Epidemiologic Field Studies

<b>BCDDP：乳腺癌检测示范项目随访研究(1030)</b><br>本研究对约6万名乳腺癌示范项目（BCDDP）前参与者进行了随访。目前的分析包括：1)体重指数、激素替代疗法和乳腺癌风险；2)乳腺癌组织学类型的危险因素；3)根据乳腺癌ER/PR状态分析危险因素；4)饮食模式与结直肠癌的关系；5)体重指数与死亡率；6)体育活动与乳腺癌风险；7)涉及乳腺癌、结肠癌、卵巢癌和肾癌的膳食池项目分析；8) DCEG汇集项目，包括非甾体抗炎药和膀胱癌风险。<br><br><b>黑人/白人PHS研究(430)</b><br>食管癌和胰腺癌的发病率黑人明显高于白人。我们正在进行一项基于人群的病例对照研究，调查在易感性的遗传和分子标记方面的种族差异及其与环境因素的相互作用。这些标记物可能有助于预防和早期发现策略。<br><br><b>儿童癌症研究中减少反应偏倚的可行性研究(443)</b><br>对急性淋巴细胞白血病（ALL）患儿的母亲和对脑肿瘤患儿的母亲进行了两次焦点小组会议，以探讨：一天中最佳的访谈时间、给药方法和地点；替代性数据来源的可用性；儿童癌症诊断与流行病学访谈的间隔时间以及其他可能影响母亲访谈反应的特征。患有这两种癌症的孩子的母亲更喜欢晚上在家接受采访，并愿意提供他们孩子的完整医疗记录。与患有脑肿瘤的儿童的母亲相比，患有ALL儿童的母亲更愿意在儿童治疗过程中更早地参与流行病学访谈，并提供更多的产妇生殖史记录，这体现了母亲群体之间的情感、社会经济和文化差异。父母对脑癌的担忧和治疗过程的困难是他们决定推迟参加流行病学访谈的关键因素，因为他们的孩子被诊断出癌症。我们的结论是，焦点小组方法可以为改进儿童癌症流行病学研究的问卷调查和方法提供广泛的策略。<br><br>< br>胃癌：山东省临区（446）的随机多干预试验，以抑制胃癌前病变</b><br>使用中国农村8年试验的数据，我们观察了长期补充维生素（C， E和硒）和大蒜以及一次服用阿莫西林/奥美拉唑对幽门螺杆菌患病率的影响。长期服用维生素和大蒜补充剂既不能降低幽门螺杆菌患病率，也不能增强抗生素治疗。阿莫西林和奥美拉唑对该流行地区的幽门螺杆菌患病率产生了持久的降低。我们还评估了长期使用大蒜制剂和补充维生素对胆固醇、低密度脂蛋白和高密度脂蛋白水平的可能作用，以及对408名随机样本研究参与者血清叶酸、VB12、同型半胱氨酸和谷胱甘肽的影响。补充维生素/硒7.3年后，总胆固醇和低密度脂蛋白显著增加，但补充大蒜或一次性阿莫西林/奥美拉唑治疗没有影响。经年龄、性别和吸烟因素调整后的回归表明，补充大蒜后叶酸增加10.2%，补充维生素/硒后谷胱甘肽增加13.4%。阿莫西林/奥美拉唑对任何分析物都没有统计学上的显著影响，大蒜或维生素/硒补充剂对其他分析物也没有统计学上的显著影响。<br><br><b>炎性乳腺癌（IBC）中试研究和病例对照研究(314)</b><br>我们在埃及和突尼斯两个中心完成了一篇题为《炎性乳腺癌病例特征》的中试研究的论文。我们已经开始设计一项炎症性乳腺癌危险因素的病例对照研究，该研究将包括北非6个中心（1个突尼斯中心，1个埃及中心，2个阿尔及利亚中心，2个摩洛哥中心）和法国1个中心在两年时间内积累的约400例IBC病例。对照组分为两组：1)400例非ibc乳腺癌患者；2)随机抽取研究医院女性住院患者（不包括乳腺癌、卵巢癌、子宫内膜癌和儿科癌症患者）400名访客对照（不包括一级亲属）。这项研究将包括问卷调查、人体测量、滤纸上的血液采集、唾液采集、IBC病例乳房的数码照片，以及在选定的中心收集IBC病例和非IBC乳腺癌对照组的石蜡包埋肿瘤组织。该研究将作为一个联合体进行，由国际癌症研究机构（IARC）协调表格的开发和翻译。NCI-DCEG负责制定埃及和突尼斯研究中心的研究程序。<br><br><b>德国血液样本肺癌DNA提取(352)</b><br>我们正在根据1990年至1996年在德国进行的一项肺癌研究的血液样本调查候选基因在肺癌中的作用。DNA修复和致癌物质代谢基因的DNA提取和基因分型已经完成，数据正在分析中。吸烟和氡暴露的详细信息使我们能够研究基因-环境效应和基因-基因相互作用。<br><br><b>乳腺癌血清库中乳腺癌和增生性乳腺疾病的风险与遗传变异(1100)</b><br>本研究随访了2636名接受良性乳腺活检的绝经前妇女，这些妇女参加了1977年至1987年在密歇根州大急流城进行的乳腺癌血清库队列研究。本随访研究的具体目的包括：1)检索和编码绝经前参与者血清库中良性乳腺疾病活检的初始病理报告；2)追踪参与者并与全州癌症登记处和NDI联系，以确定乳腺癌病例；3)在特异性目标1（如上）中检索和编码后，发现患有乳腺癌风险相当高的良性乳腺疾病诊断的参与者，或在特异性目标2中追踪后发现在随访期间患有乳腺癌的参与者，并选择匹配的对照组进行基因分型。每项具体目标的进展情况：1)正在寻找的2632份病理报告中，有2184份已从大急流城的医院取回。2)所有参与者先前已提交给养老金福利信息（PBI）以确定生命状态，而推定活着的人与TransUnion数据库进行匹配以确认其社会安全号码（SSN），而推定死亡的人则提交给国家死亡指数（NDI）加死因确定。通过与NDI和密歇根州癌症登记处的匹配，以及最初的后续调查问卷的结果，得出了186名患有乳腺癌的独特女性。3)具体目标3的试点研究已经完成。从12个样本标本中提取DNA，并在ATCC-Frederick合同实验室对两种遗传变异进行基因分型

<b>BCDDP: Breast cancer detection demonstration project follow-up study (1030)</b><br>This study follows about 60,000 former participants in the Breast Cancer Demonstration Project (BCDDP). Current analyses include: 1) body mass index, hormone replacement therapy and breast cancer risk; 2) risk factors for histologic types of breast cancer; 3) risk factors according to breast cancer ER/PR status; 4) dietary patterns and colorectal cancer; 5) body mass index and mortality; 6) physical activity and breast cancer risk; 7) dietary pooling project analyses involving cancers of the breast, colon, ovary, and kidney; 8) DCEG pooling projects, including NSAIDS and bladder cancer risk.