CASE CONTROL STUDY OF OVARIAN CANCER HORMONAL ETIOLOGY

描述：在1995年的美国，大约有2.6万个新的 卵巢癌的病例，大约14,500名妇女死于卵巢癌， 使其成为最致命的妇科恶性肿瘤。超过了 一生中，近2%的女性会受到影响。卵巢癌是 很难治疗，因为它通常是无症状的，直到晚期 患者往往出现在病程较晚的阶段。这个 既定的风险因素并不清楚地占到很大一部分 疾病的发病率，以及可能的排卵或激素机制 这些因素中哪些影响发生卵巢癌的风险不好 明白了。这项应用提出了一种新的荷尔蒙假说 卵巢癌的病因学，并展示了大量的 支持这一点的病理学、内分泌学和流行病学证据 假设。一项基于人群的病例对照研究来检验这一点 假设是在康涅狄格州进行的。这个 这项研究将检查与荷尔蒙表达相关的一系列因素 在生殖年中和之后。总共约500例非粘液性 还有80个年龄在35-79岁之间的粘液性卵巢癌病例将被确认。 通过共享的快速案例确定预期在该州 耶鲁大学癌症中心的资源。大约1,000个随机选择的 人口控制将与三个年龄段的病例频率匹配 组。将使用随机数字拨号来识别这些控件 65岁以下，并从名册中随机挑选，由 65岁及以上的医疗保健融资管理局。所有的 受试者将在家中接受训练有素的面试者的采访，使用 标准化的结构化调查问卷，将包括医疗和 生育史，以及与各种激素相关的近似 各种因素。将使用单变量和多变量分析来估计 病例与对照比较的相对风险。总体而言, 将要检查的激素因素只得到了很少的关注。 关于卵巢癌，拟议的研究将是第一个 在严格的大规模研究中对它们进行系统评估，这将 将所有因素整合在一个连贯的病因学框架内。

DESCRIPTION: In the United States in 1995, there were about 26,000 new cases of cancer of the ovary, and approximately 14,500 women died from it, making it the most lethal of the gynecological malignancies. Over the lifetime, close to 2 percent of women are affected. Ovarian cancer is difficult to treat because it is typically asymptomatic until advanced stages, and patients frequently present late in the disease course. The established risk factors do not clearly account for a large fraction of disease incidence, and the possible ovulatory or hormonal mechanisms by which these factors affect risk of developing ovarian cancer are not well understood. The application suggests a new hormonal hypothesis regarding the aetiology of ovarian cancer, and demonstrates a substantial body of pathologic, endocrinologic and epidemiologic evidence in support of this hypothesis. A population-based, case-control study to examine this hypothesis is proposed to be conducted in the State of Connecticut. The study will examine a collection of factors related to hormonal expression during and after the reproductive years. In total, about 500 non-mucinous and 80 mucinous ovarian-cancer cases, aged 35-79 years, will be identified prospectively in the state through the Rapid Case Ascertainment Shared Resource of the Yale Cancer Center. Approximately 1,000 randomly-selected population controls will be frequency-matched to the cases in three age groups. Controls will be identified using random-digit dialing for those under 65 years of age, and randomly chosen from rosters, provided by the Health Care Financing Administration for those 65 years and over. All of the subjects will be interviewed at home by trained interviewers, using a standardized, structured questionnaire which will include medical and reproductive history, and approximations of the various hormone-related factors. Univariate and multivariate analyses will be used to estimate relative risks for comparison of the cases with the controls. In general, the hormonal factors to be examined have received only a little attention with respect to ovarian cancer, and the proposed study will be the first to evaluate them systematically in a rigorous, large-scale study which will integrate all of the factors within a coherent aetiologic framework.