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）：美国乳腺癌发病率在经历了几十年的上升之后，在2000年左右突然下降，并在2003-2004年期间稳定下来。乳腺癌发病率的下降主要发生在患有雌激素受体阳性癌症的老年妇女中，此前妇女健康倡议宣布，在使用激素替代疗法的妇女中，有统计学意义的乳腺癌风险。人们对雌激素受体阴性肿瘤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雌激素受体阴性肿瘤。然而，随后在美国进行的研究证实，长期来看，雌激素受体阴性的乳腺癌发病率有所下降，而雌激素受体阳性的乳腺癌发病率却在上升；由于ER阳性和ER阴性癌症的不同危险因素的长期变化，这与病因异质性一致。在具有类似风险因素模式的其他国家观察到的类似趋势将支持这样一种观点，即美国的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。随后的结果显示，丹麦和美国的乳腺癌发病率趋势是相似的，并且与病因不同的乳腺癌亚型随时间的动态变化是一致的。雌激素受体阳性癌症在较早出生队列（或几代）的中老年丹麦妇女中有所增加，这意味着围绝经期和绝经后时期的危险因素暴露的汇合。另一方面，在最近的队列中，雌激素受体阴性的癌症在年轻女性中有所下降。丹麦和美国的经验或许预示着世界范围内的一种共同模式。新出现的数据表明卵巢癌因肿瘤分级而异。然而，石蜡组织显微分级的可靠性在一般医疗界和反映在以人群为基础的癌症登记是未知的。我们检查了两名妇科病理学家和NCIs监测流行病学和最终结果（SEER）残留组织库（SEER）之间的等级一致性。研究病理学家和SEER之间的等级一致性最多是公平的；因此，在SEER中记录的分级应该谨慎使用，并且可能不是普通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）的巢式病例对照研究中调查了炎症性乳腺癌的危险因素。高BMI和炎症性乳腺癌之间的联系尤其显著，这表明这种临床上不同的乳腺癌有不同的病因。2002年妇女健康倡议（WHI）的一份报告指出，美国绝经期激素治疗（MHT）使用的急剧下降与乳腺癌发病率的下降有关。鉴于MHT的使用也与卵巢癌风险增加有关，我们使用北美中央癌症登记协会（NAACCR）数据库测试了2002年后卵巢癌发病率是否发生变化。在2002年前后MHT的使用显著减少后，卵巢癌的发病率显示出加速下降，其中子宫内膜样癌的变化最大。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，但表明激素暴露在某些卵巢癌亚型的发展和行为中起作用。虽然卵巢癌的发病率在美国有所下降，但人们对乳腺癌幸存者患卵巢癌的趋势知之甚少。因此，我们在SEER中检查了第一原发性乳腺癌后的第二原发性卵巢癌。在整个研究期间，持续升高的SIRs和不断下降的绝对比率表明，在普通人群和乳腺癌幸存者中，卵巢癌的发病率都在平行下降，可能是因为共同的风险因素暴露。SEER项目的发病率数据被用于其他几个项目。在一项胆道癌症的研究中，女性胆囊癌的发病率在所有种族/民族中都很明显，而男性肝外胆管和壶腹癌的发病率则明显高于女性。时间趋势因地区而异，在许多性别/种族/民族群体中，胆囊癌发病率下降，肝外胆管发病率上升。这些发现表明，这些癌症在病因上可能是不同的。在广泛接种HPV疫苗之前，研究了美国潜在的HPV相关的侵袭性和侵袭性肿瘤的发病率。宫颈、阴道和阴茎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。在浸润前和浸润性肛门肿瘤中均出现了最快速的增长。除了侵袭性头颈部肿瘤发病率只在白人男性中增加外，不同种族/族裔群体的模式大致相似。鉴于缺乏对这些部位肿瘤的有效筛查方式，不断上升的发病率表明迫切需要接种疫苗。甲状腺癌总体和主要乳头状型的增加已被充分记录，但滤泡性甲状腺癌（一种不太常见但更具侵袭性的变体）的趋势尚未被很好地描述。女性和男性的滤泡性甲状腺癌发病率在局部阶段比局部阶段上升得更快；在女性中，所有肿瘤大小的发病率都有所增加，但主要是男性中较小的肿瘤。这些结果进一步证明，甲状腺癌发病率的上升不仅是由于检测的改进，而且在未来的研究中应分别评估甲状腺类型。巴西圣保罗是世界上甲状腺癌发病率最高的城市之一，研究人员将其与美国SEER项目的发病率进行了比较。随着时间的推移，这两个人群的总发病率都在增加，圣保罗的女性和男性的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)，且不随时间变化。诊断活动和碘营养状况可能对这些模式有贡献。SEER和NAACCR数据被用于评估州一级按种族/民族划分的子宫癌发病率，校正子宫切除术患病率，并确定与州一级肥胖患病率的潜在相关性。子宫切除术矫正后，语料癌发病率上升30%-100%，且与肥胖的适度关联变得明显。在大多数州，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。利用国际癌症研究机构公开提供的数据，以及从非洲裔男性和前列腺癌（MADCaP）协会和非洲加勒比癌症协会收集的数据，评估了非洲裔男性前列腺癌发病率、侵袭性和死亡率的全球模式。前列腺癌的发病率和死亡率在美国和加勒比地区的非洲裔男性中最高。肿瘤分期和分级在撒哈拉以南非洲最高。在每10万人中用于医疗保健和医生的国内生产总值比例较高的国家，处于T1期的前列腺肿瘤比例较高。虽然在撒哈拉以南的男子中前列腺癌的诊断和/或报告似乎不足，但前列腺癌的发病率和死亡率是世界各地非洲人后裔男子的一个重大公共卫生问题。