A Follow-up Study for Causes of Cancer in Black Women

非洲裔美国人（AA）女性患多种癌症的发病率较高（例如，结肠、胰腺）和更高 癌症死亡率（例如，乳房，结肠，胰腺）相对于其他美国妇女，其中许多人 差异无法解释。黑人妇女健康研究（BWHS），AA的最大的后续研究 1995年开始设立一个名为“妇女”的项目，以提供有关这些种族差异的信息。59 000名AA妇女， 来自17个州的21-69人通过填写健康问卷登记。BWHS成功地跟踪了他们 通过两年一次的问卷调查和与24个癌症登记处的联系， 参与者生活。已经收集了关于许多潜在风险因素的数据（例如，医疗、生殖、 生活方式、社会心理、社会经济、空气污染）。癌症诊断由医院和癌症验证 登记病理学数据。一个DNA/口腔微生物组生物储存库包含了来自26，800名 参与者血样采集工作正在进行中，迄今已从9 300名参与者那里采集了血样 (14，000+预期）。收集了750例乳腺癌患者的乳腺肿瘤组织。该研究 到目前为止，已经确认了5，631例癌症，包括2，651例乳腺癌。该研究已广泛发表 乳腺癌和其他癌症的非遗传和遗传风险因素。因为参与者都很年轻 在基线（中位年龄= 38岁），不太常见的癌症的增加是缓慢的。参与者现已达到 癌症高发年龄，这意味着将积累足够的数字进行信息评估。 这一基础设施提案有三个目标：（1）继续并加强对生物武器卫生系统的后续行动和数据收集， 增加有关癌症治疗和结果的信息（包括医疗保险数据）（2）管理和增强 通过向唾液/漱口水和血液储存库中添加额外的样品来收集生物样品， 收集除乳腺癌外的所有实体癌的肿瘤组织，收集全视野数字预诊断 乳房X光检查，以及全基因组阵列的基因分型，这些都是我们有DNA的癌症病例。 样本（~ 2，800）以及相同数量的DNA对照;（3）在财团项目中共享数据。 BWHS的继续是一个高度优先事项，因为：a）89%的参与者仍然没有癌症， 基线时年龄较小; B）随访成功且无偏倚; c）BWHS可以评估以下因素的影响 暴露（例如，2级和3级肥胖、早产、种族主义经历），这些在美国不太普遍 d）需要越来越多的人来研究科学问题和BWHS遗传， 非遗传和生物样本数据将有助于许多财团研究一系列癌症; e） （f）需要进一步开展工作，以了解 癌症发病率和存活率。总而言之，继续开展生物武器卫生系统将大大有助于增进知识， 关于癌症病因学和在服务不足人群中的生存率;生物标本和乳房X光检查 资料库将极大地促进这一努力，参与联合研究也是如此。

African-American (AA) women have a higher incidence of many cancers (e.g., colon, pancreas) and higher cancer mortality (e.g., breast, colon, pancreas) relative to other American women, and many of these differences are unexplained. The Black Women's Health Study (BWHS), the largest follow-up study of AA women, was begun in 1995 to provide relevant information on these racial disparities. 59,000 AA women ages 21-69 from 17 states enrolled by completing health questionnaires. The BWHS has successfully followed them for cancer through biennial questionnaires and linkage to 24 cancer registries in the states in which >95% of participants live. Data have been collected on numerous potential risk factors (e.g, medical, reproductive, lifestyle, psychosocial, socioeconomic, air pollution). Cancer diagnoses are validated by hospital and cancer registry pathology data. A DNA/oral microbiome biorepository contains saliva-mouthwash samples from 26,800 participants. Blood sample collection, in progress, has obtained blood samples from 9,300 participants to date (14,000+ expected) . Breast tumor tissue has been collected for 750 incident breast cancers. The study has identified 5,631 incident cancers to date, including 2,651 breast cancers. The study has published extensively on nongenetic and genetic risk factors for breast cancer and other cancers. Because participants were young at baseline (median age = 38), accrual of less common cancers was slow. Participants have now reached ages of high cancer incidence, meaning that sufficient numbers will be accrued for informative assessment. This infrastructure proposal has 3 aims: (1) continue and enhance follow-up and data collection in the BWHS, adding information (including Medicare data) on cancer treatments and outcomes (2) manage and enhance biologic sample collection by adding additional samples to the saliva/mouthwash and blood repositories, collecting tumor tissue for all solid cancers in addition to breast cancer, collecting full-field digital prediagnostic mammograms, and genotyping with a genome-wide array all incident cancer cases for which we have a DNA sample (~2,800) together with an equal number of controls with DNA; (3) share the data in consortial projects. Continuation of the BWHS is a high priority because: a) 89% of participants are still cancer-free due to the young age at baseline; b) follow-up has been successful and unbiased ; c) the BWHS can assess the effects of exposures (e.g., class 2 and class 3 obesity, premature birth, experiences of racism) that are less prevalent in other populations; d) increasingly large numbers are needed to study scientific questions and BWHS genetic, nongenetic, and biospecimen data will contribute to numerous consortia to study a range of cancers; e) the BWHS has a record of high productivity; f) further work is needed to understand numerous racial disparities in cancer incidence and survival. In sum, continuation of the BWHS will contribute appreciably to knowledge about cancer etiology and survival in an underserved population; the biolospecimen and mammogram repositories will contribute greatly to that effort, as will participation in consortial studies.