
KAISER FOUNDATION HEALTH PLAN OF WASHINGTON
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-07-06 至 2012-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7885296
关键词：
2 year old Address Age Age-Years Area Breast Breast Cancer Risk Factor Calendar Cancer Research Network Cells Clinical Contraceptive Usage Data Decision Making Diagnosis Dose Drug Formulations Ductal Carcinoma ERBB2 gene Electronics Enrollment Estrogen Receptors Estrogens Frequencies General Population Grant Health Health Maintenance Organizations Health Personnel Healthcare Healthcare Systems Heterogeneity Histologic Histology Hormonal Hormone Receptor Human Individual International Agency for Research on Cancer Knowledge Laboratories Life Link Lobular Carcinoma Malignant Neoplasms Managed Care Marketing Medical Records Menopause Mitotic Activity Morbidity - disease rate Nandrolone Nested Case-Control Study Oral Contraceptives Patient Self-Report Pharmacy facility Pilot Projects Progesterone Receptors Progestins Public Health Questionnaires Records Regimen Relative (related person)Research Research Project Grants Risk Route Safety Site Synthetic Progestogens Testing Time Time Study Tumor Markers United States National Institutes of Health Washington Woman abstracting base cancer epidemiology cancer risk care systems clinically relevant hormone therapy in vivo malignant breast neoplasm mortality outcome forecast public health relevance reproductive response sound tumor working group

项目摘要

DESCRIPTION (provided by applicant): Project Summary/Abstract Approximately 82% of US women have ever used oral contraceptives (OCs) during their reproductive lives and there is a modest increased risk of breast cancer associated with recent use of OCs among young women, yet there have been few studies that have assessed the magnitude of this risk according to OC formulation or breast cancer subtype. There have been important changes in OC formulations over time including a reduction in estrogen dose and the inclusion of new synthetic progestins. Given the varying estrogenic, progestational, and androgenic activities of different synthetic progestins, it is important to investigate which specific types of OCs are related to breast cancer risk. It is also important to assess whether OC use is associated with risk of particular breast cancer subtypes. In response to the National Institutes of Health announcement for small grants in cancer epidemiology, we propose a pilot study assessing whether the effect of current and recent OC use on breast cancer risk varies by OC formulation or by breast cancer subtype within Group Health Cooperative (GHC), a large managed health care system in western Washington State. Group Health is part of a research network of 14 health maintenance organizations called the Cancer Research Network (CRN). This pilot study will provide vital preliminary data for a potential multisite study within the CRN that would pool electronic OC pharmacy data from numerous sites and link these exposure data to cancer endpoints. Considering the large differences in prognosis according to breast cancer subtype, frequency of OC use, recent OC formulation changes, and the limited data thus far assessing specific OC formulations defined by pharmacy data, this study is of great public health importance. This nested case-control study will include GHC women who are 20-49 years of age between 1996 and 2008 and have been enrolled continuously at GHC for at least one year immediately before diagnosis date (or a comparable date for controls). Cases will be diagnosed with a primary breast cancer within the study time period and controls will be frequency-matched to cases by age at diagnosis, calendar year, and years of enrollment at GHC. OC exposure information will be obtained via electronic pharmacy records. Breast cancer risk factor information will be ascertained from existing electronic questionnaire data and via medical record review for women without questionnaire data. The specific aims of this study are: (1) To determine if current and recent use of various OC formulations (grouped by type, dose, and potency of estrogen and progestin) are associated with breast cancer risk among women 20-49 years of age. (2) To determine if the relationships between current and recent OC use and breast cancer risk vary by histologic type or by expression of estrogen receptor, progesterone receptor, and HER2-neu (considered both individually and jointly). PUBLIC HEALTH RELEVANCE: Project Narrative Evidence supports a modest increased risk of breast cancer among young women associated with recent use of oral contraceptives (OCs); however there are limited data assessing this risk by specific OC formulation (particularly newer formulations) or by breast cancer subtype. This study will use automated pharmacy dispensing data in a large managed health care setting to accurately categorize OC exposure according to formulation and examine overall breast cancer risk and risk according to histology and expression of different tumor markers. This area of research is critical given the high frequency of OC use, heterogeneity of OC formulations, changes in OC formulations over time, and the morbidity and mortality associated with different breast cancer subtypes.

描述（由申请人提供）：