A multi-center population-based case–control study of ovarian cancer in African-American women: the African American Cancer Epidemiology Study (AACES)

Abstract

BackgroundOvarian cancer (OVCA) is the leading cause of death from gynecological cancer, with poorer survival for African American (AA) women compared to whites. However, little is known about risk factors for OVCA in AA. To study the epidemiology of OVCA in this population, we started a collaborative effort in 10 sites in the US. Here we describe the study and highlight the challenges of conducting a study of a lethal disease in a minority population.MethodsThe African American Cancer Epidemiology Study (AACES) is an ongoing, population-based case–control study of OVCA in AA in 10 geographic locations, aiming to recruit 850 women with invasive epithelial OVCA and 850 controls age- and geographically-matched to cases. Rapid case ascertainment and random-digit-dialing systems are in place to ascertain cases and controls, respectively. A telephone survey focuses on risk factors as well as factors of particular relevance for AAs. Food-frequency questionnaires, follow-up surveys, biospecimens and medical records are also obtained.ResultsCurrent accrual of 403 AA OVCA cases and 639 controls exceeds that of any existing study to date. We observed a high proportion (15%) of deceased non-responders among the cases that in part is explained by advanced stage at diagnosis. A logistic regression model did not support that socio-economic status was a factor in advanced stage at diagnosis. Most risk factor associations were in the expected direction and magnitude. High BMI was associated with ovarian cancer risk, with multivariable adjusted ORs and 95% CIs of 1.50 (0.99-2.27) for obese and 1.27 (0.85- 1.91) for morbidly obese women compared to normal/underweight women.ConclusionsAACES targets a rare tumor in AAs and addresses issues most relevant to this population. The importance of the study is accentuated by the high proportion of OVCA cases ascertained as deceased. Our analyses indicated that obesity, highly prevalent in this population (>60% of the cases), was associated with increased OVCA risk. While these findings need to be replicated, they suggest the potential for an effective intervention on the risk in AAs. Upon completion of enrollment, AACES will be the largest epidemiologic study of OVCA in AA women.

Synergism of spectra averaging and extrapolation for quantification of in vivo MRS time signals encoded from the ovary

“…Moreover, there appears to be a trend towards increasing incidence of this malignancy in many parts of the world [1][2][3][4]. The case fatality rate for ovarian cancer is very high; more than 14 000 women die each year from this disease in the USA alone [5,6].…”

The Association Between Body Mass Index and Presenting Symptoms in African American Women with Ovarian Cancer

“…8 Briefly, women with ovarian cancer are identified using rapid case ascertainment systems through state cancer registries, Surveillance, Epidemiology, and End Results registries, or individual hospital registries. Inclusion criteria are African American/black race (full or mixed), aged 20-79 years, diagnosis of invasive, epithelial ovarian cancer, no history of ovarian cancer, and ability to complete an interview in English.…”

“…[4][5][6] Meta-analyses and pooled analyses conducted among predominantly white populations have concluded that overweight and obese women are at increased risk for ovarian cancer 4,5 and have poorer survival after an ovarian cancer diagnosis. 6 For African American women, some 7,8 but not all 9 studies suggest obesity is a risk factor for ovarian cancer. No studies have specifically addressed the effect of obesity on ovarian cancer survival among African American women.…”

In vivo magnetic resonance spectroscopy for ovarian cancer diagnostics: quantification by the fast Padé transform

“…Cancers in this tiny organ are the sixth most often occurring malignancy among women throughout the world. In many parts of the world, including the U.S., Scandinavia and Israel, ovarian cancer is even more common, and in a number of countries the incidence of ovarian cancer appears to be increasing [2][3][4][5]. Ovarian cancer has a very high case fatality rate [6].…”

“…The expansion coefficients of the polynomials P ± K and Q ± K in the FPT (±) are calculated from the time signal {c n } using the definitions in (4) and (5). After this initial step of the analysis, the non-parametrically computed total shape spectra are obtained at a given set of real-valued sweep frequencies ν.…”