Monitoring Health Behaviors And Risk Factors
This area of research focuses on monitoring cancer-related behaviors
and other risk factors. The RRSS mechanism has funded studies to
develop new and innovative methods to monitor risk factors and add
these to the cancer statistics data. These have included cross-sectional
and prospective studies.
RRSS investigators are conducting studies to:
- assess the association of weight, physical activity, diet, hormones,
and prognostic factors to breast cancer;
- determine whether polymorphisms in several cytokine genes are
associated with risk of multiple myeloma;
- evaluate the relationship between hormone replacement therapy
and breast cancer survival;
- expand the surveillance of risk and prognostic factors to add
risk factor information to tumor registries;
- determine risk factors associated with breast cancer, including
genetic alterations, alcohol use, use of hormone replacement therapy,
duration of breastfeeding, overweight/obesity, and reproductive
factors;
- examine the possible associations between specific viral diseases
and certain cancers;
- identify related individuals and determine their family history
of cancer;
- seek to understand how elderly cancer patients perceive, evaluate,
and act on disease symptoms;
- estimate the risk of endometrial cancer associated with use
of tamoxifen to treat breast cancer;
- evaluate the relationship between timing of surgery for ovarian
and cervical cancer and survival;
- improve the utility of the cancer registry database for examining
effects of race/ethnicity; socioeconomic status; neighborhood,
social, and built environment; and immigration on cancer burden
measures.
Registries Funded to Conduct these Studies
Atlanta (Metropolitan)
Connecticut
Detroit (Metropolitan)
Hawaii
Iowa
Los Angeles
New Mexico
Northern California Cancer Center (SF-OAK)
Seattle (Puget Sound)
Utah
Key Findings
In a population-based study, patients decreased their total physical activity by an estimated two hours per
week from pre-breast cancer diagnosis to post diagnosis, an 11 percent decrease. Greater decreases in sports
physical activity were observed among women who were treated with radiation and chemotherapy compared with women
who underwent surgery only or who were treated with radiation only. Greater decreases in sports physical activity
were observed among obese patients (41 percent decrease) compared with patients of normal weight (24 percent
decrease).
Investigators found lower risks of recurrence and mortality in
women who used hormone replacement therapy (HRT) after breast cancer
diagnosis than in women who did not. The results suggest that HRT
after breast cancer has no adverse impact on recurrence and mortality.
High dietary exposure to heterocyclic aromatic amines (HHA) results
from eating well-done meat and from high frequencies of certain
cooking practices (frying, barbecuing, broiling, and using meat
drippings). High dietary exposure to HHA and cigarette smoking are
significantly associated with a specific subset of colon cancers
(cancers with high microsatellite instability (MSI)).
Estrogen replacement therapy (ERT) use and obesity, both established
endometrial cancer risk factors and markers of estrogen exposure,
substantially modify the association between tamoxifen use and endometrial
cancer risk among patients with breast cancer. Women with positive
ERT histories and those who are obese, when prescribed tamoxifen,
may warrant closer surveillance for endometrial cancer than women
without such histories.
Comorbidity in older patients may limit the ability to obtain prognostic
information (i.e., axillary lymph node dissection), tends to minimize
treatment options (e.g., breast-conserving therapy), and increases
the risk of death from causes other than breast cancer.
Future Use
Two KO7s were funded based on work
in this area.
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