Abstract
With its population of over 1.3 billion persons, China offers abundant opportunities to discover causes of disease. However, few rigorous population-based case-control studies have as yet been conducted in mainland China. We conducted a population-based case-control study of nasopharyngeal carcinoma in Guangdong Province and Guangxi Autonomous Region. We collected questionnaires and biospecimens from incident cases recruited between March 2010 and December 2013, and population-based controls between November 2010 and November 2014. Preparatory activities prior to subject enrollment required approximately 18 months. We enrolled a total of 2554 NPC cases and 2648 controls. Among all identified cases, 83.8% participated. For the participating cases, the median time between diagnosis and interview was 2 days. Among all contacted controls, 82.7% participated. From the enrolled cases, we collected 2518 blood specimens (provided by 98.6% of eligible cases), 2350 saliva specimens (92.0%), 2514 hair specimens (98.4%), and 2507 toenail/fingernail specimens (98.2%). From the enrolled controls, we collected 2416 blood specimens (91.2%), 2505 saliva specimens (94.6%), 2517 hair specimens (95.1%), and 2514 toenail/fingernail specimens (94.9%). We demonstrate that population-based epidemiologic research can successfully be conducted in southern China. The study protocols, databases, and biobank will serve as an extraordinarily valuable resource for testing future etiologic hypotheses.
Highlights
The revolution in genomic technologies offers novel opportunities to discover how genetic factors influence risk of disease, and how these factors interact with environmental and lifestyle factors in the causal web of human diseases
We demonstrate that populationbased epidemiologic research can successfully be conducted in southern China
Preparatory activities prior to subject enrollment required approximately 18 months. This extended period was necessitated by the absence of pre-existing infrastructure for the conduct of population-based epidemiologic research in southern China
Summary
The revolution in genomic technologies offers novel opportunities to discover how genetic factors influence risk of disease, and how these factors interact with environmental and lifestyle factors in the causal web of human diseases. Regardless of how cutting-edge the genomic technologies are, a valid assessment of non-genetic risk factors requires a rigorous epidemiologic study design. Case-control studies are more efficient than cohort studies for identifying risk factors. Case-control studies should include all incident cases of the disease under study in a defined population during a specified time period. Control subjects without the disease should be sampled in such a way (randomly) that they inform about the distribution of exposures in the person-time that gave rise to the cases. Many important human diseases escape proper investigation of their causes altogether
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