Gastric Cancer Epidemiology Initiative in Central America

描述（由申请人提供）：候选人：道格拉斯摩根，医学博士MPH是医学和胃肠病学助理教授在北卡罗来纳州大学。职业发展计划：候选人将进行指导研究，并参加课程，以发展翻译研究和实施的重要技能，发展学术领导力。候选人将成为美国和拉丁美洲胃癌流行病学的领导者。近期目标：获得癌症，营养和遗传流行病学方法的专业知识，重点是胃癌。长期目标：通过在中美洲高发地区开展深入的流行病学倡议，降低拉丁美洲和美国拉丁裔人口的胃癌死亡率。具体目的：1）阐明研究人群胃癌的遗传易感性。2)确定H. pylori cagA毒力部分是一个独立的危险因素。3)评估该地区与胃癌相关的饮食因素。研究方法：在洪都拉斯西部进行的病例对照人群研究，该地区是一个高发地区（男性和女性分别为39例和21例/10万/年）。我们的初步数据表明，该地区是一个独特的流行病学生态位，具有独特的胃癌遗传和环境易感性。在目标1中，我们将确定宿主风险促炎细胞因子谱（IL-1B、IL-10、TNF α、IL-8）。在目标2中，我们将描述H。pylori和cagA毒力流行率以及与胃癌的关系。在目标3中，我们将评估饮食风险因素。我们将构建多变量模型来评估遗传、H. pylori和饮食因素，据我们所知，第一次这样的调查。累积目标入组为500例病例和500例对照。工作环境：在洪都拉斯西部唯一的地区医院招募了事故病例，过去4年来，该医院一直是成功的合作地点。以人口为基础的控制是从该地区的村庄招募的。数据简化和分析，标本处理和标本库是在胃肠道生物学和疾病中心。导师：主要导师将提供罗伯特桑迪耶，医学博士公共卫生硕士，在胃肠道癌症流行病学的国家领导人。二次导师是促进与三个成功的研究人员：一个国际领先的细菌和H。pylori毒力（Richard Peek博士，范德比尔特大学），营养癌症流行病学家（杰西Satia博士，斯坦福公共卫生学院）和遗传流行病学家（Kari North博士，斯坦福公共卫生学院）。相关性：胃癌是全球癌症死亡率的第二大原因，在拉丁美洲是重要的，并且可以通过筛查、细菌根除和/或饮食干预来预防。这项研究，通过系统流行病学，将提供详细的病因学信息，针对拉丁美洲的干预计划，并可能不断增长的美国拉丁裔人口。

DESCRIPTION (provided by applicant): Candidate: Douglas Morgan, MD MPH is an assistant professor of Medicine and Gastroenterology at the University of North Carolina. Career Development Plan: the candidate will conduct mentored research and participate in coursework to develop vital skills in translational research and implementation, to develop academic leadership. The candidate will be positioned to become leader in gastric cancer epidemiology in the U.S. and Latin America. Immediate Objective: to acquire expertise in cancer, nutrition, and genetic epidemiology methods with a focus upon gastric cancer. Long-term Objective: to decrease gastric cancer mortality in Latin America and the U.S. Latino population, through an in-depth epidemiology initiative in a high incidence region in Central America. Specific Aims: 1) Delineate the gastric cancer genetic susceptibility of the study population. 2) Determine if the H. pylori cagA virulence moiety is an independent risk factor. 3) Appraise dietary factors associated with gastric cancer in the region. Research Methods: case-control population-based study in Western Honduras, a region of high incidence (39 and 21 per 100K/year, M and F, respectively). Our preliminary data suggests that the region is a distinct epidemiologic niche, with unique gastric cancer genetic and environmental susceptibility. In aim 1, we will determine the host risk proinflammatory cytokine profile (IL-1B, IL-10, TNFa, IL-8). In aim 2, we will delineate the H. pylori and cagA virulence prevalence, and association with gastric cancer. In aim 3, we will assess dietary risk factors. We will construct multivariate models to assess the interaction between genetic, H. pylori and dietary factors, to our knowledge the first such investigation. Cumulative target enrollment is 500 cases and 500 controls. Environment: incident cases are recruited at the sole district hospital in Western Honduras, the site of an established, successful collaboration over the past 4 years. Population-based controls are recruited from villages, in the region. Data reduction and analysis, specimen processing, and specimen banking is within the UNC Center for Gastrointestinal Biology and Disease. Mentorship: primary mentorship will be provided Robert Sandier, MD MPH, a national leader in gastrointestinal cancer epidemiology. Secondary mentorship is facilitated with three successful researchers: an international leader in bacterial and H. pylori virulence (Dr Richard Peek, Vanderbilt University), a nutrition cancer epidemiologist (Dr Jessie Satia, UNC School of Public Health), and a genetic epidemiologist (Dr. Kari North, UNC School of Public Health). Relevance: gastric cancer is the second leading cause of global cancer mortality, important in Latin America, and preventable through initiatives in screening, bacterial eradication, and/or dietary intervention. This study, through systematic epidemiology, will provide detailed etiologic information, to target intervention programs in Latin America and possibly the growing U.S. Latino population.