Although cancer represents one of the leading causes of disease-related deaths in young adults (20-39 years), little attention has been given to risk factors for cancers in this population. This is particularly important given the increasing evidence that a substantial proportion of the cancers in young adults have a different biology, and probably etiology/pathogenesis, than found in older persons. Despite some reports from studies in middle-aged to older adults, the association between obesity, diabetes, the metabolic syndrome, and the most common cancers in young adults remains poorly understood. However, this knowledge may help to improve cancer screening and diagnosis. The goal of the proposed pilot study is to pave the way for future research on risk factors for cancer in young adults utilizing the memberships of the KPSC and KPNC health plans. The specific aims of this proposed research are (1) to establish a prospective population-based cohort of about 1.5 million young adults to investigate the association between obesity, diabetes, metabolic syndrome and cancer, and (2) to describe the completeness of exposure and confounding variables in these CRN sites. Initial efforts will focus on the most common cancers in young adults -- thyroid, testicular, and breast. Importantly, the cohort will serve as a potential resource for CRN and other scientists seeking to collaborate on studies of less common and rare cancers in young adults, such as colorectal and brain cancers. Thus, the proposed pilot study will lay the foundation for future R01-funded studies focused on the longitudinal association between obesity, diabetes, the metabolic syndrome and the risk for breast, thyroid and testicular cancer in young adults. These studies will provide information necessary to overcome the disparities in screening for and diagnosis of cancer in young adults.
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