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WHI/CCC update May 4, 2017
Currently Active WHI Participants N=75,420 as of February 28, 2017
Age N %
<75 9771 13.0 75-79 20306 26.9 80-84 20440 27.1 85-89 15847 21.0 90-94 7399 9.8
95+ 1657 2.2
Race/Ethnicity N % American Indian/Alaska Native 251 0.3
Asian/Pacific Islander 1606 2.1 Black/African American 4814 6.4
Hispanic/Latina 2067 2.7 White 65802 87.2
Unknown 880 1.2
Follow-up and outcomes
• F33 response rates still strong (~89%)
• Gradual slippage • Increasingly dependent on
telephone follow-up • Some modifications in
procedures seem to have improved completion rates
Ext. Study Outcomes (2010-present)
Reported Closed
CVD 6575 6468 HF 2490 2083
Stroke 1774 1748 Cancer 9577 9484
Fracture 823 807 Deaths 2879 2815
Total 24118 23405 UNC-HF 4499 4499
Stroke 3484 3483
0 5 10 15 20 25 30 35 40 45 50
Sink/counter heights
Ramps
Other
Tacking down carpets/rugs
Non-slip surfaces
Railings
Increasing lighting
Decreasing clutter
Grab bars
No changes
Percent of Total (N=74,852)
Changes to Home
0
10
20
30
40
50
<65 65-69 70-79 80-89 90+
Perc
ent %
Age at Start of Extension 2010-2015
Falls at Home by Age
0 10 20 30 40 50 60 70 80 90
Shingles vaccine ever
Pneumonia shot ever
Flu shot past 12 months
Percent of Total N=74,852
Vaccines Total
0
5
10
15
20
25
White Black Hispanic AmericanIndian
Asian/PacificIslander
Unknown
Perc
ent %
Glaucoma Ever by Race/Ethnicity
0 10 20 30 40 50
Not enough money for food
Fewer than 2 meals per day
Problems making it hard to eat
Not able to shop, cook, feed
Eat alone most of the time
Percent of Total N=74,852
Eating Habits
0
10
20
30
<65 65-69 70-79 80-89 90+
Perc
ent %
Age at Start of Extension 2010-2015
Not Able to Shop, Cook, Feed by Age
0
2
4
6
8
10
White Black Hispanic AmericanIndian
Asian/PacificIslander
Unknown
Perc
ent %
Not Enough Money for Food by Race/Ethnicity
0 10 20 30 40 50 60 70 80 90 100
Looked at WHI website
Use smart phone, iPad, device
Send or receive text messages
Use internet for health info
Use computer internet
Use computer for email
Use a computer
Own cell phone
Percent of Total N=74,852
Phone and Computer Use
0
20
40
60
80
<65 65-69 70-79 80-89 90+
Perc
ent %
Age at Start of Extension 2010-2015
Sends or Receives Text Messages by Age
0
10
20
30
40
50
60
70
80
90
100
Independently With family member(not spouse)
Assisted living Other
Perc
ent o
f Tot
al N
=70,
753
Current living arrangement
Skilled nursing: 0.4%
0
10
20
30
40
50
60
70
80
90
Lack Companionship Feel Left Out Feel Isolated
Perc
ent %
Companionship
Hardly ever Some of the time Often
6
10
14
18
22
26
30
<65 65-69 70-79 80-89 90+
Mea
n O
ptim
ism
Sco
re
Age at Start of Extension 2010-2015
Optimism by Age
Optimism Score ranges from 6 to 30 where a higher score indicates greater optimism.
0
10
20
30
40
50
60Pe
rcen
t %
Intensity of Emotion in Last 24 Hours
Not at all or a little bit
Moderately A great deal Extremely
RFQ for items for new questionnaire (F159)
• Proposals due to Helen Penor (hpenor@whi.org) by May 30 • Local funding no longer required based on recent OMB change
• Assumes 1 page, scannable form
Cancer incidence by age at diagnosis (annualized %)
57-69 70-79 80-89 90+
N % N % N % N % Breast cancer 913 0.51% 2606 0.56% 1391 0.47% 99 0.33% Invasive breast cancer 724 0.41% 2180 0.47% 1220 0.41% 93 0.31% Non-invasive breast cancer 203 0.11% 494 0.11% 208 0.07% 8 0.03% Ovarian cancer 77 0.04% 243 0.05% 173 0.06% 16 0.05% Endometrial cancer 137 0.08% 375 0.08% 175 0.06% 15 0.05% Colorectal cancer 123 0.07% 546 0.12% 545 0.19% 78 0.26% Leukemia 85 0.05% 252 0.05% 219 0.07% 29 0.10% Lung cancer 196 0.11% 932 0.20% 776 0.26% 89 0.30% Non-Hodgkins lymphoma 109 0.06% 388 0.08% 338 0.11% 37 0.12% Melanoma cancer 181 0.10% 630 0.13% 400 0.14% 32 0.11% Pancreas cancer 54 0.03% 276 0.06% 289 0.10% 35 0.12%
Invasive and In Situ Breast Cancer Age-specific incidence/100,000 in SEER and WHI SEER WHI
0
50
100
150
200
250
300
350
400
450
500
57-69 70-79 80-89 90+
Invasive Breast In Situ Breast
0
50
100
150
200
250
300
350
400
450
500
55-59 60-64 65-69 70-74 75-79 80-84 85+
Invasive Breast In Situ Breast
Endometrial and Colorectal Cancer Age-specific incidence/100,000 in SEER and WHI
SEER
0
50
100
150
200
250
300
55-59 60-64 65-69 70-74 75-79 80-84 85+
Endometrial Colorectal
WHI
0
50
100
150
200
250
300
57-69 70-79 80-89 90+
Endometrial Colorectal
Lung Cancer and Melanoma Age-specific incidence/100,000 in SEER and WHI SEER
0
50
100
150
200
250
300
350
400
450