<br><br><b>Black/white PHS study (430)</b><br>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.<br><br><b>Feasibility study for reducing response bias in studies of childhood cancer research (443)</b><br>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.<br><br><b>Gastric cancer: Randomized multi-intervention trial to inhibit precancerous gastric lesions in Linqu, Shandong Province (446)</b><br>Using data from an 8-year trial in rural China we looked at the effects of long-term vitamin (C, E, and selenium) and garlic supplementation and one time administration of amoxicillin/omeprazole on the prevalence of H. pylori. Long-term administration of the vitamin and garlic supplements neither reduced H. pylori prevalence nor potentiated antibiotic treatment. Amoxicillin and omeprazole produced long-lasting reductions in H. pylori prevalence in this endemic region. We also evaluated the possible role of long-term use of the garlic preparation, and vitamin supplementation on levels of cholesterol, LDL, and HDL, and on serum folate, VB12, homocysteine and glutathione in a random sample of 408 study participants. There were significant increases in total cholesterol and LDL after 7.3 years of vitamin/selenium supplementation, but no effect of garlic supplementation or one-time amoxicillin/omeprazole treatment. Regressions adjusted for age, gender and smoking indicated an increase of 10.2% in folate after garlic supplementation and an increase of 13.4% in glutathione after vitamin/selenium supplementation. No statistically significant effects were seen from amoxicillin/omeprazole for any analyte, nor from garlic or vitamin/selenium supplementation for other analytes.<br><br><b>Inflammatory breast cancer (IBC) pilot study and case-control study (314)</b><br>We completed a manuscript based on the pilot study entitled Characteristics of inflammatory breast cancer cases at two centers in Egypt and Tunisia. We have begun designing a case-control study of risk factors for inflammatory breast cancer that will include approximately 400 IBC cases accrued over a two-year period at 6 centers in North Africa (1 center in Tunisia, 1 in Egypt, 2 in Algeria, and 2 in Morocco) and 1 center in France. Two control groups will be included: 1) 400 non-IBC breast cancer cases and; 2) 400 visitor controls (excluding first-degree relatives) to randomly selected female inpatients (excluding those with breast, ovarian, endometrial, and pediatric cancers) in the study hospitals. The study will involve the administration of a questionnaire, anthropometric measurements, blood collection on filter paper, saliva collection, digital photographs of the breasts of IBC cases, and the collection of paraffin-embedded tumor tissue for IBC cases and non-IBC breast cancer controls at selected centers. The study will be conducted as a consortium, with forms development and translation coordinated at the International Agency for Research on Cancer (IARC). The NCI-DCEG is responsible for developing study procedures at the study centers in Egypt and Tunisia.