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National Cancer Institute   U.S. National Institutes of
Rapid Response Surveillance Studies
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 Methodologic Issues
 Cancer Treatment & Outcomes
 Monitoring Screening Practices
 Health Behaviors & Risk Factors
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 Technical Aspects of Registry Operations

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)
Detroit (Metropolitan)
Los Angeles
New Mexico
Northern California Cancer Center (SF-OAK)
Seattle (Puget Sound)

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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