Hormone-Related Cancers

该项目涵盖了广泛的研究基础，旨在评估大多数激素相关癌症的流行病学。针对乳腺癌、子宫内膜癌、卵巢癌和睾丸癌的重大努力正在进行中。我们也有一个活跃的前列腺癌研究项目，在单独的报告（Z01 CP010180-02）中有涉及。我们对所有这些癌症的研究都与各种环境、遗传和激素的风险预测因素有关。众所周知，与高加索人相比，发生在非洲人和非裔美国人中的乳腺癌往往表现出不同的临床特征，包括雌激素受体阴性和三阴性肿瘤的患病率更高，这些癌症通常预后较差。为了更好地了解这些癌症发生的原因，我们正在加纳进行一项病例对照研究，那里的乳腺癌发病率一直在上升。该研究旨在评估一些新的病因假说，并将危险因素与仔细定义的乳腺癌亚型联系起来。我们也对研究一些乳腺癌风险的中间标记物有很大的兴趣，包括乳房x线摄影乳房密度和终末导管小叶单位对合。我们已经开发并使用了一些新的方法来测量这两种假定的乳腺癌前体，并将乳腺癌的危险因素与不同的测量方法联系起来。我们还在研究这些措施与随后的乳腺癌之间的关系。我们与妇科肿瘤学组合作，对一项大型子宫内膜癌试验中的妇女进行了标准化问卷调查。这使得分析表明，子宫内膜癌在组织学亚型之间存在很大的病因异质性。我们还评估了在调整其他临床预后因素后，这些因素与生存的关系。我们学到了很多关于自然历史的知识

This project covers a broad base of studies aimed at assessing the epidemiology of the majority of hormonally-related cancers. Major efforts are underway for breast cancer, endometrial cancer, ovarian cancer, and testicular cancer. We also have an active research program on prostate cancer, covered in a separate report (Z01 CP010180-02). Our efforts for all of these cancers relate to a variety of environmental, genetic and hormonal predictors of risk. It is well recognized that breast cancers that occur among Africans and African-Americans tend to exhibit different clinical characteristics as compared with Caucasians, including a higher prevalence of estrogen receptor negative and triple negative tumors, cancers associated with a generally poor prognosis. To better understand the reasons for the occurrence of these cancers, we are conducting a case-control study in Ghana, where incidence rates of breast cancer have been increasing. The study has been designed to evaluate some novel etiologic hypotheses as well as to relate risk factors to carefully defined subtypes of breast cancers. We have also had a major interest in studying a number of intermediate markers of breast cancer risk, including mammographic breast density and terminal duct lobular unit involution. We have developed and used some novel methods for measuring both of these presumed breast cancer precursors and have related breast cancer risk factors to varied measures. We are also examining how these measures relate to subsequent breast cancers. In collaboration with the Gynecologic Oncology Group, we have administered a standardized questionnaire to women in a large endometrial cancer trial. This has enabled analyses which have demonstrated that there is great etiologic heterogeneity of endometrial cancer across histologic subtypes. We have also assessed how these factors relate to survival after adjusting for other clinical prognostic factors. We have learned much about the natural history of