A pooled analysis of risk factors of small intestine cancer

项目摘要/摘要在中低收入资源国家，由于经济和社会的变化，导致人口规模的增加和人口老龄化，以及烟草和酒精、超重和肥胖、生殖习惯和职业因素等危险因素的暴露模式的改变，癌症发病率大大增加。在中等资源国家的转型期人口中进行的流行病学研究强调了这些生活方式因素在决定癌症风险迅速变化方面的作用。然而，这些研究大多为病例对照研究，其回顾性设计比前瞻性队列研究提供了更大的选择和信息偏倚风险。队列研究能够更好地利用低资源和中等资源国家的大量暴露和风险对比，来调查许多这些人口中正在发生的转变的影响。这种方法对常见的癌症都有帮助，如果足够大的人群可以聚集在以联盟为基础的汇总分析中，对罕见的和研究较少的肿瘤也有帮助。我们的目标是对来自亚洲的队列研究进行汇总分析，以评估烟草、酒精和BMI升高对小肠癌病因的影响，这是罕见癌症系列研究中的第一项研究。该分析还将检验主要类型的小肠癌，腺癌（AC）和其他组织学类型之间的病因异质性假设。汇总分析将在亚洲队列联盟（ACC）内的队列中进行，该联盟最近成立，目的是促进亚洲当前和未来流行病学队列研究之间的协作和数据汇集。我们的联盟解决了NCI的目标是“扩大中心、网络和联盟的能力”，目标是“创建和维持促进研究合作的基础设施，作为技术开发的平台，并提供对全方位研究资源的访问”，正如NCI计划和优先事项中概述的那样。我们预计，ACC内部的分析将是朝着提高对罕见癌症的原因和机制的理解迈出的重要一步，并将加强联盟内部的合作，以进一步汇集分析。此外，我们计划将ACC数据与来自北美和欧洲的其他大型队列的数据汇总，以进一步提高研究小肠癌危险因素的统计能力。

DESCRIPTION (provided by applicant): Project Summary/Abstract Cancer incidence has greatly increased in low- and medium-resource countries as a result of economic and social shifts, which have contributed to an increase in population size and the aging of populations, as well as altered the pattern of exposure to risk factors such as tobacco and alcohol, overweight and obesity, reproductive habits, and occupational agents. Epidemiologic studies conducted in populations in transition in medium-resource countries have stressed the role of such lifestyle factors in determining the rapid change in cancer risk. However, most of these studies were designed as case-control studies, the retrospective design of which provides greater risks of selection and information biases than prospective cohort studies. Cohort studies are better able to take advantage of large exposure and risk contrasts in low- and medium-resource countries to investigate the effects of the transition that is occurring in many of these populations. This approach is helpful for both common cancers and, if large enough populations can be assembled in consortium-based pooled analyses, for rarer and less widely studied neoplasms. We aim to conduct a pooled analysis of cohort studies from Asia to assess the contribution of tobacco, alcohol, and elevated BMI to the etiology of cancer of the small intestine, as the first study in a series on rare cancers. The analysis will also test the hypothesis of heterogeneity in the etiologic factors between the main type of cancer of the small intestine, adenocarcinoma (AC), and other histologic types. The pooled analysis will be conducted among cohorts within the Asia Cohort Consortium (ACC), which was recently established with the goal of promoting collaboration and data pooling among current and future epidemiologic cohort studies in Asia. Our consortium addresses the NCI objective to "expand the capacity of centers, networks, and consortia," and the goal to "create and sustain infrastructures that facilitate research collaboration, serve as platforms for technology development, and provide access to the full range of research resources," as outlined in the NCI Plans and Priorities. We anticipate that the analysis within the ACC will be a major step toward improving understanding of the causes and mechanisms of rare cancers and will enhance the collaboration within the consortium for further pooled analyses. Furthermore, we plan to pool the ACC data with those of other large cohorts from North America and Europe to further increase the statistical power of looking at risk factors of small intestine cancer.