Epidemiology

癌症流行病学 癌症流行病学计划的目标是利用跨学科的流行病学方法，发现与癌症病因、诊断、预后、生存和预防相关的新知识。这项研究主要是在北卡罗来纳州以人口为基础的大规模病例对照研究的背景下进行的，重点是纳入非洲裔美国人。这些研究通常包括收集 不同的暴露数据、基因组DNA和肿瘤样本。北卡罗来纳州和其他研究特别关注的癌症包括乳腺癌、结直肠癌、恶性黑色素瘤、前列腺癌、头颈癌和儿童癌。一个不断扩大的重点领域是遗传和环境因素对癌症存活率的影响。来自选定的以人群为基础的大型病例对照研究的病例组构成了幸存者队列的基础，这些队列正在更新和评估多种生存预测因素。项目研究的重点包括确定乳腺癌分子亚型及其与非裔美国女性风险因素和预后的关系。这一重要发现将通过正在进行的2000名新诊断的乳腺癌患者的登记来进一步调查，这些患者将被严格跟踪五年，以确定治疗与乳腺癌分子亚型之间的相互作用，以及评估乳腺癌存活率和获得护理的种族差异。 该计划的其他亮点包括关于肥胖和体力活动在乳腺癌风险和生存中的作用的新发现，乳腺癌和乳腺组织中独特的表达模式，以及暴露与BRAF突变黑色素瘤之间的联系。 该计划通过其基于人口的研究资源为中心增加价值，这些资源为独特的跨学科研究提供了基础。它的领导人安德鲁·奥尔山博士是一位资深癌症流行病学家，拥有广泛的研究和培训计划。2009年，该方案有16个成员，总成本资金为970万美元，其中包括NCI资金590万美元。在过去六年中，出版物平均每年约100份；12%是方案内出版物，28%是方案间出版物。该计划的未来计划包括重点研究各种暴露和基因-环境相互作用与几种癌症风险以及癌症存活率的关系。从12000多个病例中获得DNA，并从基于人群的研究中获得类似数量的对照，促成了两项大规模的全基因组关联研究(CBCS和Chance)。使用基于人群样本的转译研究也将结合来自微阵列研究的肿瘤图谱结果。例如，进一步阐明癌症风险因素与癌前病变和正常组织中基因表达之间的关系的研究正在进行中。

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.