Women's Health Initiative Cancer Survivor Cohort

描述（由申请人提供）：妇女健康倡议代表了一个基于人口的大样本，包括161,000名绝经后美国妇女。这些妇女在人口统计学、不同的暴露、生活质量评估和慢性病发病率方面具有良好的特点，包括在平均12年的随访期间发生的2万多例侵袭性癌症。生物储存库保存了500万瓶血清、血浆和DNA， 93,000多名妇女继续积极随访。WHI研究人员通过解决现有项目中的两个关键限制，寻求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重要性的研究。具体来说，我们建议：1)在WHI参与期间，通过医疗保险联系或直接病历提取，收集诊断为选定癌症（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）的妇女的癌症治疗、临床结果（复发）和患者报告结果的信息；2)收集选定癌症（结直肠癌和卵巢癌、黑色素瘤、淋巴瘤、乳腺癌和肺癌亚型，预计n= 5900）的石蜡包埋肿瘤组织。我们将尽可能通过与医疗保险数据集的链接来收集治疗和结果数据，以提高成本效率，并将寻求和评估通过访问其他管理数据库来收集这些数据的方法。通过增强WHI数据库中的癌症治疗和复发数据，WHI将成为检验癌症诊断和治疗对老龄化人群总体健康和生活质量影响的宝贵资源——老龄化人群代表着增长最快的人口，承受着巨大的癌症负担，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项目将能够支持“最新”的癌症表型，并有助于我们对癌症的分子基础、治疗和生存的理解。我们希望尽快开始，以确保能够实现一个庞大且具有代表性的资源，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.