Diet and second-hand smoke in lung cancer prediction

描述（由申请人提供）： 该应用是评估饮食单独或作为暴露于二手烟（SHS）的调节剂是否明显影响从不吸烟者的肺癌（LC）风险预测的形成性步骤。我们建立了一个LC的流行病学风险预测模型，该模型是我们最近从一项正在进行的LC病例对照研究中构建的[Spitz MR et al JNCI 2007]。在终身不吸烟者的风险模型中（基于330名白人LC患者和370名对照），暴露于SHS和癌症家族史是LC的唯一重要风险因素。该模型是利用流行病学和临床数据开发的，其区分能力仅为59%。此外，该模型不包括饮食数据。我们认为，将美国农业部的水果和蔬菜金字塔式服务纳入其中将导致歧视性权力的实质性增加。我们还假设，在LC风险模型中，SHS可能与其他环境，行为或生活方式因素相互作用，这些因素的联合作用可能会大大改变个人的LC风险。因此，使用我们正在进行的病例对照研究，和广泛的流行病学和135项食物频率问卷数据库从父母补助金，我们建议评估的增量价值纳入模型美国农业部金字塔的水果和蔬菜的服务和水果和蔬菜服务和SHS的联合作用，以提高我们的LC风险模型的歧视权力。该项目的具体目标是： 1.评估美国农业部金字塔式水果和蔬菜对从不吸烟者的LC风险的影响- 330名新诊断的LC患者和379名健康对照。我们还将研究饮食是否是生活方式的指标（包括体育活动，酒精摄入量和维生素矿物质补充）。 2.研究水果和蔬菜服务和二手烟对LC风险的联合影响。 3.构建一个扩展的LC风险模型，将目标1和2中的数据合并。 我们的长期目标是确定美国农业部金字塔水果和蔬菜的数量，这些水果和蔬菜有助于我们的LC风险模型，并确定特定的水果和蔬菜是否会改变SHS的LC风险。为了在临床上有用，该模型必须使用易于获得的自我报告数据，这些数据来自于简化的饮食调查问卷，重点关注降低SHS LC风险的特定食物。 Layman摘要：该项目将生成一个从不吸烟者患肺癌的风险模型，其中包括您的饮食和体育活动的作用。我们认为，从不吸烟者的肺癌风险预测模型对于帮助识别高风险人群非常重要，因为每年有10- 15%的肺癌被诊断为从不吸烟者。

DESCRIPTION (provided by applicant): This application is a formative step towards assessing whether diet alone or as a modulator of exposure to second hand smoke (SHS) appreciably influences lung cancer (LC) risk prediction in never smokers. We build upon an epidemiologic risk prediction model for LC, that we recently constructed from an ongoing LC case-control study [Spitz MR et al JNCI 2007]. In the risk model for life-long never smokers (based on 330 Caucasian LC patients and 370 controls), exposure to SHS and family history of cancer were the only significant risk factors for LC. This model was developed using epidemiologic and clinical data and had a discriminatory power of only 59%. Furthermore, this model did not include dietary data. We believe that inclusion of USDA pyramid servings of fruit and vegetables will result in a substantial gain in discriminatory power. We also hypothesize that SHS in the LC risk model may interact with other environmental, behavioral, or lifestyle factors and the joint effects of these factors may substantially alter an individual's LC risk. Therefore, using our on-going case-control study, and the extensive epidemiologic and 135-item food frequency questionnaire database from the parent grant, we propose to evaluate the incremental value of incorporating into the model USDA pyramid servings of fruit and vegetables and the joint effects of fruit and vegetable servings and SHS to improve the discriminatory power of our LC risk model. The specific aims for this project are: 1. To estimate the effect of USDA pyramid servings of fruit and vegetables on LC risk in never smokers- 330 newly diagnosed LC patients and 379 healthy controls. We will also examine whether diet is an indicator for lifestyle (including physical activity, alcohol intake and vitamin mineral supplementation). 2. To examine the joint effects of fruit and vegetable servings and second-hand smoke on LC risk. 3. To construct an expanded LC risk model incorporating the data in aims 1 and 2. Our long-term goal is to identify the number of USDA pyramid servings of fruit and vegetables that contribute to our LC risk model in never smokers and determine whether specific fruit and vegetable servings modify LC risk from SHS. In order to be clinically useful, the model must use easy to obtain self-reported data derived from an abbreviated dietary questionnaire focusing on specific foods that reduce LC risk from SHS. Layman's abstract: This project will generate a risk model for lung cancer in never smokers that includes the role of your diet and physical activity. We believe that a lung cancer risk prediction model in never smokers is important to help identify persons at high risk because 10-15 % of lung cancers are diagnosed in never smokers each year.