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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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