Descriptive Studies and Record Linkage

描述性研究和记录链接

• 批准号: 8763632
• 负责人: William Anderson
• 金额: $ 16.77万
• 依托单位: DIVISION OF CANCER EPIDEMIOLOGY AND GENETICS
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/8763632
• 关键词: Affect; Africa South of the Sahara; African; African Caribbean; Agreement; American; Ampulla of Vater Carcinoma; Anatomic Sites; Anus Neoplasms; Area; Attention; Behavior; Biliary Tract Cancer; Birth; Brazil; Breast Cancer Surveillance Consortium; Cancer Etiology; Cancer Surveillance Research; Caribbean region; Cervix Neoplasms; Characteristics; Communities; Country; Data; Data Linkages; Databases; Denmark; Detection; Development; Diagnosis; Diagnostic; Diagnostic Neoplasm Staging; Disease; Employee Strikes; Endometrioid Carcinoma; Ethnic Origin; Ethnic group; Etiology; Extrahepatic Bile Ducts; Female; Follicular thyroid carcinoma; Future; Gender; General Population; Generations; Gynecologic; Head and Neck Neoplasms; Healthcare; Heterogeneity; Hispanics; Hormonal; Hormone replacement therapy; Hormones; Human Papillomavirus; Hysterectomy; Incidence; International Agency for Research on Cancer; Iodine; Link; Malignant Neoplasms; Malignant neoplasm of gallbladder; Malignant neoplasm of ovary; Malignant neoplasm of prostate; Malignant neoplasm of thyroid; Medical; Medical Surveillance; Menopause; Metric; Microscopic; Modality; Neoplasms; Nested Case-Control Study; Obesity; Ovarian; Papillary; Paraffin Tissue; Pathologist; Pattern; Persons; Physicians; Population; Postmenopause; Prevalence; Prostate carcinoma; Prostatic Neoplasms; Public Health; Race; Reporting; Residual state; Risk; Risk Factors; Role; Rosa; SEER Program; Site; Staging; Subgroup; Survivors; Testing; Thyroid Gland; Time; Tissues; Tumor stage; United States; Vaccination; Vagina; Variant; Woman; Women' s Health; cancer epidemiology; cancer risk; cancer type; carcinogenesis; cohort; experience; falls; geographic difference; hormone therapy; inflammatory breast cancer; male; malignant breast neoplasm; men; middle age; mortality; neoplasm registry; nutrition; older women; penis; population based; racial and ethnic; repository; screening; trend; tumor; young woman

General descriptive studies (00350): Following decades of rising breast cancer incidence in the U.S. there were abrupt declines circa 2000 that stabilized during 2003-2004. The fall in breast cancer rates occurred mostly among older women with ER positive cancers, following the Womens Health Initiative announcement that reported statistically significant breast cancer risks among women using hormone replacement therapy. Much less attention was given to falling ER negative cancer rates, especially since hormonal exposures were not expected to affect ER negative tumors. Subsequent studies in the U.S., however, confirmed that ER negative breast cancers had declined while ER positive cancers were rising over the long-term; consistent with etiologic heterogeneity due to secular changes in different risk factor profiles for ER positive and ER negative cancers. The observation of similar trends in other countries with similar risk factor patterns would support the view that US trends reflect changes in the prevalence of exposures linked to different breast cancer subtypes. Denmark was an excellent test case. Subsequent results showed that trends in breast cancer incidence rates in Demark and U.S. were similar and consistent with dynamic changes in etiologically distinct breast cancer subtypes over time. ER positive cancers had increased among middle-aged and older Danish women in earlier birth-cohorts (or generations), implying a confluence of risk factor exposures during the peri-menopausal through the post-menopausal periods. On the other hand, ER negative cancers had decreased among younger women in more recent cohorts. The Danish and US experience may foreshadow a common pattern worldwide. Emerging data suggest that ovarian cancers differ by tumor grade. However, the reliability of microscopic grade from paraffin tissue in the general medical community and as reflected in population-based cancer registries is unknown. We examined grade agreement between two gynecologic pathologists and the NCIs Surveillance Epidemiology and End Results (SEER) Residual Tissue Repository (SEER). Grade agreement was fair at best between the study pathologists and SEER; and therefore, recorded grade in SEER should be used with caution and is probably not a reliable metric for ovarian cancer epidemiology in the general population. We investigated risk factors for inflammatory breast cancer in a nested case-control study in the Breast Cancer Surveillance Consortium database (1994-2009). Associations between high BMI and inflammatory breast cancer were particularly striking and suggest a different etiology for this clinically distinct breast cancer. After a report from the Womens Health Initiative (WHI) in 2002, a precipitous decline in menopausal hormonal