DESCRIPTION (provided by applicant): Project Summary/Abstract Cancer incidence has greatly increased in low- and medium-resource countries as a result of economic and social shifts, which have contributed to an increase in population size and the aging of populations, as well as altered the pattern of exposure to risk factors such as tobacco and alcohol, overweight and obesity, reproductive habits, and occupational agents. Epidemiologic studies conducted in populations in transition in medium-resource countries have stressed the role of such lifestyle factors in determining the rapid change in cancer risk. However, most of these studies were designed as case-control studies, the retrospective design of which provides greater risks of selection and information biases than prospective cohort studies. Cohort studies are better able to take advantage of large exposure and risk contrasts in low- and medium-resource countries to investigate the effects of the transition that is occurring in many of these populations. This approach is helpful for both common cancers and, if large enough populations can be assembled in consortium-based pooled analyses, for rarer and less widely studied neoplasms. We aim to conduct a pooled analysis of cohort studies from Asia to assess the contribution of tobacco, alcohol, and elevated BMI to the etiology of cancer of the small intestine, as the first study in a series on rare cancers. The analysis will also test the hypothesis of heterogeneity in the etiologic factors between the main type of cancer of the small intestine, adenocarcinoma (AC), and other histologic types. The pooled analysis will be conducted among cohorts within the Asia Cohort Consortium (ACC), which was recently established with the goal of promoting collaboration and data pooling among current and future epidemiologic cohort studies in Asia. Our consortium addresses the NCI objective to "expand the capacity of centers, networks, and consortia," and the goal to "create and sustain infrastructures that facilitate research collaboration, serve as platforms for technology development, and provide access to the full range of research resources," as outlined in the NCI Plans and Priorities. We anticipate that the analysis within the ACC will be a major step toward improving understanding of the causes and mechanisms of rare cancers and will enhance the collaboration within the consortium for further pooled analyses. Furthermore, we plan to pool the ACC data with those of other large cohorts from North America and Europe to further increase the statistical power of looking at risk factors of small intestine cancer.
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