Cancer Epidemiology Cohort in Male Health Professionals

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The goal of this competing renewal application is to support the core infrastructure and follow-up of the Health Professionals Follow-up Study (HPFS), a cancer epidemiology cohort of 51,529 U.S. male health professionals age 40 to 75 years at baseline in 1986. This cohort is unique in its focus on men’s health and with 35 years follow-up, provides a time frame essential to study modifiable risk factors for cancer incidence with realistic latencies. Information has been regularly updated on diet, physical activity, smoking, weight, medications, and other potentially modifiable determinants of cancer risk. The biorepository is key element of the cohort and includes DNA, red blood cells, plasma, stool, and toenails. Tumor tissue has been obtained from 7,522 incident cancers of the prostate, colon, bladder, kidney, and lung (nonsmokers), and hematologic cancers. Cohort follow-up is consistently 90% at each two-year cycle and mortality follow-up is virtually complete. At present, 21,853 participants are living and at a heightened age of cancer incidence; these will be the most informative cases given extensive exposure data since midlife. In the current grant, 492 papers were published that utilize data and/or biological samples from HPFS; 317 of these specifically examined cancer or precursor outcomes including >100 led by external investigators. To date, 17,091 participants have been diagnosed with cancer and 4,704 cancer deaths have occurred; 7,061 men are currently living with a cancer diagnosis. In the next funding cycle, we propose the following aims: Aim 1. To actively follow-up for cancer incidence and mortality; to update exposures pre- and post-diagnosis of cancer; Aim 2. To collect data on quality of life, treatment, progression, and cannabis use among cancer survivors. Aim 3. To update the food composition and nutrient databases that support the HPFS and external studies; to jointly calibrate dietary questionnaires with the Southern Community Cohort Study (SCCS) to support combined studies. Aim 4. To maintain and expand the HPFS tissue biorepository to collect tissue from prostate, colon, lung, kidney, and bladder cancers; to pilot artificial intelligence approaches to characterize morphologic features of prostate tumors. Aim 5. To maintain other biorepositories including plasma, red blood cells, toenails, and germline DNA. Aim 6. To expand linkage of geocoded addresses of HPFS and SCCS participants to assess longitudinal measures of the built environment and neighborhood SES over three decades. Aim 7. To maintain and augment the statistical infrastructure and data management to support HPFS analyses by internal and external investigators; to develop new software to facilitate latency and competing risk analyses in HPFS and share with external investigators. Aim 8. To facilitate resource sharing and collaborations with external investigators and consortia, including the transfer of HPFS questionnaire datafiles onto a secure cloud environment. With additional follow-up, including after cancer diagnosis, the HPFS remains ideally positioned to make innovative contributions to our goal of reducing cancer burden by identifying primary and secondary prevention strategies.