A pooled analysis of risk factors of small intestine cancer

说明(申请人提供)：项目摘要/摘要由于经济和社会变化，中低资源国家的癌症发病率大大增加，这导致人口规模增加和人口老龄化，并改变了暴露在烟草和酒精、超重和肥胖、生殖习惯和职业因素等风险因素中的模式。在中等资源国家转型人口中进行的流行病学研究强调了这些生活方式因素在确定癌症风险快速变化方面的作用。然而，这些研究中的大多数都是病例对照研究，其回溯性设计比前瞻性队列研究提供了更大的选择和信息偏差的风险。队列研究能够更好地利用低资源和中等资源国家的大暴露和风险对比，来调查在这些人口中的许多人正在发生的转变的影响。这种方法对常见癌症都有帮助，如果可以在基于联合体的汇集分析中聚集足够多的人群，则对较罕见和较少被广泛研究的肿瘤也是有用的。我们的目标是对来自亚洲的队列研究进行汇集分析，以评估烟草、酒精和BMI升高对小肠癌症病因的贡献，这是一系列罕见癌症的第一项研究。该分析还将检验主要类型的小肠癌、腺癌(AC)和其他组织学类型之间的病因异质性假说。联合分析将在亚洲队列联盟(ACC)内的队列中进行，该联盟最近成立，目的是促进亚洲当前和未来流行病学队列研究之间的合作和数据汇集。我们的联合体致力于实现NCI的目标，即“扩大中心、网络和联合体的能力”，以及NCI计划和优先事项中概述的“创建和维持促进研究协作的基础设施，作为技术开发平台，并提供获取各种研究资源的途径”的目标。我们预计，ACC内的分析将是朝着改善对罕见癌症的原因和机制的理解迈出的重要一步，并将加强联盟内的合作，以进行进一步的汇集分析。此外，我们计划将ACC数据与来自北美和欧洲的其他大型队列的数据结合在一起，以进一步增强研究小肠癌危险因素的统计能力。 与公共卫生的相关性：项目简介近年来，由于人口数量增加、人口老龄化以及暴露于吸烟、饮酒、超重和肥胖、生殖习惯和职业因素等风险因素的模式发生变化，中低资源国家的癌症负担大大增加。对中等资源国家转型人口的流行病学研究将产生与美国和其他高收入国家同样相关的癌症病因学证据，因为它有能力评估更广泛的接触范围的影响，特别是在光谱的低端(例如，卡路里摄入量、体重指数)。这一方法将有助于常见癌症，如果足够大的人群可以聚集在基于联盟的汇集分析中，则对于本研究中建议的较罕见和较少被广泛研究的肿瘤，如小肠癌，将是有用的。

DESCRIPTION (provided by applicant): Project Summary/Abstract Cancer incidence has greatly increased in low- and medium-resource countries as a result of economic and social shifts, which have contributed to an increase in population size and the aging of populations, as well as altered the pattern of exposure to risk factors such as tobacco and alcohol, overweight and obesity, reproductive habits, and occupational agents. Epidemiologic studies conducted in populations in transition in medium-resource countries have stressed the role of such lifestyle factors in determining the rapid change in cancer risk. However, most of these studies were designed as case-control studies, the retrospective design of which provides greater risks of selection and information biases than prospective cohort studies. Cohort studies are better able to take advantage of large exposure and risk contrasts in low- and medium-resource countries to investigate the effects of the transition that is occurring in many of these populations. This approach is helpful for both common cancers and, if large enough populations can be assembled in consortium-based pooled analyses, for rarer and less widely studied neoplasms. We aim to conduct a pooled analysis of cohort studies from Asia to assess the contribution of tobacco, alcohol, and elevated BMI to the etiology of cancer of the small intestine, as the first study in a series on rare cancers. The analysis will also test the hypothesis of heterogeneity in the etiologic factors between the main type of cancer of the small intestine, adenocarcinoma (AC), and other histologic types. The pooled analysis will be conducted among cohorts within the Asia Cohort Consortium (ACC), which was recently established with the goal of promoting collaboration and data pooling among current and future epidemiologic cohort studies in Asia. Our consortium addresses the NCI objective to "expand the capacity of centers, networks, and consortia," and the goal to "create and sustain infrastructures that facilitate research collaboration, serve as platforms for technology development, and provide access to the full range of research resources," as outlined in the NCI Plans and Priorities. We anticipate that the analysis within the ACC will be a major step toward improving understanding of the causes and mechanisms of rare cancers and will enhance the collaboration within the consortium for further pooled analyses. Furthermore, we plan to pool the ACC data with those of other large cohorts from North America and Europe to further increase the statistical power of looking at risk factors of small intestine cancer. PUBLIC HEALTH RELEVANCE: Project Narrative The burden of cancer has greatly increased in low- and medium-resource countries in recent years, as a consequence of the increase in population size, the aging of the population, and changes in pattern of exposure to risk factors, including tobacco smoking, alcohol drinking, overweight and obesity, reproductive habits, and occupational agents. Epidemiologic studies in populations in transition in medium-resource countries will generate evidence on cancer etiology that is relevant also for the United States and other high- income countries, owing to the capacity to assess the effect of broader exposure ranges, especially at the low end of the spectrum (e.g., caloric intake, body mass index). This approach will be helpful both for common cancers and, if large enough populations can be assembled in consortium-based pooled analyses, for rarer and less widely studied neoplasms such as small intestine cancer, as proposed in this research.