Traci Bethea: Neighborhood Deprivation, Social Factors, and Head and Neck Cancer

描述（由申请人提供）：头颈部鳞状细胞癌（HNSCC）是美国（US）第十大常见癌症，是一个集合术语，通常包括口腔癌（舌、颊腔、牙龈、口底）、咽癌和喉癌。众所周知，吸烟、饮酒和人乳头瘤病毒（HPV）血清阳性均与HNSCC风险增加有关。然而，虽然邻里剥夺和其他社会因素已被发现与烟草和酒精消费以及性传播感染（即HPV）有关，但这些因素对HNSCC和癌症的作用一般来说还不太清楚。因此，拟议的研究将利用现有的HNSCC病例对照研究，以调查个人层面和社区层面的社会因素对HNSCC风险的作用。母研究包括从1999年至2003年在大波士顿都市区招募705例事件病例和815例匹配对照。数据包括参与者的特征，如年龄，性别，种族，烟草和酒精的使用，以及饮食。将从美国人口普查中获得有关社区一级社会和经济因素的更多信息，如教育、就业、贫困、住房和种族构成。将制定邻里贫困指数和社区一级社会经济地位指数，以实现以下具体目标（Messer等人，2006年，Roberts等人，2004年）：（1）调查个人和社区水平的社会因素对HNSCC风险和疾病生存的作用，（2）确定个人和社区层面的社会因素是否与烟草和酒精消费有关，（3）确定个人和社区水平的社会因素是否与性行为和HPV血清阳性相关，以及（4）确定个人和社区水平的社会因素是否改变吸烟，饮酒，和HPV对HNSCC风险的影响。这些目标与国家癌症研究所（NCI）的目标是一致的，并涉及到NCI的战略计划，就声明需要对癌症健康差异进行额外的研究。此外，父母研究的现有基础设施提供了一个独特的和具有成本效益的机会，调查邻里剥夺和社区一级的社会经济地位对HNSCC风险的作用。通过访问母公司研究的数据，访问波士顿大学的广泛资源，优秀的指导团队的支持以及精心设计的研究培训计划，申请人非常适合进行拟议的研究。指导小组拥有环境和社会流行病学、生物统计学和接触生物学方面的专门知识，并致力于在培训期间提供必要的指导。申请人的长期目标是在环境和社会流行病学领域制定积极的研究计划，以便拟议的研究不仅将提供有价值的见解邻里剥夺和社区一级的社会经济地位对HNSCC风险的作用，而且在发展有前途的研究事业中发挥关键作用。

DESCRIPTION (provided by applicant): Head and neck squamous cell carcinoma (HNSCC), the tenth most common cancer in the United States (US), is a collective term that typically includes oral cancer (tongue, buccal cavity, gum, floor of mouth), pharyngeal cancer, and laryngeal cancer. Smoking, alcohol consumption, and human papillomavirus (HPV) seropositivity are all known to be associated with increased risk of HNSCC. However, while neighborhood deprivation and other social factors have been found to be associated with tobacco and alcohol consumption and with sexually transmitted infections (i.e. HPV), the role of such factors on HNSCC and on cancer in general is considerably less clear. Accordingly, the proposed study will utilize an existing HNSCC case-control study to investigate the role of individual-level and community-level social factors on HNSCC risk. The parent study included the recruitment of 705 incident cases and 815 matched controls in the greater Boston metropolitan area from 1999 to 2003. Data include participant characteristics such as age, gender, ethnicity, tobacco and alcohol use, and diet. Additional information will be obtained from the US Census on community-level social and economic factors such as education, employment, poverty, housing, and racial composition. An index of neighborhood deprivation and an index of community-level socio-economic status will be developed to address the following specific aims (Messer et al, 2006, Roberts et al, 2004): (1) investigate the role of individual and community-level social factors on HNSCC risk and disease survival, (2) determine whether individual and community-level social factors are associated with tobacco and alcohol consumption, (3) determine whether individual and community-level social factors are associated with sexual behavior and HPV seropositivity, and (4) determine whether individual and community-level social factors modify the effect of smoking, drinking, and HPV on HNSCC risk. These objectives are consistent with the goals of the National Cancer Institute (NCI) and relate to the NCI's strategic plan with respect to the stated need for additional research on cancer health disparities. Additionally, the existing infrastructure of the parent study presents a unique and cost-effective opportunity to investigate the role of neighborhood deprivation and community-level socio-economic status on HNSCC risk. With access to the data from the parent study, access to the extensive resources at Boston University, the support of an excellent mentoring team, and a carefully designed research training plan, the applicant is ideally positioned to conduct the proposed research. The mentoring team has expertise in environmental and social epidemiology, biostatistics, and exposure biology and is committed to providing the necessary guidance during the training period. The long term goal of the applicant is develop an active research program in the areas of environmental and social epidemiology, such that the proposed research will not only provide valuable insights into the role of neighborhood deprivation and community-level socio-economic status on HNSCC risk, but also play a key role in the development of a promising research career.