PRIOR BLOOD TRANSFUSION AS A CANCER RISK FACTOR

DESCRIPTION: (Applicant's Description) This proposal seeks five years of funding to develop research and teaching skills in cancer epidemiology and to undertake laboratory training in molecular pathology methods which can be applied to cancer epidemiology studies. I have recently finished a joint M.D.-Ph.D. degree from the University of Iowa, with a Ph.D. degree in epidemiology. I have completed postdoctoral training in cancer epidemiology at the University of Minnesota and in Aging at the University of Iowa. I am currently an Assistant Professor of Epidemiology, tenure track, in the Department of Preventive Medicine and Environmental Health at the University of Iowa. The goal of my research plan is to acquire new skills in molecular pathology and clinical immunology which can be applied to my cancer epidemiology studies. I will focus my attention on the possible role of blood transfusions in the carcinogenic process. With this grant, I will attempt to replicate and expand my work on prior blood transfusion as a cancer risk factor by analyzing three previously collected case-control studies and an ongoing prospective cohort study. I also plan to develop a nested case-control study assessing transfusion history and lymphoma risk using the Agricultural Health Study cohort. In order to assess whether any transfusion and cancer risk association is confounded by the indication for the transfusion, I will conduct a pilot study of battle-injured Vietnam veterans which will lay the groundwork for studying whether blood transfusion for a non-specific- indication (i.e., trauma) is related to cancer risk. In order to address potential mechanisms underlying the putative association, I will use molecular pathology techniques to study whether the Epstein-Barr virus has an etiologic role in the transfusion and lymphoma association and whether Cytomegalovirus has an etiologic role in the transfusion and kidney cancer association. I will also design and conduct a pilot study to assess the immunological consequences that a blood transfusion has for an immunocompetent host. My other professional goals during this grant include the development of teaching skills in cancer epidemiology and experience in helping manage a cancer registry. To accomplish these goals, I will work in consultation with senior faculty members from the Departments of Preventive Medicine and Environmental Health, Pathology, and Internal Medicine and from the Cancer Center at the University of Iowa.