Risk factors for prostate cancer in the Birmingham Prostatic Neoplasms Association Study (BiPAS)

About the supervisors: 

Dr. Maurice Zeegers is professor of Complex Genetics & Epidemiology at UM and UoB. He is ranked among the top5 bladder cancer epidemiologist worldwide. He serves as head of CAPHRI and the department of Complex Genetics. His main interest is in Cancer Epidemiology, Lifestyle Exposures and Genetic Susceptibility.

Dr. Humera Khan has obtained a PhD in Genetic Epidemiology and serves as Programme Manager at the Institute of Applied Health Research at the University of Birmingham. She is the Study Manager of the BiPAS study.

About the research group: 

This project is a continuation of the existing collaboration between the University of Birmingham and Maastricht University. For both groups of supervisors urological cancer is their core focus of research. MZ and MP have jointly written and obtained funding for the BiPAS study.This project will be embedded within CAPHRI, School for Public Health and Primary Care of Maastricht University. The School CAPHRI has been rated five stars (out of 5) for her research quality and societal impact in all international external reviews for over more then a decade. Within CAPHRI world-class researchers are appointed in the fields of Cancer Epidemiology and Complex Genetics. The PhD student will be hosted within the department of Complex Genetics of Prof. Maurice Zeegers, where he/she will be personally supervised and come in contact with other international PhD students doing similar research, including case-control studies and prostate cancer studies.

Work field of the proposed project: 
Cancer Epidemiology
Estimated duration: 
4 year
Scientific background: 

Prostate cancer is currently the second most commonly diagnosed cancer among males worldwide, accounting for 13.8% of all incident cancer cases, and is still on the rise. It is projected that by 2030 26% of all new cancers in the UK will be prostate cancer, surpassing lung cancer (14%). In the European Union, healthcare costs associated with prostate cancer reached €8.43 billion in 2009 alone, accounting for 7% of the total economic cost of cancer. While these statistics are alarming, surprisingly little is known about the etiology of prostate cancer, with age, race, and family history being the only established risk factors.

Main research question, subquestions and aim(s): 

This PhD project will use data from a case-control study in the UK, which aimed to delineate the roles of occupational, genetic and environmental risk factors for prostate cancer. This study benefits from a new approach to analysis (further described in Methods), where the case/control status was not known to both participants and investigators at the time of exposure assessment, thereby minimizing recall bias. This approach also allows the inclusion of two additional groups (high prostate specific antigen [PSA] and hospital-based controls), which adds a new dimension to the conventional analysis of prostate cancer cases and population-based controls.

Research design and methods: 

The Birmingham Prostatic Neoplasms Association Study (BiPAS) is a multicentre study of prostate cancer patients in Birmingham, UK. Eligible participants were male patients (≥50 years) with suspected prostate abnormalities, including lower urinary tract symptoms (LUTS) and/or high serum PSA levels who were routinely referred to the three urology clinics in the West Midlands (UK). Patients were categorised based on results of biopsy. Those with histologically confirmed adenocarcinoma of the prostate formed the prostate cancer case group. Those with a high repeat PSA above age-specific reference ranges and negative or no biopsy were classified as high PSA cases. The remaining patients whose repeat PSA level was normal formed the hospital controls. Population controls were identified through computer search of patient lists at four general practitioner (GP) surgeries who were men aged 50 years or over with no known prostate cancer symptoms or recorded urological history. 

Research activities: 

During the recruitment period (March 2007–October 2010), 1480 patients were referred to the clinics of whom 401 did not meet the eligibility criteria and 183 refused to participate. Of the 896 patients enrolled, 314 were prostate cancer cases, 381 were high PSA cases, and 201 were hospital controls. A total of 175 population controls were recruited from GP practices. Participants were asked to complete a self-administered questionnaire, which was divided into various sections seeking information on demographics, anthropometry, family history of cancer and different environmental factors. Also, DNA from blood serum was extracted for genotyping.

Expected results: 

The student will build a series of unconditional logistic regression models were to calculate odds ratios (ORs) and corresponding 95% confidence intervals (CIs) for the relationship between: body dimensions, diet, physical activity, UV exposure, occupation, family history, testosterone exposure en genetic factors and risk of prostate cancer or high PSA, adjusting for known risk factors (age, ethnicity, and family history) and potential confounders. In studying these relationships the two control groups were compared to each case group individually; then a fixed effect meta-analysis will be used to pool the ORs for prostate cancer, high PSA, and all cases. 

Competences the applicant needs to have or acquire for the project: 

MSc in Epidemiology or related field, Confidence in statistical analyses, Fluency in englsh

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