State Health Registry of Iowa

Research

RESEARCH PROJECTS DURING 2011

The State Health Registry of Iowa is participating in over two dozen funded studies during 2011. Brief descriptions of a few of these studies are provided.

AGRICULTURAL HEALTH STUDY

GEOGRAPHIC INFORMATION SYSTEMS

IOWA WOMEN’S HEALTH STUDY

NON-HODGKIN LYMPHOMA (NHL) CASE-CONTROL STUDY

PATTERNS OF CARE STUDIES

POOLED ANALYSES

TRANSPLANT CANCER MATCH STUDY

WECARE STUDY

SEER-MEDICARE

AGRICULTURAL HEALTH STUDY
The Agricultural Health Study is a long-term study of agricultural exposures (including pesticides) and chronic disease (especially cancer) among commercial or private pesticide applicators (and their spouses, if married) in Iowa and North Carolina. The study is funded primarily by the National Cancer Institute. Information about recent results from this study, the study background, frequently asked questions, other resources (internet & telephone) for agricultural health information, references for publications to date, and information for scientific collaborators can be found at the website, www.aghealth.org.

GEOGRAPHIC INFORMATION SYSTEMS
The State Health Registry of Iowa is involved with research utilizing geographic information systems to develop and test methodologies to identify regions of excess cancer burden in Iowa. Geographic information systems are refining measures of geographic access to cancer prevention, treatment and screening services in Iowa by using fine-scaled geographic data on individuals, the spatial choices of individuals, and the locations of service providers. Results can be used to plan more appropriate cancer prevention and control programs. The Registry has been mostly involved with this for the four major cancers in Iowa. One activity has been to create maps for use by the Iowa Cancer Consortium to assist with planning for cancer prevention and control. These maps were created under the direction of Dr. Gerard Rushton, Professor of Geography at the University of Iowa, and his graduate students. Examples can be viewed at www.canceriowa.org/News---Publications/ GIS-Smoothed-Cancer-Maps-of-Iowa. The references for a couple of recent publications involving geographic information systems are provided in the last section of this report.

IOWA WOMEN’S HEALTH STUDY
This is a population-based cohort of 41,837 Iowa women, aged 55-69 in 1986, who were recruited to determine whether diet, body fat distribution and other risk factors were related to cancer incidence. Exposure and lifestyle information was collected in a baseline mailed survey and subsequently in several follow-up mailed surveys. Mortality and cancer incidence have been ascertained since 1986 through annual linkage to the State Health Registry of Iowa databases and the National Death Index.

NON-HODGKIN LYMPHOMA (NHL) CASE-CONTROL STUDY
The State Health Registry of Iowa (SHRI) with researchers at the Mayo Clinic participated in a collaborative, population-based case-control study of NHL involving researchers at the National Cancer Institute and three other Surveillance, Epidemiology, and End Results (SEER) registries. The main objective of the study was to better characterize risk factors for NHL. In Iowa, 364 live patients newly diagnosed with NHL between July 1, 1998 and June 30, 2000 were enrolled. A similar number of population controls participated.

More recently, we are collaborating with researchers at the Mayo Clinic to investigate whether genes with functional, common variant polymorphisms involved in immune function and regulation are associated with overall survival from NHL among these patients.

PATTERNS OF CARE STUDIES
SEER Patterns of Care Studies are conducted to satisfy a U.S. Congressional directive to the National Cancer Institute to “assess the incorporation of state-of-the-art cancer treatment into clinical practice and the extent to which cancer patients receive such treatments.” This year’s Patterns of Care Study will involve bladder, kidney, head and neck, and pancreatic cancer. The SHRI has been involved with these types of studies over the past 20 years.

POOLED ANALYSES
Today, researchers are increasingly looking to combine their study data with data from other studies evaluating similar outcomes. Several studies that involve the State Health Registry of Iowa have had their data contributed for this pooling research including the Agricultural Health Study, the Iowa Women’s Health Study, the NHL Case-Control Study, and the American Cancer Society’s Cancer Prevention Study II Nutrition Cohort. During 2010, these activities addressed cancer risk associated with common lifestyle and/or genetic susceptibility factors and resulted in several publications.

TRANSPLANT CANCER MATCH STUDY
Solid organ transplantation provides life-saving treatment for end-stage organ disease but is associated with substantially elevated cancer risk, largely due to the need to maintain long-term immunosuppression. Important questions remain concerning the role of immunosuppression and other factors in causing cancer in this setting. Staff at two federal agencies, the National Cancer Institute and the Health Resources and Services Administration, are creating a database through linkage of information on U.S. transplant recipients (383,444 transplant recipients during 1987-2007), wait list candidates (216,067 candidates during 1987-2007 in addition to those who were subsequently transplanted), and donors (61,430 deceased donors, 57,961 living donors during 1999-2007) with information on cancer from multiple U.S. cancer registries, including the State Health Registry of Iowa. These data are being used to conduct research concerning the spectrum of cancer risk in transplant recipients. The data will also be used by the Health Resources and Services Administration in its public health role overseeing the U.S. solid organ transplant network to maintain and improve safety of organ transplantation, and will allow the National Cancer Institute to better characterize the burden of cancer in this population and discover risk factors for cancer among immunosuppressed individuals.

WECARE STUDY
(Women’s Environmental Cancer and Radiation Epidemiology)
The WECARE (Women’s Environmental Cancer and Radiation Epidemiology) Study is an example of a second cancer study. This study is designed to examine gene carrier status, demographic and lifestyle factors as well as environmental and treatment factors reported to be associated with breast cancer as they relate to the development of a second breast cancer in the opposite breast. Data collection not only involved medical record review, but also participant interviews and blood or buccal (cells from the mouth) sample collection. This year, we are back in the field adding more participants to this study to enable a genome-wide association study to be conducted to learn more about how genetic, environmental, and lifestyle factors work together to influence whether a woman with breast cancer will develop a second breast cancer in the opposite breast.
Results from the WECARE Study have provided important medical information and will continue to do so in the future. During 2010, findings from this study resulted in a half-dozen publications, the references for which are provided in the last section of this report.

SEER-MEDICARE
In the early 1990s, the cancer incidence and survival data from the State Health Registry of Iowa was combined with other SEER Registry data and linked to Medicare data. This linked data set has been updated on several occasions since and has become an important data resource for cancer research involving epidemiologic and health services research related to the diagnosis, treatment and procedures, costs, and survival of cancer patients. Over the years many publications have resulted from this linked data set including several during 2010, which are listed at www.healthservices.cancer.gov/seermedicare/overview/publications.html

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