Incidence of Malignancies in Californians with Sickle Cell Disease

小病例系列表明，镰状细胞病患者的癌症发病率增加 (SCD)，如果得到证实，可能会影响对这些患者的癌症监测建议 病人。实验数据将慢性炎症和细胞高周转率联系在一起 SCD的特征是恶性风险增加。因为SCD的癌症发病率增加 对这些患者的管理有重要意义，有必要严格检测 这一发现是在一大群患者中发现的。我们建议确定#年癌症发病率 通过连接两个为监测目的创建的现有数据库-加州人患有SCD 加州癌症登记中心(CCR)和加州全州卫生规划和办公室 发展(OSHPD)病人出院和急诊科利用。我们估计 将发现6,000-8,000例SCD病例。我们将检验这一假设，即癌症风险 通过以下具体目标在SCD人群中增加。具体目标1： 确定患有SCD的加州人的癌症标化发病率。南华早报 将使用由登记处和监督办公室通知的搜索算法创建队列 血红蛋白疾病系统(RASH)项目，是两个中心之间的合作 疾病控制和预防中心(CDC)和国家心肺血液研究所。这个 算法已经得到了疾控中心资助的公共卫生研究、监督和 血红蛋白病流行病学(PHRESH)研究。具体目标2：描述 SCD患者的癌症流行病学，包括恶性肿瘤类型，人口学， 以及与意外癌症相关的潜在风险因素。这些数据将具有重要的意义 影响我们对SCD并发症的认识，以及对癌症的重要影响 随着SCD患者存活率的提高而进行筛查。它还将深入了解SCD如何 会影响癌症患者的存活率。评估与以下方面相关的潜在风险因素 未来可以追踪的SCD人群中恶性肿瘤的发展，更多 机械学研究。一个例子可能是恶性程度和数量之间的联系 输血、SCD的严重程度通过入院频率或其他 并发症，或自身免疫性疾病等共病。这些结果还将作为 将确定癌症流行病学和风险的R01提案的初步数据 来自参与急救的七个州的SCD患者的癌症因素 项目(加利福尼亚州、佐治亚州、佛罗里达州、密歇根州、北卡罗来纳州、纽约州和宾夕法尼亚州)。

Small case series have suggested increased incident cancer in patients with sickle cell disease (SCD), which, if confirmed, might affect cancer surveillance recommendations for these patients. Experimental data have linked chronic inflammation and high cellular turnover, both hallmarks of SCD, to increased risk of malignancy. Because increased incident cancer in SCD has important implications for management of these patients, it is necessary to rigorously test this finding in a large patient cohort. We propose to determine the incidence of cancer in Californians with SCD by linking two existing databases created for surveillance purposes—the California Cancer Registry (CCR) and the California Office of Statewide Health Planning and Development (OSHPD) Patient Discharge and Emergency Department Utilization. We estimate between 6,000-8,000 cases with SCD will be found. We will test the hypothesis that cancer risk is increased in the SCD population through the following specific aims. Specific Aim 1: Determine the standardized incidence ratio of cancer amongst Californians with SCD. The SCD cohort will be created using a search algorithm informed by the Registry and Surveillance System for Hemoglobinopathies (RuSH) project, a collaboration between the Centers for Disease Control and Prevention (CDC) and the National Heart Lung and Blood Institute. The algorithm has been validated by the CDC-funded Public Health Research, Surveillance and Epidemiology in Hemoglobinopathies (PHRESH) study. Specific Aim 2: Describe the epidemiology of cancer in patients with SCD, including types of malignancies, demographics, and potential risk factors associated with incident cancer. These data will have significant impact on our knowledge of the complications of SCD, and important implications for cancer screening as survival for patients with SCD improves. It will also provide insight into how SCD affects cancer-specific survival. Assessment of potential risk factors associated with development of malignancy in the SCD population that can be pursued in future, more mechanistic studies. An example might be an association between malignancy and the number of transfusions, severity of SCD as measured by frequency of admissions or other complications, or co-morbidities such as autoimmune disease. These results will also serve as preliminary data for an R01 proposal that would determine the epidemiology of cancer and risk factors for cancer in patients with SCD from the seven states that participated in the RuSH project (California, Georgia, Florida, Michigan, North Carolina, New York, and Pennsylvania).