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History
of the Cancer Prevention Studies
In 1952 the Statistical Research Section, forerunner of
the present Department of Epidemiology & Surveillance
Research, began its first large prospective cohort study,
the Hammond-Horn Study, to study the effect of cigarette
smoking on death rates from cancer and other diseases.
By using 22,000 ACS volunteers to recruit a cohort of 188,000
adult men and then to trace cohort members yearly through
1955, that study set the methodologic foundation for the
two subsequent Cancer Prevention Studies (CPS-I and CPS-II).
In contrast to the Hammond-Horn Study, both CPS-I and CPS-II
were designed to address a wide range of potential exposures,
in addition to tobacco use, that may be associated with
cancer. CPS-I included approximately one million men and
women recruited by 68,000 volunteers in 25 states. Participants
were followed for 12 years, through 1972.
CPS-I data continue to be analyzed today, often in collaboration
with external investigators, or to compare with results
from CPS-II, a separate and more contemporary cohort. CPS-II
began in 1982 and encompassed 1.2 million subjects recruited
by 77,000 volunteers in 50 states. In addition, mortality
followup of all CPS-II cohort members remains active. Cancer
incidence followup is being conducted currently in a sub-cohort.
Accomplishments
Early contributions from CPS-II primarily involved tobacco
research. The increase in lung cancer risk among male and
female smokers in CPS-II, compared to smokers in CPS-I,
was highlighted by a 1989 U.S. Surgeon General's Report
and a 1997 NCI Monograph. CPS-II provides the relative risk
estimates from smoking used by the Centers for Disease Control
and Prevention to estimate deaths attributable to smoking
in the United States.
More recently, CPS-II publications have contributed to our
understanding of how various medications, medical conditions,
familial, and environmental factors may affect cancer risk.
CPS-II data stimulated research interest and funding regarding
the potential of aspirin-like drugs to inhibit colorectal
cancer. The relationship between postmenopausal hormone
replacement in women and mortality from cancers of the colon,
breast, and ovary has been examined in eight publications.
A CPS-II publication on obesity and early mortality showed
that the optimal range of body mass index remains constant
throughout life, rather than increasing with age. Medical
conditions associated with increased risk of various cancers
include diabetes (pancreatic and colon cancer), infertility
(ovarian), non-melanoma skin cancer (several), and hypertension
or antihypertensive medications (renal cancer), but not
spontaneous abortion (breast cancer). The department has
made notable contributions to research on environmental
factors such as air pollution.
The 1995 analysis with Dr. Arden Pope and other air pollution
researchers at Harvard found increased death rates from
cardiopulmonary conditions among CPS II participants living
in cities with higher particulate air pollution. Together
with the Harvard Six Cities Study, this finding motivated
EPA to propose more stringent limits on particulate air
pollution.
http://www.cancer.org/
docroot/RES/content/
RES_6_1_History_and_
Accomplishments.asp
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