Long Term Multidisciplinary Study of Cancer in Women: The Nurses Health Study

描述(由申请人提供)：这是一个UIVII申请，以支持最初的护士健康研究(NHS)的基础设施。NHS始于1976年，有12.17万名女性，在37年的时间里积累了19份问卷的数据；后续调查仍有90%左右。丰富的行为数据与多种生物标本收集相结合，包括从1.983开始的相当大比例的女性的血液、脚趾甲、尿液、口腔细胞和肿瘤组织，为研究癌症预防、病因和生存提供了无与伦比的资源。通过重复发送调查问卷和持续识别癌症发病率和死亡率，对国民健康保险制度进行持续的跟踪，将使关键的新研究成为可能。随着队列的成熟(女性现在66岁以上，癌症发病率的高峰期)，我们建议增加对两个主要主题的强调。首先，我们建议扩大癌症生存研究的基础设施，包括癌症患者的持续时间和生活质量。多年来对癌症患者诊断前后的特征，将使我们能够区分癌症及其治疗的原因和后果。其次，我们建议改善我们的基础设施，以支持我们研究的系统生物学方法，将问卷数据与DNA、血液、肿瘤组织和其他生物标本中的生物标记物相结合；这种研究同时整合包括行为、基因组学、转录组学、代谢组学等在内的多个“系统”，可能会阐明癌症的新机制。我们大量且不断增加的癌症病例，以及问卷和生物标本的独特组合，是进行这种综合研究的必要条件。具体地说，我们的目标包括新的生活质量数据收集、新的(肿瘤组织收集)、改进的数据管理/对“大数据”分析的统计支持、以及增强的数据共享基础设施(NHS资源已经得到广泛利用--在过去5-6年中，我们已经为75名外部研究人员和27个NCI癌症联盟提供了访问)。NHS的结构结合了高级领导人的长期经验和几个发展中领导人的支持；这种结合是有目的的，以保持领导地位，以维持队列的未来。总而言之，NHS处于有利地位，可以继续进行尖端研究，以降低癌症发病率和死亡率。由于NIH和研究人员之前的投资，与将出现的独特有价值的发现相比，继续进行这一队列的增量成本是适度的 未来5年。 相关性：这一UMI应用程序是为了扩展最初的护士健康研究的后续行动，利用关于健康和生活方式的广泛数据，与生物数据(例如基因组学、血浆生物标记物、肿瘤组织等)相结合，使关于癌症病因、预防和生存的新研究成为可能。没有其他类似规模的队列包括重复行为测量和来自8.2万名女性的生物样本进行如此长时间的随访。这使得研究癌症病因学和存活率的因果和预防因素的时间框架成为可能。

DESCRIPTION (provided by applicant): This is a UIVII application to support the infrastructure of the original Nurses' Health Study (NHS). The NHS began in 1976 with 121,700 women, and has accumulated data from 19 questionnaires over 37 years; follow-up remains about 90 percent. The wealth of behavioral data combined with multiple bio-specimen collections, including blood, toenails, urine, buccal cells and tumor tissues beginning in 1.983 from a substantial proportion of women, provide an unparalleled resource in studying cancer prevention, etiology, and survival. Sustained follow-up of the NHS through repeated questionnaire mailings and continued identification of cancer incidence and mortality will permit critical new research. With the cohort's maturation (women are now 66+ years, at peak ages for cancer incidence), we propose to add emphasis to two overarching themes. First, we propose to expand the infrastructure for cancer survival research, including both the duration and quality of life in cancer patients. The many years of characterization of cancer patients before and after diagnosis, will allow us to distinguish between causes and consequences of cancer and its treatment. Second, we propose to improve our infrastructure to support a systems biology approach to our research, integrating questionnaire data with biomarkers in DNA, blood, tumor tissue, and other bio specimens; such research simultaneously integrating multiple "systems", including behavior, genomics, transcriptomics, metabolomics, etc., may illuminate new mechanisms underlying cancer. Our large and growing number of incident cancer cases, and the unique combination of questionnaires and bio specimens, are a necessity for such integrative research. Specifically, our Aims include new collection of quality of life data, new (collection of tumor tissue (resulting in tissue collections, across 17 cancer sites), improved dat management/statistical support for "big data" analyses, and enhanced infrastructure for data sharing (the NHS resource is already extensively utilized - we have provided access to >75 external investigators in the past 5-6 years and 27 NCI cancer consortia). The NHS structure combines the long experience of senior leaders with support of several developing leaders; this combination is purposeful, to maintain leadership to sustain the cohort's future. In conclusion, NHS is well-positioned to continue cutting-edge research to reduce cancer morbidity and mortality. With the previous investment from NIH and investigators, the incremental costs of continuing this cohort are modest in relation to the uniquely valuable findings that will emerge in the coming 5 years. RELEVANCE: This UMI application is to extend follow-up of the original Nurses' Health Study, with extensive data on health, and lifestyle, integrated with biologic data (e.g., genomics, plasma biomarkers, tumor tissue, etc.), enabling novel research on cancer etiology, prevention and survival. No other cohort of comparable size includes such long follow-up with repeated behavioral measures, and bio specimens from 82,000 women. This enables studies of the time frame for causal and preventive factors for cancer etiology and survival.