The California Teachers Study (CTS) has collected high-quality and detailed exposure, biospecimens, cancer, and clinical endpoint data on 133,477 female volunteers followed since 1995. The cancers, hospitalizations, and deaths to date are less than half of the total endpoints projected to occur in the CTS over the next 30 years. In the next 5 years, CTS follow-up will include over 37,000 cancers; 455,000 hospitalizations; and 41,000 deaths. This provides a solid foundation for collaborative research using these unique resources. Since 2013, the CTS collected new blood samples from 14,674 participants. Cloud computing and integrated mobile devices generated rich phenotype data and exceptionally low pre-analytical variability for 488,000 aliquots that are being stored as CTS follow-up continues. Since 2015, the CTS modernized its data collection, storage, and analysis infrastructure by implementing a secure data warehouse and flexible analytics environment designed for high-quality and integrated epidemiologic analysis. The CTS includes secure user authentication & authorization; a collaborative workspace with documents, data visualizations, tools, and workflows; metadata; application programming interface (API) capabilities; and a scalable data model. The CTS is now positioned to streamline its resources for long-term sustainability. The goals of this competing renewal are to preserve existing resources that enable research and strategically expand areas that create high-value opportunities. First, we will maintain existing CTS data and extend passive follow-up through efficient cancer, hospitalization, and mortality linkages. These ongoing linkages will generate additional endpoints used for future etiologic, consortial, aging, and other research. Second, we will store the 488,000 high-quality biospecimens collected since 2013. These specimens are all currently available to everyone; ongoing storage will ensure that they remain available to everyone. Third, we will expand capacity by integrating additional targeted geospatial data on climate, extreme weather, built environment, community characteristics, health access, environmental exposures, social vulnerability, and community resilience. The new CTS infrastructure efficiently enables everyone, regardless of their GIS expertise, to rigorously incorporate individual-level geospatial exposures into their analyses. Fourth, because most participants are now over age 65, we will link the CTS with Medicare outpatient data to complement existing data and expand infrastructure for aging, survivorship, comorbidity, and health services research. The recent CTS infrastructure updates added research-ready efficiencies to manage and process complex geospatial, administrative claims, and other CTS data in ways that help all researchers, especially those outside the CTS, conduct integrative, rigorous, and reproducible research. The CTS is an innovation leader with primed assets and decades of promising future research potential. This competing renewal will maintain high-value CTS resources that can address understudied research areas, facilitate broader use by the entire scientific community, and streamline the CTS for long-term sustainability.

Public Health Relevance

This proposal requests support to maintain the high-quality data and streamline the innovative infrastructure of the prospective California Teachers Study (CTS). During the next five years, as the CTS's 133,477 female participants pass through ages of high disease risk, we will conduct efficient linkages that capture new cancer, inpatient and outpatient hospitalization, mortality, and geospatial data. Together with the CTS's commitment to facilitating open and broader use of its resources, this will create additional opportunities for impactful research on understudied areas of cancer risk and outcomes.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Research Project--Cooperative Agreements (U01)
Project #
Application #
Study Section
Special Emphasis Panel (ZCA1)
Program Officer
Mahabir, Somdat
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Beckman Research Institute/City of Hope
United States
Zip Code
Michailidou, Kyriaki (see original citation for additional authors) (2017) Association analysis identifies 65 new breast cancer risk loci. Nature 551:92-94
Milne, Roger L (see original citation for additional authors) (2017) Identification of ten variants associated with risk of estrogen-receptor-negative breast cancer. Nat Genet 49:1767-1778
Liu, Jingjing; Lon?ar, Ivona; Collée, J Margriet et al. (2016) rs2735383, located at a microRNA binding site in the 3'UTR of NBS1, is not associated with breast cancer risk. Sci Rep 6:36874
Lacey Jr, James V; Savage, Kristen E (2016) 50 % Response rates: half-empty, or half-full? Cancer Causes Control 27:805-8