Environment and Genetics in Lung cancer Etiology (EAGLE) study: An integrative population-based case-control study of lung cancer

Maria Teresa Landi, Dario Consonni, Melissa Rotunno, Andrew W. Bergen, Alisa M. Goldstein, Jay H. Lubin, Lynn Goldin, Michael Alavanja, Glen Morgan, Amy F. Subar, Ilona Linnoila, Fabrizio Previdi, Massimo Corno, Maurizia Rubagotti, Barbara Marinelli, Benedetta Albetti, Antonio Colombi, Margaret Tucker, Sholom Wacholder, Angela C. PesatoriNeil E. Caporaso, Pier Alberto Bertazzi

Research output: Contribution to journalArticle

Abstract

Background. Lung cancer is the leading cause of cancer mortality worldwide. Tobacco smoking is its primary cause, and yet the precise molecular alterations induced by smoking in lung tissue that lead to lung cancer and impact survival have remained obscure. A new framework of research is needed to address the challenges offered by this complex disease. Methods/Design. We designed a large population-based case-control study that combines a traditional molecular epidemiology design with a more integrative approach to investigate the dynamic process that begins with smoking initiation, proceeds through dependency/smoking persistence, continues with lung cancer development and ends with progression to disseminated disease or response to therapy and survival. The study allows the integration of data from multiple sources in the same subjects (risk factors, germline variation, genomic alterations in tumors, and clinical endpoints) to tackle the disease etiology from different angles. Before beginning the study, we conducted a phone survey and pilot investigations to identify the best approach to ensure an acceptable participation in the study from cases and controls. Between 2002 and 2005, we enrolled 2101 incident primary lung cancer cases and 2120 population controls, with 86.6% and 72.4% participation rate, respectively, from a catchment area including 216 municipalities in the Lombardy region of Italy. Lung cancer cases were enrolled in 13 hospitals and population controls were randomly sampled from the area to match the cases by age, gender and residence. Detailed epidemiological information and biospecimens were collected from each participant, and clinical data and tissue specimens from the cases. Collection of follow-up data on treatment and survival is ongoing. Discussion. EAGLE is a new population-based case-control study that explores the full spectrum of lung cancer etiology, from smoking addiction to lung cancer outcome, through examination of epidemiological, molecular, and clinical data. We have provided a detailed description of the study design, field activities, management, and opportunities for research following this integrative approach, which allows a sharper and more comprehensive vision of the complex nature of this disease. The study is poised to accelerate the emergence of new preventive and therapeutic strategies with potentially enormous impact on public health.

Original languageEnglish
Article number203
JournalBMC Public Health
Volume8
DOIs
Publication statusPublished - 2008

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Case-Control Studies
Lung Neoplasms
Smoking
Population
Population Control
Molecular Epidemiology
Information Storage and Retrieval
Research
Italy
Neoplasms
Public Health
Lung
Mortality
Therapeutics

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Environment and Genetics in Lung cancer Etiology (EAGLE) study : An integrative population-based case-control study of lung cancer. / Landi, Maria Teresa; Consonni, Dario; Rotunno, Melissa; Bergen, Andrew W.; Goldstein, Alisa M.; Lubin, Jay H.; Goldin, Lynn; Alavanja, Michael; Morgan, Glen; Subar, Amy F.; Linnoila, Ilona; Previdi, Fabrizio; Corno, Massimo; Rubagotti, Maurizia; Marinelli, Barbara; Albetti, Benedetta; Colombi, Antonio; Tucker, Margaret; Wacholder, Sholom; Pesatori, Angela C.; Caporaso, Neil E.; Bertazzi, Pier Alberto.

In: BMC Public Health, Vol. 8, 203, 2008.

