Epidemiology

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Cancer Epidemiology The goal of the Cancer Epidemiology Program is to discover new knowledge relevant to cancer etiology, diagnosis, prognosis, survival, and prevention using an interdisciplinary epidemiologic approach. This research has been conducted primarily in the context of large population-based case-control studies in North Carolina with an emphasis on inclusion of African-Americans. The studies have typically included collection of diverse exposure data, genomic DNA, and tumor samples. Cancers of particular interest in North Carolina and other studies have included breast cancer, colorectal cancer, malignant melanoma, prostate cancer, head and neck cancer, and childhood cancer. An expanding area of emphasis is the influence of genetic and environmental factors on cancer survivorship. Case groups from selected large population-based case control studies form the basis of survivor cohorts that are being updated and evaluated for multiple predictors of survival. Highlights of Program research include the identification of breast cancer molecular subtypes and their relationship with risk factors and prognosis among African-American women. This important finding will be further investigated by the ongoing enrollment of 2000 newly-diagnosed breast cancer patients who will be followed rigorously for five years to determine interactions between treatment and breast cancer molecular subtypes, as well as to evaluate racial disparities in breast cancer survival and access to care. Other Program highlights include new findings on the role of obesity and physical activity in breast cancer risk and survival, unique expression patterns in breast cancer and breast tissues, and the association between exposures and BRAF-mutant melanoma. The Program adds value to the Center through its population-based study resources that provide the basis for unique interdisciplinary studies. Its leader, Dr. Andrew Olshan, is a senior cancer epidemiologist with an extensive research and training program. In 2009, the Program had 16 members with total cost funding of $9.7 million, including $5.9 million in NCI funding. Publications averaged ~100 per years over the last six years; 12% were intraprogrammatic and 28% were interprogrammatic. Future plans for the Program include an emphasis on studies of diverse exposures and gene-environment interaction in relation to the risk of several cancers as well as cancer survivorship. The availability of DNA from over 12,000 cases and a similar number of controls from population-based studies has contributed to two large-scale genome-wide association studies (CBCS and CHANCE). Translational studies using population-based samples will also incorporate tumor profile results from microarray studies. For example, studies to further elucidate the relationship between cancer risk factors and gene expression in precancerous and normal tissue are under way.