Population-Based Approach to Skin Cancer Epidemiology

描述(申请人提供)：阳光是皮肤癌的环境风险因素。人们已经做了大量的工作来表征和量化太阳暴露量。然而，对黑色素瘤、鳞状细胞癌和基底细胞癌暴露风险的估计差别很大。由于太阳暴露量和剂量很难直接测量，大多数研究向研究参与者询问有关太阳暴露史的详细问题。几乎所有的问题都依赖于回忆几年前可能发生的低发病率事件。因此，这些措施容易受到系统性回忆偏差和随机错误分类的影响。此外，到目前为止，主要使用病例对照研究设计，特别是在评估黑色素瘤风险的研究中。这项建议中提出的工作将显著提高我们对皮肤癌流行病学的理解。我们有一个独特的机会在钱宁实验室的环境中测试我们的假设，现有的纵向数据集基于该实验室，例如护士健康研究(NHS)。NHS已经收集了暴露于皮肤癌相关风险因素、确诊皮肤癌病例和地理编码(即地图)地址的数据。这项建议的导师是皮肤病和流行病学方面的经验丰富的调查人员，并熟悉NHS的队列。他们也有相当多的 有皮肤癌流行病学的经验，并参与皮肤癌孢子的项目。结合这一研究环境、建议中建议的经验丰富的导师和培训计划，我们处于独特的地位，可以完成以下具体目标：1.研究国民保健系统中太阳暴露史与基底细胞癌(BCC)、鳞状细胞癌(SCC)和恶性黑色素瘤(MM)的关系。2.评估美国紫外线辐射(UV)通量暴露(通过Robertson Berger仪器)与NHS的BCC、SCC和MM发展(地理编码)之间的关系。3.探讨国民保健系统中太阳暴露史(目标1)和紫外线照射史(目标2)与多个原发BCC、SCC和MMS之间的关系。

DESCRIPTION (provided by applicant): Sunlight is an environmental risk factor for skin cancer. A great deal of work has been done to characterize and quantify sun exposure. However, sun exposure risk estimates for melanoma, squamous cell carcinoma and basal cell carcinoma vary widely. As the magnitude and dose of sun exposure are difficult to measure directly, majority of studies ask study participants detailed questions about sun exposure history. Almost all the questions rely on recalling low morbidity events that may have occurred several years ago. Hence, these measures are subject to systematic recall bias and random misclassification. Also, mainly case-control study designs have been used thus far, particularly for studies that have evaluated risk for melanoma. Work suggested in this proposal will significantly improve our understanding of skin cancer epidemiology. We have a unique opportunity to test our hypotheses in the environment at the Channing Laboratory where existing longitudinal datasets are based such as the Nurses' Health Study (NHS). Data on exposure to skin cancer-related risk factors, confirmed skin cancer cases and geocoded (i.e. mapped) addresses has already been gathered for NHS. The mentors for this proposal are experienced investigators in dermatology and epidemiology and are familiar with the NHS cohort. They also have considerable experience with the epidemiology of skin cancer and participate in projects that are part of the SPORE for Skin Cancer. Combined with this research environment, experienced mentors and training plan suggested in this proposal, we are in a unique position to accomplish the following specific aims: 1. To examine the relationship between history of sun exposure and basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and malignant melanoma (MM) in NHS. 2. To evaluate the relationship between exposure to ultraviolet radiation (UV) flux in the US (via Robertson Berger meters) and BCC, SCC and MM development (geocoded) in NHS. 3. To assess the relationship between history of sun exposure (Aim 1) and UV radiation (Aim 2) and multiple primary BCCs, SCCs and MMs in NHS.