Women's Health Initiative Cancer Survivor Cohort

描述（由申请人提供）：妇女健康倡议代表了161，000名绝经后美国妇女的大样本人群。这些妇女在人口统计学、不同暴露、生活质量评估和慢性病发病率方面都有很好的特征，包括平均12年随访期间发生的20 000多例侵袭性癌症。一个生物储存库保存着500多万瓶血清、血浆和DNA，93 000多名妇女继续接受积极的随访。WHI研究人员寻求通过解决现有计划中的两个关键限制来增加癌症生存研究的机会，特别是那些认识到肿瘤分子异质性的研究。具体而言，我们建议：1）收集癌症治疗、临床结果的信息（复发）和患者报告的结果在诊断为选定癌症的女性（乳腺癌、结直肠癌、子宫内膜癌、肺癌和卵巢癌、淋巴瘤、白血病和黑色素瘤，预计n= 21，882）使用Medicare联系或直接病历提取参与WHI期间;和2）从选定的癌症（结肠直肠癌和卵巢癌、黑色素瘤、淋巴瘤和乳腺癌和肺癌亚型，预计n= 5，900）收集石蜡包埋的肿瘤组织。我们将尽可能通过与医疗保险数据集的链接收集治疗和结果数据，以提高成本效益，并将通过访问其他管理数据库来寻求和评估收集这些数据的方法。通过增强WHI数据库与癌症治疗和复发数据，WHI将是一个宝贵的资源，以检查癌症诊断和治疗对整体健康和生活质量的影响，在一个老龄化的队列，代表了增长最快的人口，承担着巨大的癌症负担，但在随机试验中代表性不足。通过用肿瘤标本补充标本库，WHI计划将能够支持“最新”的癌症表型分析，并有助于我们了解癌症的分子基础，其治疗和生存。我们希望尽快开始，以确保能够实现大量和有代表性的资源，因为在WHI早期诊断的病例的肿瘤组织和记录将越来越难以获得。

DESCRIPTION (provided by applicant): The Women's Health Initiative represents a large population-based sample of 161,000 postmenopausal US women. These women have been well-characterized in terms of demographics, diverse exposures, quality of life assessments and incidence of chronic diseases, including over 20,000 incident invasive cancers over a mean 12 years of follow-up. A biorepository maintains >5 million vials of serum, plasma and DNA, and over 93,000 women continue in active follow-up. WHI investigators seek to enhance opportunities for cancer survivorship studies, particularly those that recognize the import of molecular heterogeneity of tumors, by addressing two key limitations in the existing program. Specifically, we propose to; 1) collect information on cancer treatment, clinical outcomes (recurrence) and patient reported outcomes in women diagnosed with selected cancers (breast, colorectal, endometrial, lung, and ovarian cancers, lymphoma, leukemia, and melanoma, projected n=21,882) during WHI participation using Medicare linkages or direct medical record abstraction; and 2) collect paraffin-embedded tumor tissue from selected cancers (colorectal and ovarian cancers, melanoma, lymphoma, and breast and lung cancer subtypes, projected n=5,900). We will collect treatment and outcome data via linkage to Medicare datasets for cost efficiencies, whenever possible, and will pursue and evaluate methods to collect these data through access to other administrative databases. By enhancing the WHI database with cancer treatment and recurrence data, WHI will be a valuable resource to examine the effects of cancer diagnosis and treatment on overall health and quality of life in an aging cohort-one that represents the fastest growing population, bears the great cancer burden but has been under-represented in randomized trials. By supplementing the specimen repository with tumor specimens, the WHI Program will be able to support "up-to-date" phenotyping of cancers and contribute to our understanding of the molecular basis of cancer, its treatment and survival. We want to begin soon to ensure that a large and representative resource can be realized, because tumor tissue and records for cases diagnosed in the early period of the WHI will become increasingly difficult to obtain.