Association between biliary tract cancers and family history of cancers in the Biliary Tract Cancers Pooling Project (BiTCaPP) 公开

Langhamer, Margaret (2017)

Permanent URL: https://etd.library.emory.edu/concern/etds/r207tq15z?locale=zh
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Abstract

Background: Biliary tract cancer (BTC) has a varied geographic and racial distribution, which differs by sex and site within the biliary tract. The established association of family history of gallstones with BTC, and the increased incidence of BTC among those with hereditary cancer syndromes, suggests a genetic component to BTC risk. We examined associations of family history of cancers with site-specific BTC risk and investigated whether these associations differ by sex and age.

Methods: This pooled analysis of seven prospective cohorts participating in the Biliary Tract Cancers Pooling Project (BiTCaPP) included individual-level data on 1,619 BTC cases and 1,185,000 non-cases from the United States and Finland. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Cox proportional hazards regression. Multivariable models were adjusted for sex, self-reported race, and calendar year at baseline. Study-specific estimates were pooled using a fixed effects model.

Results: A family history of cancer was not statistically significantly associated with independent risk of cancers of the gallbladder (HR = 0.88, 95% CI = 0.71-1.08), intrahepatic bile duct (HR = 0.99, 95% CI = 0.81-1.18), extrahepatic bile duct (HR = 0.99, 95% CI = 0.79-1.24), or ampulla of Vater (HR = 0.89, 95% CI = 0.72-1.00).

Conclusion: In the largest study to date of BTC risk, we found that family history of cancer may not be associated with risk of developing BTC.

Table of Contents

Chapter I: Background

Epidemiology of Biliary Tract Cancers……………………...……………………………1

Risk Factor Epidemiology of Biliary Tract Cancers………………………………………1

Genetic Associations………………………………………………………………………6

Significance of Thesis …………………………………………………………………….8

Chapter II: Manuscript Introduction………………………………………………………………………………10 Methods…………………………………………………………………………………..11 Results ……………………………………………………………………………………16 Discussion………………………………………………………………………………..19 Chapter III: Future Directions Summary…………………………………………………………………………………24

Future Directions………………………………………………………………………...25

Public Health Implications………………………………………………………………26

References………………………………………………………………………………..28

Tables…………………………………………………………………………………….34

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