Understanding Ethnic Differences in Cancer: The Multiethnic Cohort Study

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This renewal application seeks support for the infrastructure of the Multiethnic Cohort (MEC) Study, which was established in Hawaii and southern California in 1993-1996 to study risk factors for cancer and other chronic diseases. The study was designed to take advantage of the ethnic and cultural diversity of the two geographic areas, as well as the expertise of the investigators in nutrition, ethnic/racial disparities studies, and genetics. It is the most ethnically diverse cancer cohort in existence. It achieves high cost-efficiency by significantly supplementing active follow-up information with computerized linkages to SEER cancer registries, vital statistics, hospital-discharge diagnoses, medical claim data, electronic medical records and geospatial information. At baseline, the cohort included information on 215,000 men and women, comprised almost entirely of five ethnic/racial populations: Japanese Americans, Latinos, Whites, African Americans and Native Hawaiians. The resource was later expanded to include a prospective biorepository of blood specimens from ~70,000 of the participants and urine specimens on a large subset. Leadership of the MEC entails a highly interactive, team-science approach, and the investigators have amply demonstrated their willingness to share data/samples, and to participate actively in consortia. Research accomplishments include significant contributions to understanding both genetic and environmental risk factors for cancer. Over 291 papers describing our findings have been published during the current grant cycle. In addition, over the last 28 years, 129 NIH grants/supplements have been built around the MEC (77 were active in the current cycle), and more than 136 students and postdoctoral fellows have been trained on the study. This application describes our aims over the next 5 years for maintaining and enhancing the infrastructure of the MEC, as well as plans for methodological research. We project adding 7,253 incident cancer cases in the new 5 years, to the current 48,064 cases; 2,670 of these cases will have pre-diagnostic blood samples, to be added to the current 10,957 cases. We will add 6K FFPE tumor samples to the current ~13K. In addition, this grant renewal will make possible the continuation of a well-integrated program of research aimed at evaluating lifestyle, environmental, and genetic risk factors and social determinants of health for cancer and other common chronic diseases, taking advantage of new approaches, such as dietary quality indices, exposomics, genomics, epigenomics, microbiomics, metabolomics and multilevel exposures, including spatial environment, structural racism, and climate change. The MEC will allow the testing of innovative research hypotheses aimed at ensuring that racial/ethnic health disparities are investigated and that progress in disease prevention applies to all major US racial/ethnic minorities.