Akash+Ganapathi's+Proposal

 Health determinants are biological, environmental, and social factors that are associated with the different ways certain a disease takes its course in different types of people. Health determinants such as race, gender, socioeconomic status, weight, diet, age, etc. have been found to correlate with disparity in the progression of different diseases. Several epidemiological studies have found that lung cancer is inversely related to socioeconomic status and suggest it as a possible risk factor for lung cancer (Mao 809). Understanding how these different health determinants affect lung cancer risk, progression and outcome allows us to make observations as to what other possible risk factors that lead to disease might be. Currently the biggest accepted risk factor for lung cancer is smoking; however, learning what social environments lead to more smoking will raise more questions such as, why do those specific groups smoke more, or come to the doctor with a later staging, etc. This would allow us to later strike at society based reasons for lung cancer disparity. I will be investigating how socioeconomic status, gender and race relate to smoking history, disease outcome and the disease progression of lung cancer patients, as well as how smoking history relates to an aggressive phenotype in lung cancer development.  I work in Dr. David H. Harpole’s lab, which is primarily a clinical research lab focusing on thoracic oncology. Surgery is the foremost treatment for lower staged lung cancer, and perhaps adjuvant chemotherapy if necessary at higher stages. Their goals focus around properly staging and determining what type of treatment is necessary for patients. They also have some basic research that focuses on determining alternative methods to treat lung cancer by finding ways for tumor specific binding, etc. They maintain a large data base of close to 6000 lung cancer patients that have come to their or one of their connected clinics. This database contains data such as race, age, gender, and many other social demographics for each patient. I am being provided a de-identified version of this database to analyze.    My data will be provided to me with this database; however, I will have to mine this database and create a new database containing just the demographics I need. Following this I will perform a statistical analysis of how the disparity in smoking histories, disease progression, disease outcome and phenotype, relate to categorical differences in demographics. This will allow me to obtain a p-value that will let me know if the correlations made between the disparities and demographics were statistically significant findings. If they are not significant I will still be able to make conclusions about how we now know that certain social factors do not affect health. Then I will have to analyze what the implications of my findings mean for future questions and current problems.  There are certain risks with holding other people’s private information; however, all the data I will be in possession of will be de-identified. So there will be no way for me to personally harm the individuals. The databases are also password protected and exist only on a few password protected computers in the lab. I will only work with the data while in the lab. In this way there will be almost no chance of any information that could hurt any of the patients being leaked.  Ekberg-Aronsson, Marie et al. Socio-economic status and lung cancer risk including histologic subtyping---A longitudinal study. Lung Cancer (2006) 51, 21-29. Mao Y, Hu J, Ugnat AM, et al. Socioeconomic status and lung cancer risk in Canada. Int J Epidemiol 2001; 30:809—17. Pearce NE, Howard JK. Occupation, social class and male cancer mortality in New Zealand, International Journal of Epidemiology (1986) 15, 456-462. <span style="font-size: 12pt; line-height: 115%; font-family: "Times New Roman","serif";">van Loon AJ, Brug J, Goldbohm RA, et al. Differences in cancer incidence and mortality among socio-economic groups. Scand J Soc Med 1995; 23:110—20. <span style="font-size: 12pt; line-height: 115%; font-family: "Times New Roman","serif";">Vagero D, Persson G. Cancer survival and social class in Sweden. J Epidemiol Community Health 1987; 41:204—9.
 * <span style="font-size: 12pt; line-height: 115%; font-family: "Times New Roman","serif";">Research Proposal **
 * <span style="font-size: 12pt; line-height: 115%; font-family: "Times New Roman","serif";">An Investigation of Health Determinants Associated with Disparities in Lung Cancer Risk and Disease Outcome **
 * <span style="font-size: 12pt; line-height: 115%; font-family: "Times New Roman","serif";">Resources/Lab **
 * <span style="font-size: 12pt; line-height: 115%; font-family: "Times New Roman","serif";">Data/Methods **
 * <span style="font-size: 12pt; line-height: 115%; font-family: "Times New Roman","serif";">Safety **
 * <span style="font-size: 12pt; line-height: 115%; font-family: "Times New Roman","serif";">Bibliography **