55-59 60-64 65-69 70-74 75-79 80-84 85+
Lung Cancr Melanoma
WHI
0
50
100
150
200
250
300
350
400
450
57-69 70-79 80-89 90+
#REF! MelanomaLung
Leukemia and Non-Hodgkins Lymphoma Age-specific incidence/100,000 in SEER and WHI
SEER
0
20
40
60
80
100
120
140
55-59 60-64 65-69 70-74 75-79 80-84 85+
Leukemia NHL
WHI
0
20
40
60
80
100
120
140
57-69 70-79 80-89 90+
Leukemia NHL
Miscellaneous updates • Data releases
• Investigator website • November 2016 • June 30, 2017 (projected)
• Events through Feb 2017 • Form 521 – Physical Activity Q
administered in 2015-2016
• dbGap • Submitted in January 2017
• BIOLINCC • In preparation for early summer
submission
• Annual progress report in July • Data training and support
• In Seattle in September, 2016 • Videos available at www.whi.org
• 160 hits/month • 34 unique users
• Helpdesk responded to ~900 queries in past year
Miscellaneous updates
• Medicare • Access through interagency
agreement ending • CCC will purchase these data,
including Part D • Application is in processes • May result in disruption in access
due to expiration of data use agreement
• Virtual Data Enclave • 7 active users • 7 in process to gain access
• Query Builder continues to be enhanced
• WHI website • Update planned • Send suggestions to
helpdesk@whi.org with a subject line: Website input
Biorepository update Adequate volume of serum, plasma and DNA samples left for vast majority of participants
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
inv. Breastcancer
(N=10,386)
colorectalcancer
(N=3,074)
CHD(N=9,243)
hip fracture(N=4,256)
stroke(N=6,698)
pancreaticcancer
(N=1,078)
endometrialcancer
(N=1,724)
ovariancancer
(N=1,168)
Perc
ent w
ith v
olum
e ba
selin
e se
rum
in in
vent
ory
Outcome (total N)
Baseline Serum in Inventory for Selected Outcomes
0 ml
> 0 ml - <1 ml
1 ml - <2 ml
2 ml - <3 ml
3 ml - <4 ml
4+ ml
02,0004,0006,0008,000
10,00012,00014,00016,00018,00020,00022,000
Jan
2005
Aug
2005
Mar
200
6O
ct 2
006
May
200
7De
c 20
07Ju
l 200
8Fe
b 20
09Se
p 20
09Ap
r 201
0N
ov 2
010
Jun
2011
Jan
2012
Aug
2012
Mar
201
3O
ct 2
013
May
201
4De
c 20
14Ju
l 201
5Fe
b 20
16Se
p 20
16
Vial pull requests by month January 2005 - March 2017
Filling the gaps in WHI data and biospecimen collection for cancer survivorship and molecular epidemiology studies
LILAC –LIFE AND LONGEVITY AFTER CANCER THE WHI CANCER SURVIVOR COHORT
Garnet Anderson, Bette Caan, Electra Paskett, mPIs
26
Cancer Site WHI Incident Cases
(1994-2015)
Approached for LILAC consent (In active
follow-up in 2013/4)**
Consented, completed LILAC Baseline Q
N (%)**
Response rate to LILAC Year 1 Q
N (%) **
Breast 12,129 5352 4291 (80) 3570 (92)
Colorectal 2961 1053 802 (76) 643 (89)
Endometrial 1659 847 661 (78) 537 (89)
Ovarian/Fallopian Tube/Peritoneal
1131 259 215 (83) 156 (89)
Lung 3486 568 415 (73) 291 (86)
Melanoma 2106 1206 864 (72) 403 (89)
Lymphoma 1565 595 452 (76) 361 (88)
Leukemia 922 260 186 (72) 126 (82)
Total* 25,959 10,140 7886 (78) 6096 (91)
Cancer sites included in LILAC
*Total cancer incidence in WHI was 30,3069 as of 9/30/2015; **Tissue and medical records for WHI participants with these cancer diagnoses who were deceased at the time of LILAC initiation will be collected under a waiver of consent and are not reflected in these numbers whenever feasible
Update on Treatment Information—current status
Cancer Site Treatment Data Eligible*
Tx Data Now Available
Source: Medical records
Source: Medicare
Breast 5,916 5,240 1,954 3,286
Colorectal 1,746 1,682 716 966
Endometrial 1,019 559 3 556
Ovarian 784 574 240 334
Lung 2,305 1,337 239 1,098
Melanoma 645 333 21 312
Lymphoma 972 530 0 530
Leukemia 615 363 0 363
Total 14,002 10,618 3,173 7,445
* Cases consented to LILAC or deceased, who were diagnosed after the year 2000 or in Fee-for-service Medicare
LILAC status
• Infrastructure sufficiently mature to support ancillary study proposals • Analyses using Medicare population for treatment information can
proceed • Medical records collection should be final within a year • LILAC grant ends in early 2018 • Competitive renewal submitted in March 2017
WHI-CCC is 25! More transitions . . .
Beth Burrows, CCC Nutritionist/CC Liaison, CCC Outcomes Specialist, and all around pinch hitter (1992-present)
Doris Nodtvedt, Manager, Scientific Support Unit, Supervisor Extrordinaire, and Director of CCC Morale
Sue Mann, CCC Technical Coordinator, Quality Assurance Queen, Study Implementation Csar, enthusiastic Hutch supporter
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