Research output: Contribution to journalArticle

Landi, MT, Consonni, D, Rotunno, M, Bergen, AW, Goldstein, AM, Lubin, JH, Goldin, L, Alavanja, M, Morgan, G, Subar, AF, Linnoila, I, Previdi, F, Corno, M, Rubagotti, M, Marinelli, B, Albetti, B, Colombi, A, Tucker, M, Wacholder, S, Pesatori, AC, Caporaso, NE & Bertazzi, PA 2008, 'Environment and Genetics in Lung cancer Etiology (EAGLE) study: An integrative population-based case-control study of lung cancer', BMC Public Health, vol. 8, 203. https://doi.org/10.1186/1471-2458-8-203
Landi, Maria Teresa ; Consonni, Dario ; Rotunno, Melissa ; Bergen, Andrew W. ; Goldstein, Alisa M. ; Lubin, Jay H. ; Goldin, Lynn ; Alavanja, Michael ; Morgan, Glen ; Subar, Amy F. ; Linnoila, Ilona ; Previdi, Fabrizio ; Corno, Massimo ; Rubagotti, Maurizia ; Marinelli, Barbara ; Albetti, Benedetta ; Colombi, Antonio ; Tucker, Margaret ; Wacholder, Sholom ; Pesatori, Angela C. ; Caporaso, Neil E. ; Bertazzi, Pier Alberto. / Environment and Genetics in Lung cancer Etiology (EAGLE) study : An integrative population-based case-control study of lung cancer. In: BMC Public Health. 2008 ; Vol. 8.
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abstract = "Background. Lung cancer is the leading cause of cancer mortality worldwide. Tobacco smoking is its primary cause, and yet the precise molecular alterations induced by smoking in lung tissue that lead to lung cancer and impact survival have remained obscure. A new framework of research is needed to address the challenges offered by this complex disease. Methods/Design. We designed a large population-based case-control study that combines a traditional molecular epidemiology design with a more integrative approach to investigate the dynamic process that begins with smoking initiation, proceeds through dependency/smoking persistence, continues with lung cancer development and ends with progression to disseminated disease or response to therapy and survival. The study allows the integration of data from multiple sources in the same subjects (risk factors, germline variation, genomic alterations in tumors, and clinical endpoints) to tackle the disease etiology from different angles. Before beginning the study, we conducted a phone survey and pilot investigations to identify the best approach to ensure an acceptable participation in the study from cases and controls. Between 2002 and 2005, we enrolled 2101 incident primary lung cancer cases and 2120 population controls, with 86.6{\%} and 72.4{\%} participation rate, respectively, from a catchment area including 216 municipalities in the Lombardy region of Italy. Lung cancer cases were enrolled in 13 hospitals and population controls were randomly sampled from the area to match the cases by age, gender and residence. Detailed epidemiological information and biospecimens were collected from each participant, and clinical data and tissue specimens from the cases. Collection of follow-up data on treatment and survival is ongoing. Discussion. EAGLE is a new population-based case-control study that explores the full spectrum of lung cancer etiology, from smoking addiction to lung cancer outcome, through examination of epidemiological, molecular, and clinical data. We have provided a detailed description of the study design, field activities, management, and opportunities for research following this integrative approach, which allows a sharper and more comprehensive vision of the complex nature of this disease. The study is poised to accelerate the emergence of new preventive and therapeutic strategies with potentially enormous impact on public health.",
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AU - Rotunno, Melissa

AU - Bergen, Andrew W.

AU - Goldstein, Alisa M.

AU - Lubin, Jay H.

AU - Goldin, Lynn

AU - Alavanja, Michael

AU - Morgan, Glen

AU - Subar, Amy F.

AU - Linnoila, Ilona

AU - Previdi, Fabrizio

AU - Corno, Massimo

AU - Rubagotti, Maurizia

AU - Marinelli, Barbara

AU - Albetti, Benedetta

AU - Colombi, Antonio

AU - Tucker, Margaret

AU - Wacholder, Sholom

AU - Pesatori, Angela C.

AU - Caporaso, Neil E.

AU - Bertazzi, Pier Alberto

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