Epidemiologic Field Studies

生物统计学分支既开展自己的实地研究，也为DCEG其他分支领导的实地研究提供咨询和合作。生物统计学分支领导的实地研究BCDDP：乳腺癌检测示范项目后续研究（1030）这项研究跟踪了约60 000名乳腺癌示范项目（BCDDP）的前参与者。目前的分析包括：1）乳腺癌和卵巢癌风险的家族史; 2）生殖因素、口服避孕药和激素治疗的使用和膀胱癌风险; 3）体重、身高和体重指数和卵巢癌风险; 4）预测白色女性的绝对浸润性癌症风险：包括乳房X线摄影密度的模型; 5）BMI和乳腺癌风险; 6）乳腺癌组织学类型的风险因素; 7）根据乳腺癌ER/PR状态的风险因素; 8）BMI和死亡率; 9）饮食模式和结直肠癌风险; 10）涉及乳腺癌、结肠癌、卵巢癌和肾癌的饮食汇总项目分析。黑人/白色PHS研究（430）黑人食管癌和胰腺癌的发病率远高于白人。我们正在进行一项研究，以调查种族差异方面的遗传和分子标记的易感性及其相互作用与环境因素之间的情况下，以人口为基础的病例对照研究。这些标记物可能有助于预防和早期检测策略。乳腺癌：SEER特殊研究（10316）我们的长期目标是通过与爱荷华州、洛杉矶和夏威夷的SEER组织丢弃登记处合作，获得基于人群的注释美国乳腺癌组织样本，并使用这些材料构建组织微阵列（TMA），以验证不同乳腺癌亚型（如管腔型、基底型和HER 2表型）的基于发现的分子特征;为乳腺癌病因学、监测、预防和治疗提供见解。我们启动了一个示范项目，使用从SEER夏威夷肿瘤登记处收集的准备好的乳腺TMAs，包括1995年诊断的432例原位和浸润性乳腺癌病例。获得三组TMA用于免疫组织化学（IHC）染色：1）标准IHC，2）Q-Dot技术和3）由HistoRx Inc.开发的所谓AQUA方法。迄今为止，已收到带有标准染色剂的载玻片，并将对其进行评分。Q-Dot和AQUA染色待定;这些染色不会手动评分。减少儿童癌症研究中反应偏差的可行性研究（443）对急性淋巴细胞白血病（ALL）儿童的母亲和脑肿瘤儿童的母亲进行了两次焦点小组讨论，以探讨：一天中的最佳时间、给药方法和访谈地点;替代数据来源的可用性;儿科癌症诊断和流行病学访谈之间的时间间隔;以及可能影响母亲访谈反应的其他特征。患有这两种癌症的孩子的母亲更喜欢晚上在家里接受采访，并愿意提供完整的子女医疗记录。母亲群体之间的情感、社会经济和文化差异体现在ALL儿童的母亲愿意在其查尔兹治疗过程中更早地参与流行病学访谈，并与脑肿瘤儿童的母亲相比，提供更多的母亲生殖史记录。父母对脑癌的担忧和治疗过程的困难是他们决定在查尔兹确诊癌症后推迟数月参加流行病学访谈的关键因素。我们的结论是，焦点小组的方法可以有助于一个广泛的战略，改善问卷调查和方法进行儿科癌症流行病学研究。

The Biostatistics Branch both conducts its own field studies as well as consults and collaborates on field studies lead by other DCEG branches.Field Studies Lead by the Biostatistics BranchBCDDP: Breast cancer detection demonstration project follow-up study (1030) This study follows about 60,000 former participants in the Breast Cancer Demonstration Project (BCDDP). Current analyses include: 1) family history of breast cancer and ovarian cancer risk; 2) reproductive factors, oral contraceptive and hormone therapy use and bladder cancer risk; 3) weight, height, and body mass index and ovarian cancer risk; 4) projecting absolute invasive cancer risk in white women: a model that includes mammographic density; 5) BMI and breast cancer risk; 6) risk factors for histologic types of breast cancer; 7) risk factors according to breast cancer ER/PR status; 8) BMI and mortality; 9) dietary patterns and colorectal cancer risk; 10) dietary pooling project analyses involving cancers of the breast, colon, ovary, and kidney. Black/white PHS study (430)Rates of esophageal and pancreatic cancer are much higher in blacks than whites. We are conducting a study to investigate racial differences with respect to genetic and molecular markers of susceptibility and their interaction with environmental factors among cases from a population-based case-control study. Such markers might be useful for prevention and early detection strategies. Breast cancer: SEER special study (10316)Our long-term objective is to obtain a population-based sample of annotated U.S. breast cancer tissues through collaboration with the SEER Tissue Discard Registries in Iowa, Los Angeles, and Hawaii, and to use these materials to build tissue microarrays (TMAs) to validate discovery-based molecular signatures for different breast cancer subtypes such as luminal, basal, and HER2 phenotypes; providing insights for breast cancer etiology, surveillance, prevention, and treatment. We initiated a demonstration project, using a collection of prepared breast TMAs from SEERs Hawaii Tumor Registry; including n=432 in-situ and invasive breast cancer cases, diagnosed in 1995. Three sets of TMA were obtained for immunohistochemical (IHC) staining: 1) standard IHC 2) Q-Dot technology and 3) the so-called AQUA method, developed by HistoRx Inc. To date, the slides with standard stain have been received and will be scored. Q-Dot and AQUA stains are pending; these stains will not be scored manually. Feasibility study for reducing response bias in studies of childhood cancer research (443)Two focus group sessions with mothers of children with acute lymphoblastic leukemia (ALL) and two with mothers of children with brain tumors were conducted to explore: the optimal time of day, method of administration, and location for the interview; the availability of alternative data sources; the interval between pediatric cancer diagnosis and epidemiological interview; and other features which may affect maternal interview responses. Mothers of children with both types of cancer preferred being interviewed at home during the evening and were willing to provide complete access to their offsprings medical records. Emotional, socioeconomic, and perhaps cultural differences between the groups of mothers were exemplified by the willingness of mothers of children with ALL to participate in epidemiological interviews earlier in their childs treatment course and to provide greater access to maternal reproductive history records compared with mothers of children with brain tumors. Parental concerns about the brain cancer and the difficult treatment course were a key element in their decision to defer participating in epidemiologic interviews for many months after their childs cancer diagnosis. We conclude that the focus group approach can contribute to a broad strategy for improving questionnaires and methods for conducting pediatric cancer epidemiological research.