Development of Breast Cancer Risk Model for the Pacific

摘要 乳腺癌是关岛和北方马里亚纳群岛妇女与癌症有关的死亡的主要原因，查莫罗妇女按年龄调整的乳腺癌死亡率在人口中最高。马里亚纳群岛包括关岛和北方马里亚纳群岛联邦，其中塞班岛是最大和人口最多的岛屿。没有在关岛或塞班岛进行流行病学或临床研究来研究乳腺癌的危险因素。在这项申请中，我们建议进行一项回顾性病例对照研究，200例病例和400例对照， 建立亚太岛民乳腺癌风险模型。将包括健康行为和肥胖测量。人口将主要由岛屿的绝经后妇女组成。从U-56试点项目II收集的数据提供了 关于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、缺乏体育活动和高超重/肥胖率表明，许多妇女在卫生部。对照组将从几家当地诊所/机构接受筛查性乳腺X射线摄影的患者中招募，频率与年龄和种族病例相匹配。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，将提供宝贵的信息，从而导致采取干预措施，减少这些得不到充分服务的高风险少数民族人口的乳腺癌发病率。虽然马里亚纳群岛的妇女似乎比美国妇女的乳腺癌发病率低，但乳房X光检查的可用性有限。乳腺癌发病率正在上升，死于这种疾病的高风险表明诊断和治疗较晚。在这项申请中，我们建议进行一项 回顾性病例对照研究，以开发一个模型来预测亚太岛屿人口的乳腺癌风险。一个长期目标是进行干预研究，以预防和/或扭转与马里亚纳群岛乳腺癌有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，如果可行的话，我们的风险模型可以用乳房X线摄影密度结果进行更新。

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.