<br><br><b>Lung cancer DNA extraction from German blood samples (352)</b><br>We are investigating the role of candidate genes for lung cancer based on blood samples from a lung cancer study conducted in Germany between 1990 and 1996. DNA extraction and genotyping for DNA repair and carcinogen metabolizing genes have been completed and the data are being analyzed. Detailed information on tobacco smoking and radon exposure allows us to study gene-environment effects and gene-gene interactions.<br><br><b>Risk of breast cancer and hyperplastic breast conditions in the breast cancer serum bank in relation to inherited genetic variants (1100)</b><br>This study involves follow-up of 2636 premenopausal women who received a benign breast biopsy and were enrolled in the Breast Cancer Serum Bank cohort study in Grand Rapids, MI, from 1977 through 1987. The specific aims of this follow-up study include: 1) retrieval and coding of the initial pathology report pertaining to the benign breast disease biopsy received by premenopausal participants in the serum bank; 2) tracing of participants and linkage to statewide cancer registries and the NDI to identify breast cancer cases; 3) genotyping of participants who are found, after the retrieval and coding in Specific Aim 1 (above), to have benign breast disease diagnoses that confer a considerably elevated risk of breast cancer, or those who are found, after tracing in Specific Aim 2, to have developed breast cancer during follow-up, and selected matched controls. Progress on each specific aim: 1) 2184 out of a total of 2632 pathology reports being sought have been retrieved from hospitals in Grand Rapids. Pathology report collection is now considered completed 2) all participants had previously been submitted to Pension Benefit Information (PBI) for vital status determination, while those presumed living were matched against the TransUnion database to confirm their social security number (SSN), and those who were presumed deceased were submitted to the National Death Index (NDI) plus for cause of death determination. The match with the NDI and with the Michigan State Cancer Registry, together with results from the original follow-up questionnaires, yielded 186 unique women with breast cancer. 3) pilot studies have been completed for Specific Aim 3. DNA was extracted from 12 sample specimens and genotyped for two genetic variants by ATCC-Frederick contract laboratories