Invasiveepithelialovariancanceraccountsfor5%ofmalignanciesand,whileitistheeighthmostcommon cancerinUSwomen,itisthefifthleadingcauseofcancerdeaths.Manyoftheestablishedandsuspectedrisk factorsforovariancancershowracialdifferencesintheprevalenceand/ortimingofexposures.Racial differencesinincidenceandsurvivalarelikelyduetoacombinationoffactors,includingdifferencesinthe prevalenceofriskfactors,treatmentreceived,prevalenceofcomorbidities,andsocioeconomiccharacteristics. Thenewly-formedconsortium,OvarianCancerinWomenofAfricanAncestry(OCWAA),bringstogether investigatorsexperiencedinstudyingtheepidemiologyofovariancanceranddedicatedtounderstanding racialdifferencesinriskandoutcomesinovariancancer.TheOCWAAconsortiumincludesanongoing population-basedcase-controlstudyinAfricanAmerican(AA)women,threecompletedpopulation-based case-controlstudiesthatincludebothAAandwhitecasesandcontrolsandtwouniquecohortstudieswith largenumbersofAAparticipants.Toaddressracialdifferencesinincidenceandsurvival,wewill comprehensivelyexaminereproductiveandlifestyleexposureswhichdifferinprevalenceand/ortiming betweenAAandwhitewomen,accesstocare,treatmentandsocioeconomicfactors,anddeterminewhether theyexplainracialdisparities.Weproposetoharmonizeriskfactor,clinicalandoutcomedatafromthe participatingstudiesintheOCWAAconsortiuminordertoaccomplishthestudygoalsandcarryoutrace- specificanalysesofincidenceandsurvival.Wewillusetraditionalmethodstocalculatepopulationattributable riskpercent(PAR%)forassociatedriskfactors.Wewilluseanovelandexploratoryapproach,aMarkov state-transitionmicrosimulationmodel,toestimatetheextenttowhichracialdifferencesinpatternsof exposuretoknownriskfactorsexplainracialdifferencesinovariancancerage-specificincidenceandusethis samemethodtoestimatetheextenttowhichracialdifferencesinpatternsofexposure,treatment,and prognosticfactorsexplainracialdifferencesinovariancancersurvival.Theproposedstudywillbethelargest ofitskindandthefirsttobeadequatelypoweredtoevaluateepidemiologicandclinicalfactorsaffecting incidenceandsurvivalofovariancancerinAAwomen.Theinfrastructuregeneratedbythisapplicationwill enableOCWAAtocreateabaseonwhichtosupportfuturescientificproposals.

Public Health Relevance

AfricanAmericanwomenhavelowerincidenceofovariancancerbutmuchworsesurvivalthanwhitewomen. Whileaccesstoappropriatetreatmentislikelyamajorcontributor,itdoesnotcompletelyexplaindifferencesin survivalbyrace.Weproposetoharmonizedatafromsixexistingepidemiologicstudiestoexaminedifferences inriskfactorexposuresthatmayexplainriskdifferencesinincidence,andtoexamineriskandprognostic factorstoevaluatetheircontributiontodisparitiesinsurvival.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project (R01)
Project #
5R01CA207260-03
Application #
9669842
Study Section
Cancer, Heart, and Sleep Epidemiology A Study Section (CHSA)
Program Officer
Gallicchio, Lisa M
Project Start
2017-04-01
Project End
2021-03-31
Budget Start
2019-04-01
Budget End
2020-03-31
Support Year
3
Fiscal Year
2019
Total Cost
Indirect Cost
Name
University of Virginia
Department
Public Health & Prev Medicine
Type
Schools of Medicine
DUNS #
065391526
City
Charlottesville
State
VA
Country
United States
Zip Code
22904
Peres, Lauren C; Risch, Harvey; Terry, Kathryn L et al. (2018) Racial/ethnic differences in the epidemiology of ovarian cancer: a pooled analysis of 12 case-control studies. Int J Epidemiol 47:460-472
Williams, Lindsay A; Olshan, Andrew F; Hong, Chi-Chen et al. (2017) Alcohol Intake and Breast Cancer Risk in African American Women from the AMBER Consortium. Cancer Epidemiol Biomarkers Prev 26:787-794