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EAGLE is a
large population-based case-control study designed and conducted
to investigate the genetic and environmental determinants of lung cancer
and smoking persistence using an integrative approach that allows combined
analysis of genetic, environmental, clinical, and behavioral data.
The study includes over 2,000 incident lung cancer cases, both males
and females of Italian nationality, ages 35 to 79 years old, with verified
lung cancer of any histological type, and over 2,000 healthy population-based
controls matched to cases by age, gender, and residence. The participation
rate was high: 85% and 73% in cases and controls, respectively.
Lung cancer cases were enrolled from 13
hospitals within the Lombardy region of Italy. The healthy controls were
randomly selected from the same residential area of the lung cancer cases.
The study setting, the Lombardy region of Italy, is served by a network
of modern hospitals, medical schools, and a regional health service.
Within the Lombardy region, the catchment's area includes 5 cities and
216 surrounding municipalities, encompassing, in the selected age range,
over 1.3 million people.
Extensive epidemiological data have been collected through both an interview-based
computer-assisted questionnaire and a self-administered questionnaire.
Available data includes demographical characteristics, detailed smoking
history (active and passive), family history of lung cancer and other
cancers, previous lung diseases, medications, diet, alcohol, attempts
at quitting smoking, anxiety, depression, personality scores,
occupation, reproductive and residential history.
Clinical data (stage,
grade, histology, imaging and pathology reports, spirometry, and routine
laboratory studies) are recorded. All study subjects donated a
blood sample (or, rarely, a buccal rinse sample), which was processed
to obtain cryopreserved lymphocytes, RBC, granulocytes, DNA, RNA, whole
blood, buffy coat, serum, plasma, and blood cards. Lung tissue paraffin
blocks and slides were collected from the cases who underwent surgery,
biopsy or cytological examination of the lung tumor. Multiple fresh “normal” lung
tissue and tumor samples, frozen in liquid nitrogen within 20 minutes
of excision, were also collected from over 500 surgical cases.
All data and biospecimen information are stored
in a secure relational database. Quality control procedures have been
implemented to ensure accuracy, completeness, and privacy of the data
collected. Genetic and epidemiological
studies are ongoing. This study will help answer many questions related
to lung cancer etiology in the near future.
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