Incorporating residential histories into assessment of cancer risk in a predominantly low-income and racially diverse population

项目总结/摘要 人们越来越认识到，为了更准确地评估癌症风险和结果，必须考虑到整个生命过程中与居住地点相关的区域一级生物和物理暴露。然而，许多队列研究缺乏全面的居住史信息或将分析限制在入组或癌症诊断时的居住地，这是评估暴露因果关系的关键限制，可能导致错误分类或偏倚关联。来自商业供应商的住宅历史提供了一个令人兴奋的机会，将社区环境融入癌症研究。很少有研究将生活过程中的居住历史信息纳入队列研究，特别是在历史上被边缘化的人口生活在持续贫困地区，如在东南部。在美国所有人口中，居住在东南部的人口的癌症风险最高，健康状况最差。为了解决如何最好地将地理空间数据通过生命历程居住史整合到癌症研究队列研究中的知识差距，我们建议在资源充足和大规模的观察性前瞻性队列中评估居住史，这些队列是代表性不足的成年人，具体目标如下：1）收集和描述自我报告的成人生活过程中的居住历史，从历史上边缘化的人口，2）开发算法，以重建历史上被边缘化的个人的临时居住历史，和3）评估居住的流动性和时空变化的地区一级的生命过程暴露和癌症的差异。我们假设供应商和自我报告之间的居住史的一致性因人口群体而异，并将居住流动性纳入改善暴露评估并减少癌症研究中的偏倚。我们建议构建住宅历史，将住宅历史与地理空间暴露联系起来，并测试整个生命过程中地理空间暴露与癌症差异之间的关联。我们将重点关注四种最常见的癌症（乳腺癌，肺癌，结直肠癌，前列腺癌），在12个南方州招募了超过84，000名参与者。我们的设计重点是强大的方法来识别预测历史边缘化人群（包括生活在持续贫困地区的人群）的居住历史模式的因素，以及将居住历史信息转换为可解释背景的新颖翻译。然后，我们的项目研究了可以在空间和时间上影响癌症风险的社区。我们的项目促进了一个多学科团队之间的创新合作，该团队具有癌症差异，癌症流行病学，调查设计，地理空间分析，小面积估计和生物统计学方面的科学专业知识。我们的多学科方法的结果将产生持续的影响，因为它将揭示提高精确度的途径，以将整个生命过程中的区域水平暴露纳入其中，并激励解决差异的战略。

PROJECT SUMMARY/ABSTRACT There is growing recognition that area-level biological and physical exposures associated with residential location across the life-course must be considered for more precise cancer risk and outcomes. Yet many cohort studies lack comprehensive residential history information or limit analyses to the residence at enrollment or cancer diagnosis, a critical limitation in assessment of exposure causation potentially leading to misclassification or biased associations. Residential histories derived from commercial vendors offer an exciting opportunity to integrate the neighborhood environment into cancer research. Little research has been conducted incorporating life-course residential history information into cohort studies, particularly among historically marginalized populations living in persistent poverty regions such as in the Southeast. Populations living in the Southeast have the highest cancer risk and some of the poorest health outcomes among all U.S. populations. To address gaps in knowledge of how best to integrate geospatial data via life-course residential histories into cancer research cohort studies, we propose to evaluate residential histories in a well-resourced and large-scale observational prospective cohort of underrepresented adults, with the following specific aims: 1) collect and describe self-reported adult life-course residential histories from a historically marginalized population, 2) develop algorithms to reconstruct temporal residential histories for historically marginalized individuals, and 3) evaluate residential mobility and spatiotemporal changes in area-level life-course exposures and cancer disparities. We hypothesize concordance of residential history between vendor and self-report varies by population group and incorporating residential mobility improves exposure assessment and reduces bias in cancer research. We propose to construct residential histories, link residential histories to geospatial exposures, and test associations between geospatial exposures across the life-course and cancer disparities. We will focus on the four most common cancers (breast, lung, colorectal, prostate) in over 84,000 participants recruited across 12 Southern states. Our design focuses on robust methods to identify factors predictive of residential history patterns among historically marginalized populations, including those living in persistent poverty regions, and novel translation of residential history information into an interpretable context. Our project then examines neighborhoods which can influence cancer risk over space and time. Our project fosters innovative collaborations among a multidisciplinary team with scientific expertise in cancer disparities, cancer epidemiology, survey design, geospatial analyses, small area estimation, and biostatistics. Findings from our multidisciplinary approach will have sustained impact since it will reveal pathways for improved precision to incorporate area-level exposures across the life-course and motivate strategies to address disparities.