Endometrial cancer in black women

黑人女性的子宫内膜癌

• 批准号: 8515694
• 负责人: LAUREN A WISE
• 金额: $ 6.26万
• 依托单位: BOSTON UNIVERSITY MEDICAL CAMPUS
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-04-01 至 2015-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8515694
• 关键词: 18 year old; Address; Adolescence; Affect; Age; Age at Menarche; Birth; Cancer Etiology; Case-Control Studies; Cessation of life; Child; Clear Cell; Cohort Studies; Contraceptive Usage; Data; Data Collection; Disease; Endometrial Carcinoma; Environmental Risk Factor; Epidemiologic Studies; Epidemiology; Estrogens; Grant; Heterogeneity; Histologic; Histology; Hormonal; Hormones; Incidence; Knowledge; Lactation; Malignant Neoplasms; Measures; Menopause; Meta-Analysis; Metabolic; Minority; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Oral Contraceptives; Overweight; Participant; Population; Postmenopause; Primary Prevention; Recording of previous events; Relative Risks; Research; Research Design; Research Infrastructure; Risk; Risk Factors; Serous; Testing; Underrepresented Minority; Uterine Fibroids; Uterus; Waist-Hip Ratio; Weight Gain; Woman; Women' s Health; Work; cancer diagnosis; case control; cell type; cohort; cost; follow-up; improved; interest; modifiable risk; mortality; parity; prospective; public health relevance; reproductive; surveillance study; tumor; waist circumference

DESCRIPTION (provided by applicant): Although the age-adjusted incidence of endometrial cancer is 12% lower among black women than white women, age-adjusted mortality among black women is 87% higher and this racial disparity has continued to increase over the past two decades. Preliminary evidence from the Epidemiology of Endometrial Cancer Consortium (E2C2) suggests that oral contraceptive use, parity, and older age at first and last birth are not as protective against endometrial cancer in black women as they are in white women. We propose to assess the influence of anthropometric, reproductive, hormonal, and metabolic factors on incident endometrial cancer diagnosed over 18 years of follow-up (1995-2013) in the Black Women's Health Study (BWHS), a large prospective cohort study of U.S. black women. We then propose to perform a meta-analysis of results from the BWHS, the Case-Control Surveillance Study (CCS), and 10 additional studies from the E2C2 that include black women to investigate predictors of incidence and histology (types I, II, and II). Type II and II tumors are more aggressive than type I tumors, and they are also more prevalent in black women. Little is known about risk factors for type II and III tumors. Our assessment of different histologic types for endometrial cancer has the potential to address important questions about the black-white discrepancy in mortality. The meta-analysis will involve more than 800 black cases of endometrial cancer. We will compute a relative risk (RR) for each study, evaluate heterogeneity in the RRs, and then estimate a RR for all studies combined and according to study design (e.g., cohort vs. case-control). In addition, we will perform separate analyses of histologic type to assess whether the environmental factors of interest predict types II and III cancer, which are more prevalent in black women. Black women are understudied with regard to endometrial cancer etiology. Many of the putative risk factors that we propose to study are of particular relevance to black women; for example, U.S. black women have significantly higher rates of obesity, type 2 diabetes, and uterine fibroids, and give birth at earlier ages and have more children than white women. New data about modifiable risk factors has the potential to influence primary prevention of disease. The proposed study of an underserved minority population at increasing risk of death from endometrial cancer will address gaps in research, as almost all data on determinants of endometrial cancer come from studies of white women. The proposed study can be carried out at modest cost because data collection and infrastructure are supported by other grants.

描述(申请人提供)：尽管黑人女性的年龄调整子宫内膜癌发病率比白人女性低12%，但黑人女性的年龄调整死亡率比白人女性高87%，而且在过去20年中，这一种族差距继续扩大。来自子宫内膜癌联盟流行病学(E2C2)的初步证据表明，在黑人女性中，口服避孕药的使用、产次以及第一次和最后一次出生时的年龄较大，对子宫内膜癌的预防作用不如白人女性。我们建议在黑人妇女健康研究(BWHS)中评估人体测量、生殖、激素和代谢因素对18年(1995-2013年)被诊断为子宫内膜癌的事件的影响。然后，我们建议对BWHS、病例对照监测研究(CCS)和E2C2的另外10项研究的结果进行荟萃分析，这些研究包括黑人妇女，以调查发病率和组织学(I、II和II型)的预测因素。II型和II型肿瘤比I型肿瘤更具侵袭性，在黑人女性中也更常见。人们对II型和III型肿瘤的危险因素知之甚少。我们对子宫内膜癌不同组织学类型的评估有可能解决有关死亡率黑白差异的重要问题。荟萃分析将涉及800多例子宫内膜癌的黑人病例。我们将计算每项研究的相对风险(RR)，评估RR中的异质性，然后根据研究设计(例如，队列与病例对照)估计所有研究合并后的RR。此外，我们将进行单独的组织学类型分析，以评估感兴趣的环境因素是否可以预测II型和III型癌症，这两种癌症在黑人女性中更常见。黑人妇女在子宫内膜癌病因学方面研究不足。我们建议研究的许多可能的风险因素与黑人女性特别相关；例如，美国黑人女性肥胖症、2型糖尿病和子宫肌瘤的发病率明显高于白人女性，而且生育年龄更早，孩子更多。有关可改变的危险因素的新数据有可能影响疾病的初级预防。这项针对服务不足、死于子宫内膜癌风险增加的少数群体的拟议研究将弥补研究中的空白，因为几乎所有关于子宫内膜癌决定因素的数据都来自对白人女性的研究。由于数据收集和基础设施得到其他赠款的支持，拟议的研究可以以不高的费用进行。