Epidemiology of prostate cancer
The clinical course of prostate cancer is highly variable. While prostate cancer is the 2nd leading cause of prostate cancer deaths, the majority of cases represent indolent disease or aggresive but treatable cancer. We are currently undertaking several studies to identify molecular predictors of prostate cancer incidence and survival within the Physicians Health Study, in which, more than 2,000 cases of prostate cancer have been documented. We are examining components of the IGF system in relation to disease risk, as well as identifying the link between these growth factors and tissue markers of prostate cancer proliferation and progression. We are identifying polymorphisms in genes related to cancer risk, and will conduct genetic analyses using microarrays on tumor specimens to identify factors that predict poorer survival from prostate cancer. Additional work will involve blood and tissue levels of hormones and cytokines in relation to prostate cancer risk and disease progression. We will also assess polymorphisms in the genes that encode key enzymes in those pathways.
I am also involved in projects to identify aggressive and indolent prostate cancer using data from a population-based sample of 240 prostate cancer cases from Örebro, Sweden. This cohort is unique in that it represents a complete census of cases diagnosed within a defined catchment area, and that these cases have undergone “watchful waiting” as treatment. Using previously collected tumor specimens, the goals are to identify tissue and genetic markers which predict an aggressive course of prostate cancer.
Dietary acrylamide and risk of cancer
In April 2002, the Swedish National Food Administration reported elevated levels of the substance acrylamide in several commonly consumed foods, including breads, cereals, potato products and coffee. Since acrylamide is identified by IARC as a probable human carcinogen, this finding led to concern that intake of foods containing acrylamide could increase risk of human cancer. Using epidemiological data from Sweden, we are analyzing data from two population-based case-control studies and from two cohort studies of more than 50,000 women each, to examine whether intake of acrylamide in foods increases the risk of cancer of the large bowel, bladder, kidney, or breast.