DESCRIPTION: (Adapted from the Applicant's Abstract): We are requesting
continued support for an ongoing cohort study of 18,244 men, ages 45-64,
living in a geographically defined area of metropolitan Shanghai, Peoples
Republic of China. All cohort members have completed detailed diet and
medical histories and have blood and urine samples. Questionnaires have
been edited and computerized and blood and urine samples have been
processed, aliquoted, and continuously stored at both -20_C and -70_C. The
cohort was fully established in 1989. Follow-up of the cohort is proceeding
through cancer registration by the population-based Shanghai Cancer
Registry, by routine ascertainment of death certificates, and by annual
recontact of all cohort members. As of March 1994, 606 have developed
cancer and 989 have died. The leading cancers include lung, stomach, liver,
and colorectal cancers, while stroke is the number one cause of death.
Major accomplishments achieved through this cohort to date include: (1) the
first direct evidence linking aflatoxin ingestion to human hepatocellular
carcinoma (HCC); (2) strong evidence of synergy between aflatoxin biomarkers
and chronic infection with hepatitis B virus in establishing risk of HCC;
(3) failure to find an association between H. pylori serology and stomach
cancer risk; (4) the absence of an inverse association between antioxidants
and fatal stroke; and (5) the first comprehensive and systematic evaluations
of smoking-related cancer incidence and mortality in China. We propose to
continue to follow this cohort for an additional five years. We will
continue to evaluate risk factors for major health outcomes in the cohort,
building on previous observations and continuing to exploit the serum and
urine banks available for biomarker studies. Although we did not collect
buffy coats for genetic studies on cohort members, we have demonstrated that
the stored serum samples contain sufficient cells for conducting selected
PCR-based genetic studies. Among the scientific goals for the next five
years are: (1) to continue to evaluate the aflatoxin/HCC association and to
assess the impact of sequence variations in genes involved in aflatoxin
metabolism (GSTM1 and EPHX) in modifying risk; (2) to continue to assess the
role of H. pylori in gastric cancer etiology in Shanghai, and to assess the
possible protective effect of tea polyphenols on risk; and (3) to better
understand the complex interrelationships among carotenoids, smoking, and
lung cancer and to assess the possible risk modifying impact of genes
involved in metabolism of smoking-related carcinogens.
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- The DCCPS Team.