therapy (MHT) use in the United States was linked to a decline in breast cancer incidence rates. Given that MHT use is also associated with increased ovarian cancer risk, we tested whether ovarian cancer incidence rates changed after 2002 using the North American Association of Central Cancer Registries (NAACCR) database. After a marked reduction in MHT use around 2002, ovarian cancer incidence rates demonstrated an accelerated decline, with the largest changes for endometrioid carcinomas. This strong temporal association, although not proving a causal role of hormones in ovarian carcinogenesis, suggests a role for hormonal exposures on the development and behavior of certain ovarian cancer subtypes. Although ovarian cancer incidence rates have declined in the United States, less is known of ovarian cancer trends among survivors of breast cancer. Therefore, we examined second primary ovarian cancers after first primary breast cancer in SEER. Persistently elevated SIRs along with decreasing absolute rates over the entire study period suggest that ovarian cancers in both the general population and survivors of breast cancer are declining in parallel, possibly because of common risk factor exposures. The SEER program incidence data were utilized in several additional projects. In a study of biliary tract cancers, a female excess of gallbladder cancer was apparent among all racial/ethnic groups, in contrast to a male excess for extrahepatic bile duct and ampulla of Vater cancers. The temporal trends differed by site, with rates for gallbladder cancer declining and those for extrahepatic bile duct rising in many of the gender/racial/ethnic groups. These findings indicate that these cancers likely are etiologically distinct. The incidence of potentially HPV-related preinvasive and invasive neoplasms in the US was investigated to document the patterns before widespread HPV vaccination. Incidence of preinvasive squamous tumors of the cervix, vagina, and penis rose rapidly over time and decreased for invasive neoplasms. The most rapid increases occurred for both preinvasive and invasive anal tumors. Patterns were generally similar among the various racial/ethnic groups, with the exception of invasive head and neck tumor rates which increased exclusively among white males. The rising rates support an urgent need for vaccination given the absence of effective screening modalities for tumors at these sites. The increases in thyroid cancer overall and in the predominant papillary type have been well-documented, but trends for follicular thyroid cancer, a less common but more aggressive variant, have not been as well characterized. Follicular thyroid cancer rates among both women and men rose more rapidly for regional than localized stage disease; rates increased for all tumor sizes among women but primarily for smaller size tumors among men. These results add to the evidence that rising thyroid cancer rates are not only due to improvements in detection and that the thyroid types should be evaluated separately in future studies. The thyroid cancer incidence rates in Sao Paulo, Brazil, known to be among the highest in the world, were compared with those in the U.S. SEER program. Overall incidence rates increased over time in both populations and were higher in Sao Paulo than in the US among both females and males, by 65% and 23%, respectively. The female/male incidence rate ratio was higher in Sao Paulo (4.17) than in SEER (3.10), and it did not change over time. Both diagnostic activity and iodine nutrition status may be contributing to these patterns. Both the SEER and NAACCR data were used to assess state-level uterine corpus cancer incidence rates by race/ethnicity corrected for hysterectomy prevalence and to identify potential correlation with state-level obesity prevalence. Corpus cancer rates rose 30%-100% with correction for hysterectomy, and a modest association with obesity became apparent. For most states, hysterectomy correction diminished or reversed the black/white deficit and accentuated the Hispanic/white deficit. Global patterns of prostate cancer incidence, aggressiveness, and mortality in men of African descent were assessed using publicly available IARC data and collected data from the Men of African Descent and Carcinoma of the Prostate (MADCaP) Consortium and the African Caribbean Cancer Consortium. Prostate cancer incidence and mortality are highest in men of African descent in the USA and the Caribbean. Tumor stage and grade were highest in sub-Saharan Africa. The proportion of prostate tumors that were stage T1 was higher in countries with greater percent gross domestic product spent on health care and physicians per 100,000 persons. Although cancer of the prostate appears to be under diagnosed and/or under reported in sub-Saharan men, prostate cancer incidence and mortality represent a significant public health problem in men of African descent around the world.

