The MesoCase Study: Mesothelioma Case-Control and Rapid Case Ascertainment Study

项目摘要/摘要 尽管自20世纪70年代以来石棉使用量急剧下降，但美国国内间皮瘤的负担 各州并没有按比例减少。没有下降的情况在女性中尤为明显， 三十多年来，间皮瘤的发病率一直保持稳定。尽管这种关系 职业性石棉暴露与间皮瘤之间的关系已经有了很好的描述，我们对非 职业风险因素是有限的。目前癌症登记网络登记的滞后是造成延迟的原因之一 识别患者身份，防止早期干预。由于患者识别的延迟，以前的研究 主要依靠未经验证的代理面谈进行风险暴露评估。在这个项目中，我将合作 与加州公共卫生部职业健康分部(OHB)和加州癌症 (C)建立一个新的案件查明系统，以缓解这些问题。这项研究是 中心目标是使用快速病例确定和暴露评估来阐明非职业性 石棉暴露与间皮瘤的发展有关。为了评估这一点，我将进行一项 利用一个新病例确定非职业性石棉暴露的病例对照研究 确定战略(目标1)。这项研究的次要目标是评估建立一个 间皮瘤病例快速查明方案，可促进未来的研究和治疗(目标2)。一个 快速癌症报告系统将为公共卫生领域的快速暴露评估创建一种机制 监测系统，使我们能够准确地评估癌症风险因素。该提案直接回应了 NHLBI的战略愿景是“开发和优化临床和实施研究，以改善健康和 减少疾病“(目标6)。此外，通过开发创新办法，将多种形式的 数据，如自然语言处理、接触历史问卷、登记元数据、地理地图、 除了风险评估和结果数据，我们的项目还实现了“利用”新兴市场的目标 数据科学中的机会，以开辟HLBS研究的新领域“(目标7)。通过改善公众 健康监测和风险评估，可以减少暴露，加强癌症预防工作。这 对于阐明可预防的、非职业性的石棉暴露尤其重要 间皮瘤。此外，这一奖项将作为培训谢法利·甘地博士的基础，谢法利·甘地博士是 加州大学旧金山分校，为她的学术研究生涯做准备。这一团契将 为她提供必要的支持，磨练她的流行病学和生物统计学技能，以便成为一名 独立内科医生-研究职业性和环境性肺病流行病学的科学家。

Project Summary/Abstract Despite steep declines in asbestos usage since the 1970s, the burden of mesothelioma within the United States has not decreased proportionately. The lack of decline is particularly pronounced among women, in whom mesothelioma rates have remained stable for more than three decades. Although the relationship between occupational asbestos exposure and mesothelioma is well-described, our understanding of non- occupational risk factors is limited. Current lags in the cancer registry network enrollment contribute to delayed patient identification, preventing early intervention. Due to delayed patient identification, previous studies primarily relied on unvalidated proxy interviews for risk exposure assessment. In this project, I will collaborate with the California Department of Public Health's Occupational Health Branch (OHB) and the California Cancer Registry (CCR) to create a novel case ascertainment system in order to mitigate these issues. This study's central objective is to use rapid case ascertainment and exposure assessment to elucidate non-occupational asbestos exposures that are associated with the development of mesothelioma. To assess this, I will conduct a case-control study to determine the non-occupational exposures to asbestos utilizing a novel case ascertainment strategy (Aim 1). The secondary objective of this study is to assess the feasibility of creating a rapid mesothelioma case ascertainment program that could facilitate future research and treatment (Aim 2). A rapid cancer-reporting system will create a mechanism for rapid exposure assessments within the public health surveillance system, allowing us to assess cancer risk factors accurately. The proposal is directly responsive to NHLBI's Strategic Vision to "develop and optimize clinical and implementation research to improve health and reduce disease" (Objective 6). Additionally, by developing innovative approaches to integrate multiple forms of data such as natural language processing, exposure history questionnaires, registry metadata, geo-mapping, exposure assessments, and outcome data, our project also fulfills the goal of "leverag[ing] emerging opportunities in data science to open new frontiers in HLBS research" (Objective 7). Through improved public health surveillance and risk assessment, exposures can be mitigated, bolstering cancer prevention efforts. This is particularly important to elucidating the preventable, non-occupational asbestos exposures related to mesothelioma. Furthermore, this award will serve as a foundation for training Dr. Sheiphali Gandhi, a fellow at the University of California San Francisco, to prepare her for her academic research career. This fellowship will provide her with the necessary support to hone her epidemiology and biostatistical skills in order to become an independent physician-scientist studying the epidemiology of occupational and environmental lung diseases.