A Population-based Case-control Study of Lung Cancer in Appalachian Kentucky: The Role of Environmental Carcinogens
Appalachian Kentucky has one of the highest incidence rates of lung cancer in the United
States. The disproportionately high incidence is not explained by tobacco alone.
Preliminary analysis of trace element content in toenail samples reveals higher levels of
arsenic, chromium and nickel in Appalachian Kentucky residents than elsewhere in Kentucky.
Trace elements are known to promote carcinogenesis by increased oxidative stress,
inflammation, DNA damage, and reduced DNA repair efficiency. These findings justify further
investigation of the role that trace elements play in the development of lung cancer in this
region. Hypothesis: The unexpectedly high rate of lung cancer in Appalachian Kentucky is
associated with exposure to environmental carcinogens that increase oxidative stress and DNA
Specific Aims Aim 1: Conduct a case-control study of lung cancer and matched controls in the
5th Congressional District of Kentucky to compare rates of moderate to high arsenic in lung
cancer cases and controls.
Aim 2: Create a specimen repository of biologic and environmental samples from these
subjects and their residences for analysis of DNA repair markers and, in the future, markers
of oxidative stress and inflammation.
Aim 3: Fund four pilot projects which will utilize collected data from Aim 1 to develop
investigators focused on lung cancer research in this study population and to generate
preliminary data that will lead to independent funding.
Study Design: This is a population-based, case-control study encompassing the 5th
Congressional District of Kentucky.
Relevance: This translational research and repository will fundamentally improve our
understanding of the causes of the disproportionately high incidence of lung cancer in
Appalachian Kentucky, foster collaboration among scientists dedicated to the study of lung
cancer and provide a permanent resource to be used for future research.
Observational Model: Case Control, Time Perspective: Prospective
rate of moderate to high arsenic level in cases and controls
Conduct a case-control study of lung cancer and matched controls in the 5th Congressional District of Kentucky to compare rates of moderate to high arsenic in lung cancer cases and controls (primary endpoint).
up to three years
Susanne M Arnold, MD
Lucille P. Markey Cancer Center at University of Kentucky
United States: Federal Government
|University of Kentucky||Lexington, Kentucky 40536-0098|