National Cancer Registry, National Health Laboratory Service, Johannesburg, South Africa; Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
National Cancer Registry, National Health Laboratory Service, Johannesburg, South Africa; School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
Cancer Epidemiol. 2020 Apr;65:101701. doi: 10.1016/j.canep.2020.101701. Epub 2020 Mar 10.
The Johannesburg Cancer Study (JCS) aims were to examine whether cancer risk factors identified in Western countries applied to black patients in Johannesburg, South Africa and to understand the impact of HIV on cancer risk, with a view to identifying previously unrecognised HIV associated cancers. A total of 24 971 black patients with an incident histologically proven (>95%) cancer of any type were enrolled between 1995-2016. Response rates were >90%. Patients provided informed consent, lifestyle and demographic information using a structured questionnaire; 19 351 provided a serum sample and 18 972 a whole blood sample for genomic analyses. This is currently the largest cancer epidemiological biobank in Africa. JCS uses a cancer case-control method; controls being cancer types unrelated to exposures of interest. Published results show the importance of HIV in several cancers known to be infection associated e.g. Kaposi sarcoma (OR = 1683; CI = 595-5194) in those with high Kaposi-sarcoma-associated-herpesvirus titres; no effect of HIV on lung or liver cancer-in the latter showing a strong association with HBVDNA, sAg and c positivity (OR = 47; CI = 21-104). Comparable data to higher-income country studies include lung cancer ORs in relation to smoking (15+g tobacco/day) (OR = 37; CI = 21-67, OR = 18.5; CI = 8-45) and associations between alcohol and oesophageal cancer in smokers (OR = 4.4; CI = 3-6). Relationship between hormonal contraception declined to null 10 or more years after stopping for breast (OR = 1.1; CI = 0.9-1.4) and cervical cancer (OR = 1.0;CI = 0.8-1.2), and protective effects shown, five or more years after stopping for ovarian (OR = 0.6; CI = 0.4-1) and endometrial cancer (OR = 0.4; CI = 0.2-0.9). Preferential access is based on data requests promoting data pooling, equal collaborative opportunities and enhancement of research capacity in South Africa. The JCS is a practical and valid design in otherwise logistically difficult settings.
约翰内斯堡癌症研究（JCS）的目的是检验西方国家确定的癌症风险因素是否适用于南非约翰内斯堡的黑人患者，并了解 HIV 对癌症风险的影响，以期确定以前未被识别的与 HIV 相关的癌症。1995 年至 2016 年间共纳入 24971 名黑人患者，他们患有任何类型的经组织学证实的（>95%）癌症。应答率>90%。患者通过结构化问卷提供关于生活方式和人口统计学信息的知情同意；19351 名患者提供血清样本，18972 名患者提供全血样本进行基因组分析。这是目前非洲最大的癌症流行病学生物库。JCS 使用癌症病例对照方法；对照组为与感兴趣的暴露无关的癌症类型。已发表的结果表明，HIV 在几种已知与感染相关的癌症中很重要，例如在高卡波西肉瘤相关疱疹病毒滴度的患者中，卡波西肉瘤（OR=1683；CI=595-5194）；HIV 对肺癌或肝癌无影响-在后一种情况下，与乙型肝炎病毒 DNA、表面抗原和 c 阳性密切相关（OR=47；CI=21-104）。与高收入国家研究相当的数据包括与吸烟有关的肺癌 OR（15+g 烟草/天）（OR=37；CI=21-67，OR=18.5；CI=8-45）和吸烟者中酒精与食管癌之间的关联（OR=4.4；CI=3-6）。在停止使用激素避孕 10 年或更长时间后，与乳腺癌（OR=1.1；CI=0.9-1.4）和宫颈癌（OR=1.0；CI=0.8-1.2）的关系下降到零，并且显示出保护作用，在停止使用卵巢（OR=0.6；CI=0.4-1）和子宫内膜癌（OR=0.4；CI=0.2-0.9）五年或更长时间后。优先准入是基于促进数据共享、平等合作机会和增强南非研究能力的数据请求。JCS 在逻辑上困难的情况下是一种实用有效的设计。