一般描述性研究 (00350)：美国乳腺癌发病率几十年来不断上升，在 2000 年左右突然下降，并在 2003 年至 2004 年期间趋于稳定。 乳腺癌发病率下降主要发生在患有 ER 阳性癌症的老年女性中，此前女性健康倡议宣布报告称，使用激素替代疗法的女性患乳腺癌的风险具有统计学意义。 人们对 ER 阴性癌症发病率下降的关注要少得多，特别是因为激素暴露预计不会影响 ER 阴性肿瘤。 然而，随后在美国进行的研究证实，从长期来看，ER 阴性乳腺癌数量有所下降，而 ER 阳性乳腺癌数量却在上升。与 ER 阳性和 ER 阴性癌症不同危险因素谱的长期变化导致的病因异质性一致。 对具有类似危险因素模式的其他国家的类似趋势的观察将支持以下观点：美国趋势反映了与不同乳腺癌亚型相关的暴露流行率的变化。 丹麦是一个很好的测试案例。 随后的结果表明，丹麦和美国的乳腺癌发病率趋势相似，并且与病因不同的乳腺癌亚型随时间的动态变化一致。 在早期出生群体（或几代人）的中年和老年丹麦女性中，ER 阳性癌症有所增加，这意味着从围绝经期到绝经后期间，危险因素暴露的汇合。 另一方面，在最近的队列中，年轻女性的 ER 阴性癌症有所减少。 丹麦和美国的经验可能预示着世界范围内的共同模式。 新数据表明，卵巢癌因肿瘤分级而异。 然而，一般医学界和基于人群的癌症登记所反映的石蜡组织显微镜分级的可靠性尚不清楚。 我们检查了两名妇科病理学家与 NCI 流行病学监测和最终结果 (SEER) 残留组织存储库 (SEER) 之间的等级一致性。 研究病理学家和 SEER 之间的等级协议充其量是公平的；因此，SEER 中记录的分级应谨慎使用，并且可能不是一般人群中卵巢癌流行病学的可靠指标。 我们在乳腺癌监测联盟数据库（1994-2009）的一项巢式病例对照研究中调查了炎症性乳腺癌的危险因素。 高体重指数与炎性乳腺癌之间的关联尤其引人注目，表明这种临床上独特的乳腺癌有不同的病因。 2002 年妇女健康倡议 (WHI) 发布报告称，美国绝经期激素疗法 (MHT) 使用量急剧下降与乳腺癌发病率下降有关。鉴于 MHT 的使用也与卵巢癌风险增加相关，我们使用北美中央癌症登记协会 (NAACCR) 数据库测试了 2002 年之后卵巢癌发病率是否发生变化。 2002 年左右 MHT 使用量显着减少后，卵巢癌发病率加速下降，其中子宫内膜样癌变化最大。 这种强烈的时间关联虽然不能证明激素在卵巢癌发生中的因果作用，但表明激素暴露对某些卵巢癌亚型的发展和行为具有一定的作用。 尽管美国卵巢癌的发病率有所下降，但人们对乳腺癌幸存者中卵巢癌的趋势知之甚少。因此，我们在 SEER 中检查了继第一原发性乳腺癌之后的第二原发性卵巢癌。 在整个研究期间，SIR 持续升高以及绝对发病率下降表明，普通人群和乳腺癌幸存者的卵巢癌发病率正在同步下降，这可能是由于暴露于常见的危险因素所致。 SEER 计划的发生率数据被用于其他几个项目。 在一项胆道癌研究中，所有种族/族裔群体中女性胆囊癌的发病率均明显较高，而男性肝外胆管癌和壶腹部癌的发病率则较高。 时间趋势因地点而异，在许多性别/种族/民族群体中，胆囊癌的发病率下降，肝外胆管癌的发病率上升。 这些发现表明这些癌症在病因学上可能是不同的。 对美国潜在与 HPV 相关的浸润前和浸润性肿瘤的发生率进行了调查，以记录广泛 HPV 疫苗接种之前的模式。 宫颈、阴道和阴茎的浸润前鳞状肿瘤的发病率随着时间的推移迅速上升，而浸润性肿瘤的发病率则下降。 浸润前和浸润性肛门肿瘤的增长最快。 不同种族/族裔群体的模式总体相似，但侵袭性头颈肿瘤发生率仅在白人男性中增加。鉴于这些地点缺乏有效的肿瘤筛查方式，不断上升的比率表明迫切需要疫苗接种。 甲状腺癌总体和主要乳头状类型的增加已得到充分记录，但滤泡性甲状腺癌（一种不太常见但更具侵袭性的变体）的趋势尚未得到很好的表征。 女性和男性中，区域性滤泡性甲状腺癌的发病率比局部期疾病的发病率上升得更快；女性中所有肿瘤大小的发病率均有所增加，但主要是男性中较小肿瘤的发病率。 这些结果进一步证明，甲状腺癌发病率上升不仅是由于检测方法的改进，而且在未来的研究中应单独评估甲状腺类型。 巴西圣保罗的甲状腺癌发病率位居世界前列，我们将其与美国 SEER 计划的甲状腺癌发病率进行了比较。随着时间的推移，这两个人群的总体发病率均呈上升趋势，圣保罗的女性和男性发病率分别比美国高 65% 和 23%。 圣保罗的女性/男性发病率比（4.17）高于SEER（3.10），并且不随时间变化。诊断活动和碘营养状况都可能导致这些模式。 SEER 和 NAACCR 数据均用于评估州级子宫体癌发病率（按种族/族裔校正子宫切除率），并确定与州级肥胖患病率的潜在相关性。 子宫切除术矫正后，体癌发生率上升 30%-100%，并且与肥胖的适度关联变得明显。 对于大多数州来说，子宫切除术矫正减少或逆转了黑人/白人的缺陷，并加剧了西班牙裔/白人的缺陷。 使用公开的 IARC 数据和从非洲人后裔与前列腺癌 (MADCaP) 联盟和非洲加勒比癌症联盟收集的数据，评估了非洲人后裔男性前列腺癌发病率、侵袭性和死亡率的全球模式。 美国和加勒比地区的非洲裔男性前列腺癌发病率和死亡率最高。 撒哈拉以南非洲地区的肿瘤分期和分级最高。 在每 10 万人用于医疗保健和医生的国内生产总值百分比较高的国家，T1 期前列腺肿瘤的比例较高。 尽管撒哈拉以南男性的前列腺癌似乎诊断不足和/或报告不足，但前列腺癌的发病率和死亡率是世界各地非洲裔男性的一个重大公共卫生问题。