Epidemiology Research at KCI

1
Epidemiology Research at KCI
2
Epidemiology

• Epidemiology is the study of the distribution of
  diseases in the population.
• Epidemiologic methods are used for the
  identification of risk factors for disease and
  determination of optimal treatment approaches
  used in clinical practice.
• In the study of communicable and chronic
  diseases, the work of epidemiologists involves
  study design, data collection and statistical
  analysis.

3
Epidemiologic Methods

• Observational
• Case-Control Exposures, genes, and/or
  behaviors in individuals with a particular
  disease (cases) are compared to individuals
  without the disease (controls).
• Cohort A group of individuals with and without
  a particular exposure are followed to compare
  disease outcomes.
• Interventional
• Clinical Trials Individuals are randomized to
  receive a particular treatment within the clinic
  setting.
• Community Trials A community participates in a
  behavioral intervention, a screening
  intervention, etc.

4
Study Design

• Study Design
• Population-Based Individuals under study
  belong to a defined population, i.e., residents
  of a geographic region.
• Clinic or Hospital-Based Studies are based
  upon patients seen at a particular hospital or
  clinic.
• Community-Based Participants are volunteers in
  the community.

5
Population Sciences at KCI
Behavior, Genetics, Environment, Social/Cultural
Risk Factors
Pre- cancer
Survivorship
Cancer
Recurrence
Health
Tertiary Prevention
Risk Assessment, Primary Prevention
Early Detection, Secondary Prevention

• Etiologic studies
• Genetic
• Molecular
• Environmental
• Social/Cultural
• Behavioral Interventions

• Quality of life
• Predictors of survival
• Chemoprevention Trials

• Screening
• Chemoprevention Trials

All studies conducted in a population that is
racially and ethnically diverse
6
Population-Based Cancer Epidemiology

• Surveillance Epidemiology and End Results (SEER)
  Program
• Assemble and report estimates of cancer incidence
  and mortality in the United States.
• Monitor annual cancer incidence trends.
• Provide continuing information on changes over
  time
• in extent of disease at diagnosis, trends in
  therapy, and associated changes in patient
  survival.
• Promote studies designed to identify factors
  amenable to cancer control interventions.

7
SEER Registries
8
Metropolitan Detroit Cancer Surveillance System
(MDCSS)

• Cancer is a reportable disease in Michigan.
• The Metropolitan Detroit Cancer Surveillance
  System (MDCSS) is the designated arm of the
  Michigan Department of Community Health for
  collection of cancer information for the
  tri-county area.
• About 25,000 in situ and invasive cancers are
  diagnosed among residents each year.
• Our database includes information
• on over 700,000 cancer cases.

9
MDCSS
10
Descriptive Epidemiology
11
Exploring Health, Ancestry and Lung Epidemiology
(EXHALE)Schwartz AG R01 CA60691

• Case-Control study to identify chromosomal
  regions associated with risk of lung cancer among
  African Americans (AA)
• 549 AA cases from MDCSS
• 572 AA volunteer controls
• Biospecimens collected for 94 of participants
• Schwartz AG, Cote ML, Wenzlaff AS, Land S, Amos
  CI. Racial Differences in the Association Between
  SNPs on 15q25.1, Smoking Behavior, and Risk of
  Non-small Cell Lung Cancer. J Thorac Oncol 2009
• SNPS in the CHRNA3 and CHRNA5 region contribute
  to lung cancer risk
• While variant alleles are less frequent in
  African Americans, risk may be greater than in
  whites and less likely to reflect an indirect
  effect on lung cancer risk through nicotine
  dependence

12
Luminal Lipid Exposure, Genetics Colon Cancer
RiskKato I R01 CA93817

• Genotyping for FABP2 A54, APO E2/E3
  polymorphisms, which are postulated to modify
  intestinal lipid absorption
• 1205 cases from MDCSS
• 1552 controls using random digit dialing
  (RDD)
• Populations with lower intake of luminal
  modifiers (calcium, fiber) may have differential
  risks of colorectal cancer associated with
  dietary fatty acid intake
• These SNPs may not be useful in predicting
  colorectal cancer risk in populations with high
  fat intake

13
Cancer In Arab Americans Estimating Rates
Fostering Research Schwartz K, N01 PC35154-RRSS

• ArabAmerican women have similar distribution of
• breast cancer histology to EuropeanAmerican
• women.
• ArabAmerican stage, age, and hormone receptor
  status at diagnosis was more similar to
  AfricanAmerican women.
• ArabAmerican women have a better overall
  survival than even EuropeanAmerican women.

• Arab/Chaldean men had greater proportions of
  leukemia , multiple myeloma, liver, kidney, and
  urinary bladder cancers.
• Arab/Chaldean women had
• greater proportions of leukemia, thyroid, and
  brain cancers.

14
Epidemiology Research Core (ERC)

• Established in December, 2007 due to a specific
  need for standardizing procedures for access to
  and use of the local and national SEER data
• Confidentiality of metropolitan Detroit SEER
  registry data
• Complexity of SEER registry data

15
ERC Services

• Consultation and collaboration
• study design, proposal development,
  interpretation of population-based local and
  national SEER data
• Rapid case ascertainment for case identification
• Control Identification
• Oversight and support of study interviews
• Collection and abstraction of medical records
• Collection of biological specimens
• Response to data requests requiring access to
  local and national SEER data
• Linkage of external data sources to local SEER
  data

16
(No Transcript)