The Pathways Study: a prospective study of breast cancer survivorship within Kaiser Permanente Northern California
- 276 Downloads
With 2.3 million breast cancer survivors in the US today, identification of modifiable factors associated with breast cancer recurrence and survival is increasingly important. Only recently new studies have been designed to examine the impact of lifestyle factors on prognosis, including Pathways, a prospective study of women with breast cancer in Kaiser Permanente Northern California (KPNC).
Pathways aims to examine the effect on recurrence and survival of (1) lifestyle factors such as diet, physical activity, quality of life, and use of alternative therapies and (2) molecular factors such as genetic polymorphisms involved in metabolism of chemotherapeutic agents. Eligibility includes any woman diagnosed with invasive breast cancer within KPNC, no previous diagnosis of other invasive cancer, age 21 years or older, and ability to speak English, Spanish, Cantonese, or Mandarin. Newly diagnosed patients are identified daily from electronic pathology records and are enrolled within two months of diagnosis. An extensive baseline interview is conducted, blood and saliva samples are collected, and body measurements are taken. Women are followed for lifestyle updates, treatment, and outcomes by self-report and query of KPNC databases.
Recruitment began in 9 January, 2006, and as of 16 January, 2008, 1,539 women have been enrolled along with collection of 1,323 blood samples (86%) and 1,398 saliva samples (91%).
The Pathways Study will become a rich resource to examine behavioral and molecular factors and breast cancer prognosis.
KeywordsBreast cancer Prognosis Prospective cohort study Diet Complementary and alternative therapy Quality of life
We thank all Pathways Study office and field staff, and most importantly, the participants. The Pathways Study is supported by the National Cancer Institute (R01 CA105274). The ancillary studies are supported by the U.S. Department of Defense (BC043120), American Cancer Society (RSG-06-209-01-LR), and National Cancer Institute (R01 CA124924). The contents are solely the responsibility of the authors and do not necessarily represent the official views of the funding agencies.
- 1.http://www.cancer.org, American Cancer Society. 2006
- 6.World Cancer Research Fund/American Institute for Cancer Research (2007) Food, nutrition, physical activity, and the prevention of cancer: a global perspective. AICR, Washington, DCGoogle Scholar
- 8.Fisher B, Jeong JH, Bryant J et al (2004) Treatment of lymph-node-negative, oestrogen-receptor-positive breast cancer: long-term findings from National Surgical Adjuvant Breast and Bowel Project randomised clinical trials. Lancet 364(9437):858–568. doi: 10.1016/S0140-6736(04)16981-X PubMedCrossRefGoogle Scholar
- 9.Carlson RW, Brown E, Burstein HJ et al (2006) NCCN Task Force Report: adjuvant therapy for breast cancer. J Natl Compr Canc Netw 4(Suppl 1):S1–S26Google Scholar
- 13.Centers for Disease Control and Prevention NCfHS (1999–2000) National Health and Nutrition Examination Survey. NHANES 1999–2000 Public Data Release File Documentation, Available at: http://www.cdc.gov/nchs/data/nhanes/gendoc.pdf
- 14.Centers for Disease Control and Prevention NCfHS (2000–2001) National Health and Nutrition Examination Survey. NHANES 2001–2002 Public Data General Release File Documentation. Available at: http://www.cdc.gov/nchs/data/nhanes/nhanes_01_02/general_data_release_doc.pdf
- 15.U.S. Department of Agriculture ARS (2006) USDA food and nutrient database for dietary studies 2.0Google Scholar
- 20.Pierce JP, Faerber S, Wright FA et al (2002) A randomized trial of the effect of a plant-based dietary pattern on additional breast cancer events and survival: the Women’s Healthy Eating and Living (WHEL) Study. Control Clin Trials 23(6):728–756. doi: 10.1016/S0197-2456(02)00241-6 PubMedCrossRefGoogle Scholar
- 21.Gammon MD, Neugut AI, Santella RM et al (2002) The Long Island Breast Cancer Study Project: description of a multi-institutional collaboration to identify environmental risk factors for breast cancer. Breast Cancer Res Treat 74(3):235–254. Medline doi :10.1023/A:1016387020854 PubMedCrossRefGoogle Scholar
- 35.Oehrli MD, Quesenberry CP, Leyden W (2006) Annual report on trends, incidence, and outcomes. 2006, Kaiser Permanente, Northern California Cancer RegistryGoogle Scholar
- 39.Bloechl-Daum B, Deuson RR, Mavros P, Hansen M, Herrstedt J (2006) Delayed nausea and vomiting continue to reduce patients’ quality of life after highly and moderately emetogenic chemotherapy despite antiemetic treatment. J Clin Oncol 24(27):4472–4478. doi: 10.1200/JCO.2006.05.6382 PubMedCrossRefGoogle Scholar