Epidemiology of Ovarian Cancer in African-American Women

非裔美国女性卵巢癌的流行病学

• 批准号: 8078993
• 负责人: Joellen M. SCHILDKRAUT
• 金额: $ 223.91万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-06-01 至 2015-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8078993
• 关键词: Accounting; Address; African; African American; Age; Alabama; Androgen Receptor; Area; Breast; CAG repeat; Cancer Etiology; Cancer Patient; Case-Control Studies; Caucasians; Caucasoid Race; Cessation of life; Characteristics; Collaborations; Collection; Colorectal; Consult; Data; Diagnosis; Digit structure; Enrollment; Epidemiologic Studies; Epidemiology; Epithelial ovarian cancer; Ethnic Origin; Etiology; Genes; Genetic; Geographic Locations; Gynecologic; Health Services Accessibility; Illinois; Incidence; Institution; International; Knowledge; Lung; Malignant - descriptor; Malignant Neoplasms; Malignant neoplasm of ovary; New Jersey; North Carolina; Obesity; Ohio; Outcome; Pattern; Patterns of Care; Population; Population Attributable Risks; Population Heterogeneity; Positioning Attribute; Prevalence; Prognostic Factor; Publishing; Receptor Gene; Recruitment Activity; Reporting; Research; Research Infrastructure; Research Personnel; Risk Factors; Sample Size; Services; South Carolina; Staging; Survival Rate; Symptoms; Treatment outcome; United States; Woman; acronyms; cancer risk; case control; child bearing; editorial; experience; follow-up; genetic risk factor; genome wide association study; information gathering; insight; outcome forecast; population based; prognostic; public health relevance; racial difference; reproductive

DESCRIPTION (provided by applicant): Ovarian cancer is the most lethal of gynecologic malignancies. Although African-American women have lower incidence rates than white women, their five-year survival rates are lower. To date, there has been little research on ovarian cancer in African-American women. In 1993, an analysis involving 110 cases and 365 controls was the first published report describing ovarian cancer risk factors in African-American women. An editorial accompanying this report called for further research on ovarian cancer in African-Americans, however there has been little progress in this area in the past fifteen years. In the international Ovarian Cancer Association Consortium, women of African descent comprise fewer than 300 of the more than 12,000 cases from 18 case-control studies, including 144 cases from our North Carolina Ovarian Cancer Study (NCOCS). Within the NCOCS, we have found evidence suggesting differences between African-Americans and whites in certain ovarian cancer risk factors including CAG repeats in the androgen receptor (AR) gene and anthropometric characteristics. Although these findings are intriguing, we have been unable to confirm them because of the paucity of data on African-American women in other studies. The purpose of this application is to establish a multi-center case-control study involving nine geographic regions within the United States to study the etiology of ovarian cancer in African Americans. The specific aims are: 1. To establish the infrastructure to recruit 1000 African-American women with invasive epithelial ovarian cancer and an equal number of age-matched controls. 2. To determine how risk factors for ovarian cancer in African-American women are similar or different to established risk factors for white women. We will calculate population attributable fractions to determine if differences in the prevalence of risk factors (e.g. reproductive characteristics or obesity) can account for racial differences in ovarian cancer incidence. 3. To evaluate genetic risk factors for ovarian cancer, focusing on concordance or discordance of results with genes that have been reported to be associated with ovarian cancer in white women in studies from large consortia or genome-wide association studies (GWAS). 4. To obtain information on treatment and outcome for ovarian cancer cases. We will analyze patterns of care and assess factors associated with obtaining treatment consistent with recommended standards for therapy. We also will be positioning ourselves to study predictors of survival among African-American ovarian cancer patients. The proposed study will fill an important gap in research on ovarian cancer in African-American women. Not only will we explore risk factors and prognostic characteristics that have been established as important in white women, we will investigate associations with factors that may be specific to African Americans. The large sample size and the diverse populations represented will provide critical insight into the similarities and differences in ovarian cancer risk factors between African-American and white women and may contribute to a better understanding of the poorer survival experienced by African Americans. PUBLIC HEALTH RELEVANCE: Although the epidemiology of ovarian cancer has been well-studied among Caucasian women there is very little known about risk factors for ovarian cancer among African-Americans. This is largely due to the sparse enrollment of African Americans in existing epidemiologic studies. The purpose of this study is to enroll 1,000 ovarian cancer cases and 1,000 controls of African American ethnicity from 9 geographic regions in the U.S. to comprehensively evaluate known and suspected epidemiologic and genetic factors for ovarian cancer in this population. The collection of treatment and follow-up data will set the stage to address the disparity in ovarian cancer survival among African-American women diagnosed with ovarian cancer compared to whites. This study will provide new insight into both the etiology and prognosis of ovarian cancer in African-American women.

描述（申请人提供）：卵巢癌是妇科恶性肿瘤中最致命的。尽管非裔美国妇女的发病率低于白人妇女，但她们的五年存活率更低。迄今为止，关于非裔美国女性卵巢癌的研究很少。1993年，一项涉及110例病例和365例对照的分析是首次发表的描述非裔美国妇女卵巢癌风险因素的报告。该报告的一篇社论呼吁对非裔美国人的卵巢癌进行进一步的研究，然而在过去的15年里，这一领域几乎没有进展。在国际卵巢癌协会联合会中，来自18项病例对照研究的12,000多例病例中，非洲裔妇女占不到300例，其中包括来自我们的北卡罗来纳卵巢癌研究（NCOCS）的144例病例。在NCOCS中，我们发现有证据表明非洲裔美国人和白人在某些卵巢癌风险因素上存在差异，包括雄激素受体（AR）基因中的CAG重复序列和人体测量学特征。虽然这些发现很有趣，但我们无法证实它们，因为在其他研究中缺乏关于非裔美国女性的数据。本申请的目的是建立一项涉及美国九个地理区域的多中心病例对照研究，研究非裔美国人卵巢癌的病因学。具体目标是：1。建立基础设施，招募1000名患有侵袭性上皮性卵巢癌的非裔美国妇女和相同数量的年龄匹配的对照组。2. 确定非裔美国女性患卵巢癌的风险因素与白人女性的风险因素相似或不同。我们将计算人群归因分数，以确定风险因素（如生殖特征或肥胖）患病率的差异是否可以解释卵巢癌发病率的种族差异。3. 评估卵巢癌的遗传风险因素，重点关注在大型财团或全基因组关联研究（GWAS）中报道的与白人女性卵巢癌相关的基因结果的一致性或不一致性。4. 获取卵巢癌病例的治疗和结果信息。我们将分析护理模式，并评估与获得符合推荐治疗标准的治疗相关的因素。我们还将研究非裔美国人卵巢癌患者的生存预测因素。这项研究将填补非裔美国女性卵巢癌研究的重要空白。我们不仅将探索在白人女性中已经确立的重要的风险因素和预后特征，我们还将调查可能是非洲裔美国人特有的因素的关联。大样本量和所代表的不同人群将为非裔美国妇女和白人妇女卵巢癌风险因素的异同提供重要见解，并可能有助于更好地理解非裔美国人的较差生存率。