Risk factors for breast cancer subtypes in racial/ethnic minorities

 描述(由申请人提供)：乳腺癌发病率的种族/民族差异已经有了很好的记录，但这些差异背后的原因只被部分理解。在种族/少数民族人口中进行的研究相对较少，有些研究得出的关于风险因素的结果与报告的非西班牙裔白人妇女的结果不同。此外，尽管越来越多的证据表明乳腺癌是一种异质性疾病，乳腺癌亚型的风险因素因雌激素受体(ER)、孕激素受体(PR)和人类表皮生长因子受体-2(HER2)的状态而不同，但大多数少数群体的研究都全面评估了乳腺癌的风险因素。目前已知的大多数乳腺癌危险因素适用于激素受体阳性(ER+和/或PR+)或腔A(ER+和/或PR+，HER2)肿瘤。很少有研究集中于激素受体阴性(ER-PR-)、三重阴性(ER-PR-HER2-)或HER2过度表达(ER-PR-HER2+)等不常见亚型的危险因素。关于不常见亚型的风险因素的报告，除了少数例外，都是基于小病例数量，主要包括非西班牙裔白人妇女。鉴于乳腺癌亚型在种族/民族群体中的分布并不均匀，少数族裔人群中侵袭性亚型的发生率较高，因此，少数族裔人群的病因学研究必须评估与特定乳腺癌亚型有关的风险因素。为了解决这一重大的知识差距，我们将汇集参与五项基于人群的研究的9000例乳腺癌病例和7855名对照的现有访谈和癌症登记数据。参与者的年龄范围很广(18-79岁)，71%的病例和66%的对照病例是少数族裔(西班牙裔、亚裔、非裔美国人、非西班牙裔白人)。在目标1中，我们将评估乳腺癌亚型的危险因素，并根据年龄和绝经状况评估异质性。使用多分类Logistic回归，我们将评估亚型与一系列广泛的危险因素的相关性，包括乳腺癌家族史、激素因素和可改变的生活方式因素。在目标2中，我们将评估MAI亚型的风险因素是否因种族/民族而异。利用现有数据，这项研究将提供有关不太常见的乳腺癌亚型风险因素的迫切需要的信息，并将允许直接比较不同种族/民族的亚型特定风险因素。 这些信息将为制定与特定种族/族裔群体直接相关的预防战略提供信息。

 DESCRIPTION (provided by applicant): Racial/ethnic differences in breast cancer incidence have been well documented, yet the reasons underlying these differences are only partially understood. Relatively few studies have been conducted in racial/ethnic minority populations and some have produced findings on risk factors that are different from those reported for non-Hispanic White women. Furthermore, most studies in minority populations have assessed risk factors for breast cancer overall, despite growing evidence that breast cancer is a heterogeneous disease, with risk factors that differ for breast cancer subtypes defined by estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor-2 (HER2) status. Most currently known breast cancer risk factors apply to hormone receptor positive (ER+ and/or PR+) or Luminal A (ER+ and/or PR+, HER2) tumors. Few studies have focused on risk factors for the less common subtypes, such as hormone receptor negative (ER- PR-), triple negative (ER-PR-HER2-), or HER2 over-expressing (ER-PR-HER2+) tumors. Reports on risk factors for the less common subtypes were, with a few exceptions, based on small case numbers and included primarily non-Hispanic white women. Given that breast cancer subtypes are not equally distributed across racial/ethnic groups, with a higher incidence of aggressive subtypes in minority populations, it is important that etiologic studies in minority populations assess risk factors in relation to specific breast cancer subtypes. To address this significant gap in knowledge, we will pool existing interview and cancer registry data for 9,000 breast cancer cases and 7,855 controls who participated in five population-based studies. Participants cover a broad age range (18-79 years) and 71% of cases and 66% of controls are racial/ethnic minorities (Hispanics, Asian Americans, African Americans, non-Hispanic whites). In Aim 1, we will evaluate risk factors for breast cancer subtypes and assess heterogeneity by age and menopausal status. Using polytomous logistic regression, we will assess associations of subtypes with a broad set of risk factors, including family history of breast cancer, hormonal factors and modifiable lifestyle factors. In Aim 2, we will assess whether risk factors for the mai subtypes differ across racial/ethnic groups. Leveraging existing data, this study will provide much needed information about risk factors for the less common breast cancer subtypes and will allow direct comparison of subtype-specific risk factors across multiple racial/ethnic groups. Such information will inform the development of preventive strategies that are directly relevant for specific racial/ethnic groups.