||5R01CA030931-16 Interpret this number
||Systematic Analysis-Cancer Incidence and Mortality
DESCRIPTION: (Adapted from the Investigator's Abstract) Cancer registries
provide valuable information on trends for cancer incidence in a specified
population and the Connecticut Tumor Registry is the oldest registry of its
kind. An appropriate understanding of these trends often provides valuable
clues for the etiology of cancer, demonstrates the success of the health
care system in maintaining the health of the population, and assists in
planning for future health care requirements of a population. However,
valid interpretations of these trends require a good understanding of the
interplay of different perspectives of time, including the effects of age,
time period of diagnosis, and birth cohort. These effects are best
appreciated through the active collaboration of researchers with a good
understanding of disease etiology, as well as the statistical complications
that arise from these analyses. The investigator's previous work in this
area has concentrated on the development and application of methods for
using age-period-cohort models to understand cancer incidence trends. These
methods have been used in an extensive analysis of all the major cancer
sites, and the investigators have recently used similar approaches to better
understand trends by histologic type, stage, and tumor subsite. In
addition, they have developed models for lung cancer incidence that
incorporate external information about the carcinogenesis process, as well
as population-based information on cigarette smoking. These methods have
helped many epidemiologists to better understand incidence and mortality
trends, although they also can point out fundamental limitations to our
understanding that arise from the unidentifiability of some effects. A rich
array of tools is now available for descriptive epidemiology and these need
to be made more accessible while, at the same time, there are promising new
areas that require further study before they can be recommended for general
use. This is a proposal to build on work that has developed and applied a
variety of statistical methods to the study of the descriptive epidemiology
of cancer with the goal of obtaining a better understanding of the reasons
for existing trends in cancer incidence and mortality. The specific aims of
this work are: 1. Study the importance of histology, stage of disease, and
tumor subsite on time trends for the following malignancies: cervix,
prostate, brain, ovary, thyroid, endometrium, bladder, and testis. 2.
Develop a comprehensive model for breast cancer incidence and mortality in
order to better understand the role of trends in detecting earlier stage
tumors on the discrepancy between incidence and mortality trends; and, 3.
Develop a Bayes model for incorporating estimates of trends in known risk
factors for disease on incidence in order to quantify the extent to which
existing knowledge about etiology can explain observed trends in cancer
incidence using information on the effect of cigarette smoking on lung
cancer incidence as an example to illustrate the method.
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