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有关。暴露和生活方式信息是在1986年的一次基线邮寄调查中收集的，以及1987年、1989年、1992年、1997年和2004年的五次后续调查中收集的。自1986年以来，癌症发病率和死亡率一直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来获得。该项目卓有成效，迄今已出版了260多份研究出版物。我们建议，在这5年的续展中，继续解决与老年妇女癌症相关的重要问题。关于不太常见的癌症，以及老年人癌症发生和生存的生活方式预测因素，队列正在变得特别有信息量。我们还提出了与社区层面数据来源的新联系，这将使我们能够研究个人的社会和物理环境如何影响他们的癌症风险。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，以及爱荷华州立大学农村发展倡议研究的数据。我们在拟议的资助期内的具体目标是：1)继续跟踪IWHS队列，目前78-92岁，总计27年(1986-2012年)；2)扩大我们对女性癌症发病风险因素的持续调查；3)确定与女性癌症幸存者的生活质量和死亡率相关的因素；4)确定社区层面的社会和环境特征与老年女性癌症结局和生活质量之间的关联。继续为综合世界卫生大会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中的辅助研究也是关键。IWHS还积极参与了几个队列研究联盟。广泛的接触和已经收集的后续数据、与将免费获得的社区一级数据的联系、一个富有成效的研究团队以及提出的重要研究问题相结合，使IWHS的5年延续期成为改善公共卫生的极具成本效益的手段。 公共卫生相关性：随着65岁以上美国人数量的增加，预防癌症及其对晚年生活的影响变得更加重要。爱荷华州妇女健康研究的研究结果将继续加深我们对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卫生保健从业者优先考虑和更好地利用卫生保健资源。

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.