Bisphosphonate use and Lung Cancer Incidence and Mortality in Elderly Women

 描述（由申请人提供）：肺癌已成为女性中具有重大公共卫生意义的问题。虽然吸烟是肺癌最重要的危险因素，但吸烟仍不能完全解释风险的变化。此外，虽然已经有相当多的肺癌预后因素的研究，我们的知识，肺癌生存相关的因素仍在不断发展。骨质疏松症是老年人的一种常见病，绝大多数发生在绝经后妇女。双膦酸盐是破骨细胞介导的骨吸收抑制剂，常用于治疗骨质疏松症。实验研究已经显示了双膦酸盐的抗癌特性;然而，最近只有少数流行病学研究调查了双膦酸盐使用对癌症（包括乳腺癌和结直肠癌）发展和/或进展的潜在影响。已经进行了非常有限的研究来评估双膦酸盐的使用与老年妇女肺癌发病率和死亡率的关系。利用现有的绝经后妇女前瞻性队列研究，拟议的研究将调查口服双膦酸盐使用和肺癌风险之间的关系，以及癌症诊断前使用双膦酸盐与绝经后妇女肺癌生存率之间的关系。拟议研究的结果有可能提供非常重要的信息，以了解个人使用口服双膦酸盐作为另一种适应症如何影响老年女性肺癌的发生和进展，以及提高我们对肺癌病因学和女性肺癌预后因素的理解。这些理解将为进一步的干预试验或研究双膦酸盐和肺癌进展的分子机制提供第一步数据。更重要的是，这些理解将对提高老年妇女肺癌生存率产生重大的公共卫生影响。

 DESCRIPTION (provided by applicant): Lung cancer has become a problem with major public health significance in women. Although tobacco smoking is the most important risk factor of lung cancer, there is still much of the variation in risk that is not fully explained by smoking. Furthe, although there has been considerable investigation of prognostic factors of lung cancer, our knowledge on factors related to lung cancer survival is still evolving. Osteoporosis is a common disease in aged population with the majority of cases occurring in postmenopausal women. Bisphosphonates, inhibitors of osteoclast-mediated bone resorption, are commonly used in the management of osteoporosis. Experimental studies have shown the anti-cancer properties of bisphosphonates; however, only a few recent epidemiological studies investigated the potential impact of bisphosphonate use on the development and/or progression of cancers, including breast and colorectal cancer. Very limited studies have been conducted to evaluate bisphosphonate use in relation to lung cancer incidence and mortality in older women. Utilizing an existing prospective cohort study of postmenopausal women, the proposed study will investigate relationships between oral bisphosphonate use and lung cancer risk, as well as the association of bisphosphonate use prior to cancer diagnosis with lung cancer survival among postmenopausal women. Results from the proposed study have the potential to provide very important information for understanding how personal use of oral bisphosphonate for another indication might impact on lung cancer development and progression in older women, as well as to improve our understanding about etiology of lung cancer and prognostic factors of lung cancer in women. These understandings would provide first-step data for further intervention trials or investigations of molecular mechanisms of bisphosphonate and lung cancer progression. More importantly, these understandings would have major public health implications for improving lung cancer survival in older women.