Perception of Gene-Environment Cancer Risks in Melanoma

描述(申请人提供)：本次职业发展申请的总体目标是启动一项关于基因-环境癌症风险感知的独立研究计划。越来越多的证据表明，常见的基因多态可以增加或减少环境风险，如吸烟和阳光照射，这些相互作用是致癌的主要致病途径。在接下来的几年里，很可能会有越来越多的人收到关于遗传和环境癌症风险因素的概率信息。受影响的个人数量将超过那些罕见的、高度穿透性单基因突变的人。现有针对具有单一风险因素的癌症风险沟通的研究，如仅有基因突变，或仅有生活方式风险因素，不能充分解决我们日益全面地了解环境和遗传风险相互作用所带来的潜在挑战和预防机会。基因-环境相互作用与许多癌症部位的病因学有关。黑色素瘤将为这一应用的研究提供范例，因为有证据表明基因-环境病因，发病率上升，以及行为预防的前景。鉴于目前尚无已确定的生殖系突变，研究黑色素瘤患者的一级亲属将为拟议的研究提供一种工具，以检验基因-环境风险认知以及皮肤癌筛查和防晒行为的作用。研究一是对黑色素瘤患者一级亲属风险认知的定性访谈研究。第二项研究是对最近确诊的黑色素瘤患者的一级亲属的风险认知、皮肤癌筛查和防晒行为的前瞻性评估。通过与多学科同事的深入互动，正规的流行病学课程，教学和研究，这个职业发展奖将建立我在遗传流行病学和行为科学界面上的多学科研究技能，并使我能够为基因-环境相互作用的风险感知的作用建立新的理论和测量策略，并最终开发适用于其他癌症地点的基因-环境癌症风险的沟通模型。

DESCRIPTION (provided by applicant): The overall goal of this career development application is to launch an independent research program on perception of gene-environment cancer risks. There is mounting evidence that common genetic polymorphisms can either accentuate or attenuate environmental risks, such as smoking and sun exposure, and that these interactions are a primary etiological pathway to carcinogenesis. In the coming years, it is likely that a growing number of individuals will receive probabilistic information concerning genetic and environmental cancer risk factors. The number of individuals who are affected will exceed those with uncommon, highly penetrant single-gene mutations. Existing research on cancer risk communication targeted to those with single risk factors, such as genetic mutations alone, or lifestyle risk factors alone, do not adequately address the potential challenges and prevention opportunities presented by our increasingly comprehensive understanding of environmental and genetic risk interactions. Gene-environment interactions are implicated in the etiology of a number cancer sites. Melanoma will provide the paradigm for study in this application because of the evidence for gene-environment etiology, rising incidence rates, and promise of behavioral prevention. Given the current absence of identified germ line mutations, studying first-degree relatives of melanoma patients will provide a vehicle in the proposed studies to examine the role of gene-environment risk perceptions and both skin cancer screening and sun protection behavior. Study I is a qualitative interview study of risk perceptions among first-degree relatives of melanoma patients. Study II is a prospective assessment of risk perceptions, skin cancer screening, and sun protection behaviors among first degree-relatives of recently diagnosed melanoma patients. Through intensive interaction with multidisciplinary colleagues, formal epidemiology coursework, teaching, and research, this career development award will establish my multidisciplinary research skills at the interface of genetic epidemiology and behavioral science, and position me to establish novel theory and measurement strategies for the role of risk perceptions of gene-environment interactions, and ultimately to develop communication models of gene-environment cancer risks which will be applicable to other cancer sites.