We propose to examine the association between dietary factors and risk of advanced prostate cancer,estrogen receptor negative breast cancer, and gliomas in the Pooling Project of Prospective Studies of Dietand Cancer (Pooling Project), a consortium of 27 prospective cohort studies. Each study met the followinginclusion criteria: used a prospective study design, assessed usual diet using a validated dietary assessmentmethod, and met the minimum number of incident cases. The studies were conducted in North America(n=18), Europe (n=6), Asia (n=2), and Australia (n=1) with 834,339 male (n=14 studies) and 1,364,231female (n=23 studies) participants. During follow-up of these studies, 5,503 advanced prostate cancer (whichwill be analyzed separately as either stage C and D or as Gleason score >7), 5,484 estrogen receptornegative breast cancer, and 2,516 glioma cases were identified. For advanced prostate cancer, associationswith dairy foods, calcium, vitamin D, meat, fat, fruits, vegetables, vitamin E, and body mass index will beexamined. For estrogen receptor negative breast cancer, analyses will evaluate fruits, vegetables, andalcohol. For gliomas, associations with vitamins D, C, and E, processed meat, fish, fat, fruits, vegetables,and alcohol will be analyzed. Expansion of the Pooling Project to these cancers with intermediate or lowincidence rates will take advantage of the statistical power of this project. In addition, because individualstudies will not be required to have published on the specific associations being examined, publication biaswill be avoided in these analyses. We will recode the primary data from each study using a standardizedapproach across studies so that the exposures, covariates, and outcomes will be defined and modeledconsistently across studies. This standardized approach will reduce potential sources of between-studiesheterogeneity. Analyses will also evaluate whether associationsare modified by other risk factors includingsex, ethnicity, age, smoking habits, and other dietary factors to identify potential high-risk groups that maynot otherwise be identified in smaller studies. Because the Pooling Project includes populations withdifferent diets, the range of intakes that can be examined will be wider than in individual studies, furtherincreasing the statistical power of the study. The annual meetings, and frequent communication amonginvestigators, will facilitate the analyses and interpretation of the findings. These analyses will take fulladvantage of extensive data already collected to provide powerful insights into the relation between diet andthe risk of advanced prostate cancer, estrogen receptor negative breast cancer, and gliomas, cancer sitesthat have been examined in few prospective studies. This project provides a highly cost-effective approachto evaluate these pressing issues in a detailed, standardized manner, to yield robust findings that haveimmediate clinical and public relevance.
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