Bisphosphonate use and Lung Cancer Incidence and Mortality in Elderly Women

 描述(申请人提供)：肺癌已成为对女性具有重大公共卫生意义的问题。尽管吸烟是肺癌最重要的风险因素，但仍有许多风险的变化不能完全用吸烟来解释。此外，尽管已经对肺癌的预后因素进行了大量的研究，但我们对与肺癌生存相关的因素的了解仍在不断发展。骨质疏松症是老年人群的常见病，以绝经后妇女居多。双膦酸类是破骨细胞介导的骨吸收的抑制剂，常用于治疗骨质疏松症。实验研究显示了双膦酸盐的抗癌特性；然而，最近的几项流行病学研究调查了双膦酸盐使用对癌症发展和/或进展的潜在影响，包括乳腺癌和结直肠癌。评估双膦酸类药物在老年女性中的应用与肺癌发病率和死亡率的关系的研究非常有限。利用现有的对绝经后妇女的前瞻性队列研究，这项拟议的研究将调查口服双磷酸盐的使用与肺癌风险之间的关系，以及绝经后妇女在癌症诊断前使用双磷酸盐与肺癌存活率的关系。这项拟议的研究结果有可能提供非常重要的信息，以了解个人使用口服双膦酸脂作为另一种适应症可能如何影响老年女性肺癌的发生和进展，并提高我们对肺癌病因和女性肺癌预后因素的理解。这些理解将为进一步干预试验或研究双膦酸盐与肺癌进展的分子机制提供第一步数据。更重要的是，这些理解将对提高老年女性肺癌存活率具有重大的公共健康影响。

 DESCRIPTION (provided by applicant): Lung cancer has become a problem with major public health significance in women. Although tobacco smoking is the most important risk factor of lung cancer, there is still much of the variation in risk that is not fully explained by smoking. Furthe, although there has been considerable investigation of prognostic factors of lung cancer, our knowledge on factors related to lung cancer survival is still evolving. Osteoporosis is a common disease in aged population with the majority of cases occurring in postmenopausal women. Bisphosphonates, inhibitors of osteoclast-mediated bone resorption, are commonly used in the management of osteoporosis. Experimental studies have shown the anti-cancer properties of bisphosphonates; however, only a few recent epidemiological studies investigated the potential impact of bisphosphonate use on the development and/or progression of cancers, including breast and colorectal cancer. Very limited studies have been conducted to evaluate bisphosphonate use in relation to lung cancer incidence and mortality in older women. Utilizing an existing prospective cohort study of postmenopausal women, the proposed study will investigate relationships between oral bisphosphonate use and lung cancer risk, as well as the association of bisphosphonate use prior to cancer diagnosis with lung cancer survival among postmenopausal women. Results from the proposed study have the potential to provide very important information for understanding how personal use of oral bisphosphonate for another indication might impact on lung cancer development and progression in older women, as well as to improve our understanding about etiology of lung cancer and prognostic factors of lung cancer in women. These understandings would provide first-step data for further intervention trials or investigations of molecular mechanisms of bisphosphonate and lung cancer progression. More importantly, these understandings would have major public health implications for improving lung cancer survival in older women.