Cancer Epidemiology

The primary goal of the Cancer Epidemiology Program is to develop new knowledge relevant to cancer etiology, diagnosis, prognosis, and prevention using an interdisciplinary epidemiologic approach. To date, this research has been conducted primarily in the context of large population-based case-control studies in North Carolina with an emphasis on inclusion of African-Americans.

The studies have typically included collection of diverse exposure data, genomic DNA, and tumor samples. Cancers of particular interest in North Carolina and other studies have included breast cancer, colorectal cancer, melanoma, prostate cancer, head and neck cancer, and childhood cancer. A new area of emphasis is the investigation of the influence of genetic and environmental factors on cancer survivorship. Case groups from selected large population-based case-control studies are forming the basis of survivor cohorts that are being updated and evaluated for multiple predictors of survival.

Highlights of Program research include

• the identification of DNA polymorphisms related to the risk of breast and head and neck cancer
• the association of dietary factors with colon cancer
• the characterization of the p53 mutational spectrum in breast tumors in relation to relation to smoking
• the description of a poor-prognosis breast cancer subtype among African-American women
• the lack of association between certain environmental factors and an increased risk of breast cancer, and
• the reduction in the risk of a childhood cancer with maternal vitamin use.

The Program adds value to the Center through its population-based study resources that provide the basis for unique interdisciplinary studies.

The Program is led by Dr. Andrew Olshan, a senior cancer epidemiologist with an extensive research and training program. In 2003, the Program had 15 members with direct cost funding in 2003 of $7.8 million, including $3.8 million in NCI funding. In 2002, the total number of publications was 51; 18% of the publications were intraprogrammatic and 18% were interprogrammatic. Two adjunct members also contribute intellectually to the Program. Future plans for the Program include an emphasis on obesity, diet and physical activity in relation to the risk of several cancers. The availability of DNA from over 14,000 cases and a similar number of controls from population-based studies will provide the basis for future large-scale genome-wide association studies to examine gene-gene and gene-environment interactions. Translational studies using population-based samples will also incorporate tumor profile results from microarray studies to further examine genetic heterogeneity, prognosis, and treatment response. New survivor studies and population-based studies including a broader array of behavioral and health services questions will be emphasized.