Enhancing ARIC Infrastructure to Yield a New Cancer Epidemiology Cohort

描述(由申请人提供)：我们建议加强ARIC的基础设施；社区中的动脉粥样硬化风险，以产生一个新的癌症流行病学队列，为癌症流行病学研究带来新的特征。1987年，从北卡罗来纳州福赛斯公司、密歇根州杰克逊、明尼苏达州明尼阿波利斯和马里兰州华盛顿公司招募了15,792名年龄在45岁-之间的参与者。55%是女性，27%是非裔美国人。参与者接受了4次临床检查；第5次计划在2011年进行。血液和尿液样本已被储存，药物记录，并完成了食物频率调查问卷。参与者每年接受一次电话采访，现在每半年接受一次电话采访，以获得最新的健康信息。在第21年的回应率为91%。由于ARIC从未被视为癌症流行病学队列以及基础设施和成本限制，因此只有癌症诊断被系统地记录下来。到2006年，3145名参与者被诊断为第一次初选事件，376名参与者被诊断为第二/第三次初选。目前还没有解决当代问题所需的信息，如分期、分级和组织学、在器官中的位置、偏侧性、受体状态、治疗、复发和再治疗。分子/遗传学研究所需的组织还没有收集到。因此，我们建议：1)从2012年开始，前瞻性地从半年一次的电话访谈中识别病例，并收集与癌症诊断、治疗、复发、再治疗和组织块有关的医疗/病理记录。2)从4个ARIC州的癌症登记处(已获得同意)和医疗记录中追溯收集2012年前癌症诊断和复发的特征信息，并收集组织块。到2016年，我们预计将有4900起经过充分注释的事故案例。我们建立了一个癌症工作组，以制定判定癌症终点的方案，并利用资源确定研究的优先顺序。有了增强的基础设施，我们预计这样的研究问题在ARIC中是唯一可以解决的：1)使用4个空腹血糖和2个HbAlc测量来确定糖尿病自然病史的时间与癌症诊断的时间之间有什么联系？2)使用Gwas和测序数据，主要癌症是否有一组共同的风险变量，或者每个位置都有特定的变量？

DESCRIPTION (provided by applicant): We propose to enhance the infrastructure of ARIC; the Atherosclerosis Risk in Communities, cohort to yield a new Cancer Epidemiology Cohort that brings novel features to cancer epidemiology research. In 1987, 15,792 participants aged 45-64 years were recruited from Forsyth Co., NC; Jackson, MS; Minneapolis, MN; and Washington Co., MD. 55% are women and 27% are African-American. Participants underwent 4 clinical exams; a 5th is scheduled for 2011. Blood and urine specimens have been banked, medications recorded, and a food frequency questionnaire completed. Participants were interviewed by phone annually and now semi-annually to obtain updated health information. The response at year 21 is 91%. Because ARIC has never been viewed as a Cancer Epidemiology Cohort and infrastructure and cost constraints, only cancer diagnosis has been systematically recorded. By 2006, 3,145 participants were diagnosed with an incident first primary and 376 with a 2nd / 3rd primary. Information, such as stage, grade, and histology, location in organ, laterality, receptor status, treatment, recurrence, and re-treatment, needed to address contemporary questions is not currently available. Tissue needed for molecular/genetic studies has not been collected. Thus, we propose: 1) Starting 2012, to prospectively identify cases from semi-annual phone interviews and collect medical/pathology records pertaining to cancer diagnosis, treatment, recurrence, and retreatment and tissue blocks. 2) To retrospectively collect information characterizing cancer diagnoses and recurrences before 2012 from cancer registries in the 4 ARIC states (consent already obtained) and medical records, and collect tissue blocks. By 2016, we expect 4,900 fully annotated incident cases. We established a Cancer Working Group to develop protocols for adjudicating cancer endpoints and prioritize research using the resource. With enhanced infrastructure, we expect that research questions such as these are addressable uniquely in ARIC: 1) What is the association between timing of the natural history of diabetes using 4 fasting glucose and 2 HbAlc measurements and timing of cancer diagnosis? 2) Using GWAS and sequencing data, is there a set of risk variants shared by major cancers or are variants specific to each site?