Epidemiology of Cancer in a Cohort of Older Women

描述（由申请人提供）：爱荷华州妇女健康研究（IWHS）始于1986年，是一项纵向队列研究，旨在确定饮食、体脂分布和其他风险因素是否与41，836名年龄在55-69岁的绝经后妇女的癌症发病率相关。1986年的基线邮寄调查和1987年、1989年、1992年、1997年和2004年的五次随访调查收集了暴露和生活方式信息。自1986年以来，通过与爱荷华州癌症登记处（SEER癌症登记处）和国家死亡指数的年度联系获得癌症发病率和死亡率。该项目非常富有成效，迄今已发表了260多份研究出版物。我们建议，在这五年的更新中，继续解决与老年妇女癌症有关的重要问题。该队列对于不太常见的癌症以及老年人癌症发生和生存的生活方式预测因素变得特别有用。我们还提出了新的联系，社区层面的数据，这将使我们能够研究如何个人的社会和物理环境影响他们的癌症风险的来源。这些数据来源包括地区资源文件（美国卫生与公众服务部）、美国人口普查数据以及来自爱荷华州州立大学的农村发展倡议研究的数据。我们在拟议拨款期内的具体目标是：1）继续跟踪IWHS队列，他们现在78-92岁，总共27年（1986-2012年），2）扩大我们正在进行的对女性癌症发病风险因素的调查，3）确定与女性癌症幸存者生活质量和死亡率相关的因素，以及4）确定社区水平的社会和环境特征与老年妇女癌症结果和生活质量之间的关联。继续为国际妇女卫生研究所提供资金不仅对完成具体目标中所述的研究至关重要，而且对支持现有的和几项计划的辅助研究也至关重要。妇女卫生研究所还积极参加了几个群组研究联合会。已经收集的大量接触和后续数据、与免费获得的社区一级数据的联系、富有成效的研究小组以及提出的重要研究问题相结合，使国际妇女卫生研究所继续开展五年活动成为改善公共卫生的一个极具成本效益的手段。 公共卫生相关性：随着65岁以上的美国人越来越多，预防癌症及其对晚年生活的影响越来越重要。爱荷华州妇女健康研究的研究结果将继续增加我们对有助于癌症预防和生存的潜在可改变因素的理解，并将帮助公共卫生和医疗保健从业者优先考虑和更好地利用医疗保健资源。

DESCRIPTION (provided by applicant): The Iowa Women's Health Study (IWHS) began in 1986 as a longitudinal cohort study to determine whether diet, body fat distribution, and other risk factors were related to cancer incidence among 41,836 post- menopausal women aged 55-69 years. Exposure and lifestyle information was collected in a baseline mailed survey in 1986, and five follow-up surveys in 1987, 1989, 1992, 1997 and 2004. Cancer incidence and mortality have been obtained by annual linkage with the Iowa Cancer Registry (a SEER cancer registry) and the National Death Index since 1986. The project has been extremely productive, with more than 260 research publications published to date. We propose, in this 5-year renewal, to continue to address important questions related to cancer in older women. The cohort is becoming especially informative with regard to less common cancers, and for lifestyle predictors of cancer occurrence and survival among the elderly. We also propose new linkages to sources of community-level data that will allow us to study how an individual's social and physical environment influences their cancer risk. These data sources include the Area Resource File (US Department of Health and Human Services), US Census Data, and data from the Rural Development Initiative Study based at Iowa State University. Our specific aims for the proposed funding period are to: 1) continue to follow the IWHS cohort, who are now 78-92 years old, through a total of 27 years (1986-2012), 2) expand our ongoing investigations of risk factors for incident cancers among women, 3) determine the factors associated with quality of life and mortality among female cancer survivors, and 4) determine the associations between community-level social and environmental characteristics and cancer outcomes and quality of life among elderly women. Continuation of funding for the IWHS is vital not only to completion of the research described in the specific aims, but is also key to supporting existing and several planned ancillary studies. The IWHS is also an active participant in several consortia of cohort studies. The combination of the extensive exposure and follow-up data already collected, linkage with community-level data that will be obtained at no cost, a productive research team, and the important research questions that are proposed make a 5-year continuation of the IWHS an extremely cost-effective means towards improving public health. PUBLIC HEALTH RELEVANCE: With the increasing number of Americans over the age of 65 years, prevention of cancer and its impact in later life is taking on greater importance. Research findings from the Iowa Women's Health Study will continue to add to our understanding of the potentially modifiable factors contributing to cancer prevention and survivorship, and will help public health and health care practitioners prioritize and better utilize health care resources.