A Follow-up Study for Causes of Cancer in Black Women

非裔美国人(AA)女性患多种癌症(如结肠癌、胰腺癌)的几率更高 相对于其他美国女性的癌症死亡率(例如，乳腺癌、结肠癌、胰腺)，以及其中许多 不同之处无法解释。黑人妇女健康研究(BWHS)，再生障碍性贫血最大的后续研究 1995年开始为妇女提供关于这些种族差距的相关信息。59,000名AA年龄的女性 来自17个州的21-69人通过填写健康问卷进行登记。BWHS已经成功地跟踪了他们 通过两年一次的问卷调查和与24个癌症登记机构的联系，这些州有95%的 参与者活着。已经收集了关于许多潜在风险因素的数据(例如，医疗、生殖、 生活方式、心理社会、社会经济、空气污染)。癌症的诊断是通过医院和癌症来验证的 注册表病理数据。DNA/口腔微生物生物库包含26,800个唾液样本 参与者。到目前为止，正在进行的血液样本采集已从9300名参与者那里获得了血液样本 (预计为14,000+)。收集了750例乳腺癌的乳腺肿瘤组织。这项研究已经 到目前为止，已确定5631例癌症，包括2651例乳腺癌。这项研究已经发表了大量的文章 关于乳腺癌和其他癌症的非遗传和遗传风险因素。因为参与者都很年轻 在基线(中位年龄=38岁)，较不常见的癌症的累积缓慢。参与者现在已经到达 高癌症发病率的年龄，这意味着将积累足够的数字进行信息性评估。 这项基础设施建议有三个目标：(1)继续加强对大湾区的后续行动和数据收集， 添加有关癌症治疗和结果的信息(包括医疗保险数据)(2)管理和增强 通过向唾液/漱口水和血液储存库添加额外的样本来收集生物样本， 收集除乳腺癌外的所有实体癌的肿瘤组织，收集全领域数字化诊断前 乳房X光检查和全基因组阵列的基因分型都是我们有DNA的偶发癌症病例 样本(约2800份)和等量的DNA对照；(3)在联合体项目中共享数据。 持续的BWHS是一个高度优先的问题，因为：a)89%的参与者仍然没有癌症，因为 基线的年轻年龄；b)后续行动是成功的和不偏不倚的；c)世界卫生组织可以评估 暴露(例如，2级和3级肥胖、早产、种族主义经历)在 其他种群；d)需要越来越多的人来研究科学问题和遗传， 非遗传和生物谱数据将有助于许多联盟研究一系列癌症；e) BWHS有高生产率的记录；f)还需要进一步的工作来了解在 癌症发病率和存活率。总而言之，BWHS的继续将对知识有相当大的贡献 关于缺乏服务的人群中的癌症病因和存活率；生物检疫和乳房X光检查 储存库将为这一努力做出巨大贡献，参与联合研究也是如此。

African-American (AA) women have a higher incidence of many cancers (e.g., colon, pancreas) and higher cancer mortality (e.g., breast, colon, pancreas) relative to other American women, and many of these differences are unexplained. The Black Women's Health Study (BWHS), the largest follow-up study of AA women, was begun in 1995 to provide relevant information on these racial disparities. 59,000 AA women ages 21-69 from 17 states enrolled by completing health questionnaires. The BWHS has successfully followed them for cancer through biennial questionnaires and linkage to 24 cancer registries in the states in which >95% of participants live. Data have been collected on numerous potential risk factors (e.g, medical, reproductive, lifestyle, psychosocial, socioeconomic, air pollution). Cancer diagnoses are validated by hospital and cancer registry pathology data. A DNA/oral microbiome biorepository contains saliva-mouthwash samples from 26,800 participants. Blood sample collection, in progress, has obtained blood samples from 9,300 participants to date (14,000+ expected) . Breast tumor tissue has been collected for 750 incident breast cancers. The study has identified 5,631 incident cancers to date, including 2,651 breast cancers. The study has published extensively on nongenetic and genetic risk factors for breast cancer and other cancers. Because participants were young at baseline (median age = 38), accrual of less common cancers was slow. Participants have now reached ages of high cancer incidence, meaning that sufficient numbers will be accrued for informative assessment. This infrastructure proposal has 3 aims: (1) continue and enhance follow-up and data collection in the BWHS, adding information (including Medicare data) on cancer treatments and outcomes (2) manage and enhance biologic sample collection by adding additional samples to the saliva/mouthwash and blood repositories, collecting tumor tissue for all solid cancers in addition to breast cancer, collecting full-field digital prediagnostic mammograms, and genotyping with a genome-wide array all incident cancer cases for which we have a DNA sample (~2,800) together with an equal number of controls with DNA; (3) share the data in consortial projects. Continuation of the BWHS is a high priority because: a) 89% of participants are still cancer-free due to the young age at baseline; b) follow-up has been successful and unbiased ; c) the BWHS can assess the effects of exposures (e.g., class 2 and class 3 obesity, premature birth, experiences of racism) that are less prevalent in other populations; d) increasingly large numbers are needed to study scientific questions and BWHS genetic, nongenetic, and biospecimen data will contribute to numerous consortia to study a range of cancers; e) the BWHS has a record of high productivity; f) further work is needed to understand numerous racial disparities in cancer incidence and survival. In sum, continuation of the BWHS will contribute appreciably to knowledge about cancer etiology and survival in an underserved population; the biolospecimen and mammogram repositories will contribute greatly to that effort, as will participation in consortial studies.