Population-based Cohort of Endometrial Cancer Survivors in Utah

 描述(申请人提供)：子宫内膜癌是美国女性癌症幸存者中第二常见的癌症。据估计，目前有60万名子宫内膜癌幸存者。此外，每年还诊断出49,560例子宫内膜癌病例。子宫内膜癌已被NCI确定为研究不足的肿瘤部位，对子宫内膜癌患者的远期效应研究非常有限。由于化疗和放射治疗的毒副作用，癌症患者的晚期反应令人担忧。令人担忧的具体后遗症包括第二原发癌、骨质疏松症、心脏毒性、神经毒性、认知缺陷、抑郁、慢性疲劳、慢性疼痛、不孕不育和性功能障碍。犹他州人口数据库(UPDB)为流行病学研究提供了独特而出色的资源，并将犹他州癌症登记处、医院电子医疗记录、联邦医疗保险、驾驶执照、选民登记、家族历史记录和出生证明的数据联系起来。我们用相同的研究设计成功地完成了对1,001名睾丸癌患者的远期效应研究(93.2%的患者通过EMR获得了成功的随访)。在UPDB与犹他州癌症登记中心的关联数据中，我们建议构建一个覆盖犹他州的基于人群的子宫内膜癌患者队列。我们的具体目标是：(1)汇集3,400名子宫内膜癌患者和17,000名年龄匹配的非癌症女性作为对照组，以人群为基础，调查子宫内膜癌治疗对长期健康影响的发生率；(2)评估使用问卷评估生活方式的可行性 (3)通过对子宫内膜癌患者(n=200)进行病历提取，确定从病历中收集化疗药物等详细癌症治疗信息的可行性；(4)比较从现有记录中获得的信息的质量，以及从问卷中获得的关于晚期效应、合并症和癌症治疗的自我报告(n=1,000)。目标1的后遗症分析是基于现有的数据(癌症登记和EMR的联系)，我们能够获得犹他州90%癌症患者的后遗症信息。我们的项目解决了NCI强调的优先研究领域：晚期效应评估，对患有合并症的幸存者的研究，以及专注于未被充分研究的癌症。我们将召集一个史无前例的高质量的基于人群的3,400名子宫内膜癌患者队列，首次研究晚期效应，由于TE UPDB内现有的链接数据库，成本非常低。这一应用也将为未来大规模的基于人群的子宫内膜癌生存项目奠定重要的基础工作。对于60万名子宫内膜癌幸存者和今年将被诊断为癌症的49560名妇女来说，了解癌症治疗的长期影响及其决定因素将非常有价值。

 DESCRIPTION (provided by applicant): Endometrial cancer is the second most common cancer among female cancer survivors in the United States. There are an estimated 600,000 endometrial cancer survivors today. Additionally, 49,560 incident endometrial cancer cases are diagnosed each year. Endometrial cancer has been identified by the NCI as an understudied cancer site and late effects research on endometrial cancer patients is very limited to our knowledge. Late effects are of concern among cancer patients due to the toxic effects of chemotherapy and radiotherapy. Specific late effects of concern include second primary cancers, osteoporosis, cardio-toxicity, neuro-toxicity, cognitive deficits, depression, chronic fatigue, chronic pain, infertility and sexual dysfunction. The Utah Population Database (UPDB) provides a unique and excellent resource for epidemiologic research, and links data from the Utah Cancer Registry, hospital electronic medical records, Medicare, driver licenses, voter registration, family history records, and birth certificates. We have successfully completed a study of late effects of 1,001 testicular cancer patients with the same study design (93.2% successfully followed up through the EMR). Within the UPDB linked data with the Utah Cancer Registry, we propose to construct a population- based endometrial cancer patient cohort covering the state of Utah. Our specific aims are: (1) To assemble a population-based cohort of 3,400 endometrial cancer patients and 17,000 age-matched cancer-free women for a comparison group, to investigate the incidence of long-term health effects due to endometrial cancer treatment, (2) To assess the feasibility of administering questionnaires to assess lifestyle factors in a sample of the endometrial cancer survivors (n=500) and cancer-free women for a comparison group (n=500), (3) To determine the feasibility of collecting detailed cancer treatment information such as chemotherapy agents from medical records by conducting medical record abstraction among a sample of endometrial cancer patients (n=200), (4) To compare the quality of information obtained from the existing records and the self-report from the questionnaire on late effects, comorbidities, and cancer treatment (n=1,000). The aim 1 late effects analysis is based on existing data (linkage of cancer registry and EMR) and we are able to obtain late effects information on >90% of cancer patients in Utah. Our project addresses the priority research areas highlighted by the NCI: assessment of late effects, study of survivors with comorbidities, and focusing on an understudied cancer. We will assemble an unprecedented high-quality population-based cohort of 3,400 endometrial cancer patients to study late effects for the first time, at a very low cost due to existing linked databases within te UPDB. This application will also lay important foundation work for a future large-scale population-based endometrial cancer survivorship project. Understanding the long-term effects of cancer treatment and their determinants will be extremely valuable for the 600,000 endometrial cancer survivors and the 49,560 women who will be diagnosed this year.