Long Term Multidisciplinary Study of Cancer in Women: The Nurses Health Study

摘要 这是UM 1应用程序的竞争性更新，以支持原始护士健康的基础设施 研究（NHS），开始于1976年。NHS积累的资源为以下方面提供了难得的机会： 确定癌症预防、病因学和生存的新范例。资源包括：生活方式，饮食 来自121，700名妇女的20份两年期调查问卷的健康数据; 关于环境和邻里的数据;来自32，826名中年参与者的血液样本;第二次血液和 10年后，这些妇女中有18，743人的晨尿; 33，040名无血妇女的颊细胞; 62，641名无血妇女的颊细胞。 趾甲样本; 6，027个诊断前乳房X线照片;来自16种癌症的> 14，000名患者的组织块。 NHS的科学贡献同样出色。在这段时间里， 成果包括：400多份与癌症有关的出版物; 外部调查人员和汇集项目/财团（自2014年以来增加了130%）;以及参与 33个癌症联盟，包括22个NCI联盟。最重要的是，NHS的研究有意义地指导了 国家和国际癌症指南，从饮食到辅助治疗。 我们的首要目标是（1）通过收集关键的新数据有效地扩展资源 元素和标本，以及（2）最大限度地应用和共享现有资源， 促进它们转化为新的癌症发现。首先，NHS女性现在>70岁 年龄在美国，超过三分之一的癌症发生在75岁以后，一半的癌症幸存者是70岁以上。许多 癌症表型分布似乎随年龄而变化（例如，浆液性卵巢癌的发病率 common）。此外，在未来15年内，美国70岁以上人口的比例将增长60%。 因此，NHS的持续数据和肿瘤组织收集对于提供新的行为和生物信息至关重要 癌症病因学、生存率和老年生活质量的研究。具体而言，在下一个资助期内，我们会 继续：收集关于行为、生活质量和老年健康的问卷数据;记录癌症/ 死亡;与癌症和死亡登记处的联系，以及医疗保险索赔，以加强后续行动;保持我们的生物- 储存库;收集新的组织块。其次，我们在数据使用/共享方面取得了巨大成就，但 这可以进一步增加，以利用更多癌症科学家的脑力。掌握大， 具有数十年积累的数据元素的复杂数据系统是一个挑战， 数据共享在下一个资助期内，我们建议更新和现代化我们的数据系统， 通过用户友好的数据管理、可视化和分析工具支持大量用户。 这将通过与布罗德研究所的令人兴奋的合作来完成，布罗德研究所正在领导和开发类似的 癌症基因组图谱，基因型组织表达（GTEx）项目和其他平台。

ABSTRACT This is a competing renewal of a UM1 application to support the infrastructure of the original Nurses’ Health Study (NHS), begun in 1976. The accumulated resources of NHS provide exceptional opportunities for identifying new paradigms in cancer prevention, etiology and survival. The resources encompass: lifestyle, diet and health data from 20 biennial questionnaires spanning 4 decades from 121,700 women; linked residential data on environment and neighborhood; blood samples from 32,826 participants in mid-life; a 2nd blood and morning urine in 18,743 of these women 10 years later; buccal cells from 33,040 women without blood; 62,641 toenail samples; 6,027 pre-diagnostic mammograms; tissue blocks from >14,000 patients across 16 cancers. The scientific contributions of NHS have been equally exceptional. During this funding period, accomplishments include: >400 cancer-related publications; nearly 300 resource-sharing projects by external investigators and pooling projects/consortia (a 130% increase since 2014); and participation in 33 cancer consortia, including 22 NCI consortia. Most importantly, NHS research has meaningfully guided national and international cancer guidelines on issues ranging from diet to adjuvant treatment. Our overarching goals here are to (1) efficiently expand resources with collection of key new data elements and specimens, and (2) maximize the application and sharing of existing resources, facilitating their transformation into novel cancer discoveries. First, NHS women are now >70 years of age. Over 1/3 of cancers in the US occur after age 75, and half of cancer survivors are 70+ years. Many cancer phenotype distributions appear to change with age (e.g., serous ovarian cancer becomes more common). Moreover, in the next 15 years, the proportion of the US population >70 years will grow by 60%. Thus, continued data and tumor tissue collection in NHS is critical to inform new behavioral and biological research on cancer etiology, survival and quality of life in aging. Specifically, in the next funding period, we will continue to: collect questionnaire data on behavior, quality of life, and health in aging; document cancers/ deaths; link with cancer and death registries, and Medicare claims to enhance follow-up; maintain our bio- repository; collect new tissue blocks. Second, we have had great accomplishments in data use/sharing, but this could be further increased to harness the brain-power of more cancer scientists. Mastering the large, complex data systems with decades of accumulated data elements is a challenge that inhibits efficiency of data sharing. In the next funding period, we propose to update and modernize our data systems, to grow support a large community of users via user-friendly tools for data management, visualization, and analysis. This will be done in an exciting collaboration with The Broad Institute, which is leading and developing similar platforms for The Cancer Genome Atlas, the Genotype-Tissue Expression (GTEx) project, and others.