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