Andrew F. Olshan, PhD, and Mark C. Weissler, MD | UNC Otolaryngology/Head and Neck Surgery

Andrew F. Olshan, PhD, and Mark C. Weissler, MD, were funded in July of 2001 by the National Cancer Institute to conduct a study (The CHANCE study) in 46 counties in North Carolina to comprehensively evaluate the role of genetic susceptibility factors in the etiology of squamous cell carcinoma of the head and neck. The population-based case-control study included 1,300 cases and 1,300 controls and constituted the largest study of head and neck cancer ever conducted in the United States. Polymorphisms of genes representing metabolism (activation and detoxification) of carcinogens and nutrients, mediators of oxidative stress, and DNA repair will be investigated using a 1,536 single nucleotide polymorphism (SNP) array. The size and population-based design should allow the investigators to more confidently confirm or reject associations raised in previous studies. The study also collected tumor blocks for future studies of “downstream” somatic alterations of tumor suppressor genes and oncogenes. Manuscripts have been developed examining tobacco and alcohol, dietary patterns, and oral health. Once the genetic data is available in July 2009 Dr. Olshan and colleagues will examine the effects of specific genotypes and gene-exposure interactions. Drs. Olshan and Weissler have also conducted a pilot study to evaluate survivorship factors, including quality of life, among cases in the CHANCE study. Cases were interviewed again eight months after diagnosis about smoking habits, access to health care, and quality of life issues. This work has lead to the award of a grant from the Lance Armstrong Foundation to continue to collect data on quality of life among African-American head and neck cancer survivors.

Dr. Olshan also continues to collaborate with Dr. Weissler on analyses of gene-environment interaction and head and neck cancer using samples from a previously conducted case-control study conducted at UNC Hospitals.

Lance Armstrong Foundation Grant

Treatment for head and neck cancer is particularly aggressive, affecting speech, swallowing, breathing and communication. A grant from the Lance Armstrong Foundation to the University of North Carolina at Chapel Hill will fund research on the experiences of head and neck cancer survivors, so that health professionals can effectively manage the impact of treatment on a patient’s social, family and work roles.

The three-year, $246,760 grant was awarded to Dr. Andy Olshan, Professor and Chair of Epidemiology in the UNC School of Public Health and Principal Investigator of the study. Olshan is also a research professor in the School of Medicine’s Department of Otolaryngology/Head and Neck Surgery and program leader for cancer epidemiology in the UNC Lineberger Comprehensive Cancer Center.

Because quality of life outcomes are especially critical for head and neck cancer (oral, pharyngeal, laryngeal) patients and their caregivers, more research is needed on the experiences of survivors, especially among black patients, Olshan said. The study will examine the influence of social, clinical, access to care, and behavioral factors on quality of life. Blacks have a higher incidence and worse survival than other groups.

“Given the paucity of data and studies on quality of life among African-American head and neck cancer survivors we expect this study to yield valuable new data,” Olshan said. Olshan and his colleagues will analyze data collected for the Carolina Head and Neck Cancer Study (CHANCE), the largest epidemiologic study of squamous cell carcinoma of the head and neck in the United States and the first to include a significant number of black patients. Patient information will be collected one year after diagnosis and three years after diagnosis. Data collection for the quality of life study will be complete in six months. The CHANCE study was funded by the National Cancer Institute. To date information on quality of life has been obtained from over 500 head and neck cancer survivors. Data collection will end in December 2009 and will be followed by an analysis of predictors of quality of life and examination of patterns by age, gender, race, and other factors.

Pilot funds for the quality of life work were obtained from the Excellence Fund of the School of Medicine. CHANCE collaborators include Drs. Mark Weissler, JP Riddle Distinguished Professor of Otolaryngology/Head and Neck Surgery; William Funkhouser, Professor of Pathology; and Jianwen Cai, Professor and Associate Chair of Biostatistics in the UNC School of Public Health. The Lance Armstrong Foundation, founded in 1997 by cancer survivor and champion cyclist Lance Armstrong, is a nonprofit organization located in Austin, Texas.