This is a proposal to ascertain the mortality of the 361,622 men aged 35-57 who were seen at the initial screening of the Multiple Risk Factor Intervention Trial (MRFIT) through 10 years of follow-up. Using the location of death supplied by the Social Security Administration (SSA), state departments of health will be contacted to obtain death certificates. Currently 5 year all cause and cause-specific mortality data are available. By the end of the current grant period mortality data through 6 years will be available for all men. This proposal, which represents a continuation of the current grant, will employ methods established in the current grant and will permit more definitive analyses to be performed on two major research questions: 1) the associations of cause specific cancer mortality and serum cholesterol concentration, and 2) the association of serum cholesterol, diastolic blood pressure and cigarettes per day with mortality from coronary heart disease, and cerebrovascular disease for black and white men. For the first question, this group represents the largest prospective cohort study yet analyzed. The additional data will allow comparisons of the association of serum cholesterol and cancer mortality to be made for different cancer sites. In addition to the cholesterol-cancer question and the comparison of black and white men in the association of major risk factors with cardiovascular endpoints, further investigations on the development of risk prediction equations, and on methodological issues associated with using SSA data files and the National Death Index will be carried out.
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