Genetic Cancer Epidemiology
Cancer epidemiologic studies at the University Cancer Center Hamburg (UCCH) aim to quantify the influence of genetic as well as life-style (non-genetic) risk factors on disease occurrence and prognosis after a cancer diagnosis. State-of-the-art methods in epidemiology, molecular genetics and statistics are applied. These studies are often conducted as part of national and international research networks with multidisciplinary collaboration. The results of these studies will contribute to the identification of high-risk cohorts for targeted cancer prevention programs as well as for individualized therapies.
The MARIE projects are an important part of epidemiological research at the Hubertus Wald Tumor Center in the area of breast cancer research. The studies are conducted in close cooperation with the German Cancer Research Center in Heidelberg and are funded by Deutsche Krebshilfe, Hamburger Krebsgesellschaft, Hamburger Stiftung zur Förderung der Krebsbekämpfung and the German Cancer Research Center.
The project is based on the MARIE study (Mammacarcinoma risk factor investigation), a population-based case-control study, which was conducted between the years 2002 and 2005. The aim of the MARIE study was to investigate the influence of menopausal hormone therapy and other lifestyle factors on breast cancer risk. In total, about 3,500 breast cancer patients and more than 7,000 women without breast cancer between ages 50 to 74 years participated during the initial survey. All participants were characterized with respect to all major breast cancer risk factors, in particular postmenopausal hormone therapy (according to type), lifestyle factors and genetic factors. The study was used to determine the importance of these risk factors for breast cancer risk in Germany.
Follow-up of the study participants has been performed about every 5 years in order to identify factors associated with clinical outcomes after a breast cancer diagnosis: In 2009, a second survey was carried out with the breast cancer patients (MARIEplus-study) as well as with the women without breast cancer (MARIE II-study). In the follow-up study, information on risk factors after diagnosis was collected as well as information on the incidence of comorbidities, recurrences, second tumors and mortality. The aim was to investigate the association of various lifestyle factors (including physical activity, nutrition, use of menopausal hormone therapy) on breast cancer prognosis, cancer incidence and mortality. The follow-up data for both patients and non-affected women of the same age was used to establish a longitudinal study of postmenopausal women, which serves as a basis for studying research questions regarding time trends in preventive screening measures, changes in behavior and healthcare as well as changes in the quality of life and their associations with morbidity and mortality.
In November 2014, after more than 10 years since the first interview, a second follow-up of the patients (MARIEplus2 study) was performed. The aim of this research project is to investigate the association of changes in lifestyle factors and biomarkers (enterolactones, adipokines, inflammatory markers etc.) with breast cancer prognosis. In early 2016, a second follow-up of women without breast cancer diagnosis (MARIE III study) will be conducted.
The study participants, who are meanwhile 60 years of age or older, are often confronted with great challenges such as concurrent comorbidities, multiple medication and/or social isolation. Studying long-term survivors after a breast cancer diagnosis and women without a breast cancer diagnosis will help to discriminate between chronic diseases/health consequences due to breast cancer and those due to aging as well as the long-term development of quality of life. Furthermore, problems in the uptake and the quality of preventive breast cancer screening measures can be investigated from the female perspective over a period of more than 10 years.