Development of Breast Cancer Risk Model for the Pacific

摘要 乳腺癌是关岛和北马里亚纳群岛妇女癌症相关死亡的主要原因，查莫罗妇女的年龄调整乳腺癌死亡率是人口中最高的。马里亚纳群岛包括关岛和北马里亚纳群岛联邦(CNMI)，其中塞班岛是最大和人口最多的岛屿。尚未在关岛或塞班岛进行流行病学或临床研究，以研究乳腺癌危险因素。在这项申请中，我们建议对200例病例和400名对照进行回顾性病例对照研究，以 建立亚太岛民乳腺癌风险模型。健康行为和肥胖测量将包括在内。人口将由以岛屿为主的绝经后妇女组成。从U-56试验项目II收集的数据提供 关岛成年人癌症行为危险因素的初步数据。不良的饮食习惯，缺乏体力活动，以及超重/肥胖率高，表明许多妇女在爱潘市卫生局。将从在当地几家诊所/设施接受乳房X光筛查的患者中招募控制组，并在年龄和种族方面与患者匹配的频率。这项研究是第一项旨在研究关岛和塞班岛妇女乳腺癌风险因素的大型病例对照研究，它将提供有价值的信息，有助于采取干预措施，降低这些服务不足的高危少数群体的乳腺癌发病率。虽然马里亚纳群岛的女性似乎表现出比美国女性更低的乳腺癌发病率，但乳房X光检查的可用性是有限的。乳腺癌的发病率正在上升，死于这种疾病的高风险意味着诊断和治疗的延迟。在此应用程序中，我们建议进行 一项回顾性病例对照研究，旨在开发一种预测亚太地区岛屿人群乳腺癌风险的模型。一个长期目标是进行一项干预研究，以预防和/或逆转马里亚纳群岛与乳腺癌相关的可改变的风险因素，使用风险模型作为识别高危妇女的工具。此外，如果可行，我们的风险模型可以根据乳房X光检查密度结果进行更新。

ABSTRACT Breast cancer is the leading cause of cancer-related death among women on Guam and the Northern Mariana Islands, and Chamorro women have the highest age-adjusted breast cancer mortality rate in the population. The Mariana Islands include Guam and the Commonwealth of the Northern Mariana Islands (CNMI), of which the island of Saipan is the largest and most populated island. No epidemiological or clinical studies have been conducted on Guam or Saipan to study breast cancer risk factors. In this application, we propose to conduct a retrospective case-control study with 200 cases and 400 controls to develop a model of breast cancer risk among Asian Pacific Islanders. Health behavior and obesity measurements will be included. The population will consist of post-menopausal women of predominantly Islands. Data collected from the U-56 Pilot Project II provide preliminary data on behavioral risk factors for cancer among adults on Guam. Poor eating habits, lack of physical activity, and high rate of ovenweight/obesity suggest that many women on aipan Department of Health. Controls will be recruited from patients undergoing screening mammography in several local clinics/facilities and frequencymatched to cases on age and ethnicity. This study, the first large case-control study designed to look at risk factors for breast cancer in women on Guam and Saipan, will provide valuable information that will lead to interventions to reduce breast cancer incidence in these underserved high-risk minority populations. While women in the Mariana Islands appear to exhibit a lower breast cancer incidence than U.S. women generally, availability of mammography is limited. Breast cancer rates are increasing, and high risk of dying from the disease suggests late diagnosis and treatment. In this application, we propose to conduct a retrospective case-control study to develop a model to predict risk of breast cancer in Asian-Pacific Island populations. A long-term goal is to conduct an intervention study to prevent and/or reverse modifiable risk factors associated with breast cancer in the Mariana Islands, using the risk model as a tool to identify highrisk women. Additionally, our risk model could be updated with mammographic density results, if feasible.