Epidemiologic Field Studies

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BCDDP: Breast cancer detection demonstration project follow-up study (01030). This study follows about 60,000 former participants in the Breast Cancer Demonstration Project (BCDDP). Current analyses include: 1) dietary pooling project analyses involving cancers of the breast, colon, ovary, and kidney; and 2) numerous DCEG cohort pooling projects. Gastric cancer: Randomized multi-intervention trial to inhibit precancerous gastric lesions in Linqu, Shandong Province (00446). We gathered fifteen year follow-up data from an 8-year trial in rural China to determine whether any of three treatments would affect gastric cancer incidence or specific causes of mortality. The treatments were long-term vitamin (C, E, and selenium) supplementation and garlic supplementation, given from 1995 to 2003, and one time administration of amoxicillin/omeprazole given in 1995. A paper published in 2012 showed that amoxicillin/omeprazole treatment reduced gastric cancer incidence by 39% over a fifteen year period. We examined subgroups and determined that antibiotic treatment was effective for older members of the population and for members with advanced precancerous gastric lesions at the beginning of the study, despite the fact that Helicobacter pylori is thought to act on early stages of gastric carcinogenesis. Thus antibiotic treatment can be applied broadly to prevent gastric cancer and need not be restricted to the young or to those with mild histopathology. We discussed the pros and cons of giving antibiotic treatment to members of the original trial cohort. Inflammatory breast cancer (IBC) case-control study (00314) This case-control study will include approximately 400 IBC cases accrued at 5 centers in North Africa (1 center in Tunisia, 2 in Egypt, and 2 in Morocco). Two control groups are being included: 1) 400 non-IBC breast cancer cases and; 2) 400 visitor controls (excluding first-degree relatives) to randomly selected female inpatients (excluding those with breast, ovarian, endometrial, and nasopharyngeal cancer) in the study hospitals. The study involves the administration of a questionnaire, anthropometric measurements, saliva collection, digital photographs of the breasts of IBC cases, and the collection of paraffin-embedded tumor tissue for IBC cases and non-IBC breast cancer controls. The study is being conducted as a collaboration with the University of Nebraska, with forms development and translation coordinated at the National Cancer Institute-USA. The NCI-DCEG is responsible for developing study procedures at the study centers in Egypt, Tunisia, and Morocco. Data collection began in March 2009 in Egypt, August 2009 in Tunisia, and January 2011 in Morocco. Data collection in Egypt and Tunisia stopped on 09/30/2013. Consideration is being given to continuing the project beyond 9/30/2013 in order to reach the accrual goals. A paper published in 2013 discussed methodological issues pertinent to an epidemiologic study in middle/low income countries.