The Granada Cancer Registry conducts research projects on descriptive epidemiology and cancer risk factors, as well as on health care and outcomes assessment in cancer patients. On the other hand, we are one of the research groups that make up the CIBER in Epidemiology and Public Health (CIBERESP)
The Granada Cancer Registry, since its startup in 1985, has developed research projects produced by the GCR itself or in collaboration with other national or international institutions, along three main lines:
- Descriptive epidemiology of cancer
- Risk factors for cancer and other chronic diseases
- Health care and outcomes assessment in cancer patients
The GCR is part of the CIBER in Epidemiology and Public Health (CIBERESP), founded in 2006, as a research group attached to the Chronic Diseases Epidemiology and Prevention Program.
The main research lines and most relevant projects in each one are described below.
1) Descriptive epidemiology of cancer
The GCR has made possible to get to know cancer incidence in this province and estimate prevalence, time trends and survival rates. The comparison between the data from the GCR and other geographic areas has identified special risk situations, such as the high incidence of lip & larynx cancer or differences in survival, which have served as the basis for further studies on risk factors or variations in clinical practice.
On the other hand, the GCR takes part in the European Cancer Health Indicator Project (EUROCHIP), which it is expected to lay down a set of indicators to create a System for Surveillance and Control of Cancer in Europe. Two groups of indicators are defined: those routinely produced from the statistics of morbidity and mortality in most European countries, and others related to clinical, healthcare issues and based on research data mainly from PBCRs.
2) Risk factors for cancer and other chronic diseases (diabetes mellitus and cardiovascular diseases)
Our increased knowledge of the etiology of cancer has shown high possibilities in the field of disease prevention. Approximately 5-10% of cancers have a genetic component, whereas in the remaining 90-95% environmental factors and lifestyles are more significant. Modifying these factors and adopting healthy lifestyles would contribute to reduce the risk for some cancers among the population.
In this research line, the most relevant project is the European Prospective Investigation into Cancer and Nutrition (EPIC), a multicenter cohort study that started in 1992, and involves 520,000 people from 10 European countries, aimed at analyzing the relationship between nutrition, lifestyle and environmental factors and the incidence of cancer and other chronic diseases. In Granada, the cohort is made up of 8,000 people. Initially, the study was focused on cancer, monitoring cases through the population-based cancer registries; up to 2008 60,000 new cases of cancer had been identified in the European cohort. EPIC has retrieved key information to understand scientifically controversial issues- it is worth pointing out the connections found between fiber intake - colorectal cancer, smoking - gastric cancer and fruit and vegetable consumption - lung cancer.
In recent years its scope has been expanded to address the role of diet on the longevity of the elderly (EPIC-elderly), and the study of new diseases, particularly type 2 diabetes (INTERACT) and cardiovascular diseases (EPIC-HEART) (EPIC-HEART).
This knowledge in molecular and genetic epidemiology has provided a greater understanding of the interaction between lifestyle, environmental exposure and genetic susceptibility, how it induces and / or inhibits its activity and partly determines the way genetic mechanisms work.
3) Health care and outcomes assessment in cancer patients
This research line is primarily based on the European Cancer Registry-based Study of Survival and Care of Cancer Patients (EUROCARE) started in 1990, which estimates cancer survival rates in parts of Europe where a population-based cancer registry is located (http://www.eurocare.it/). Taking into account geographical variations in the observed survival rates, a study was carried out on breast cancer, colorectal and prostate cancer through which, by collecting additional data on diagnostic methods, stage and treatment, it was expected to identify any factors associated with survival rates, and it was proved the importance of stage at diagnosis. GCR's involvement provided information on the survival of cancer patients and patterns of cancer care in the province of Granada. A comparison with other geographical areas showed health inequalities in different populations, as well as differences in survival and variations in clinical practice for the cancers studied. This knowledge could help develop proposals for improving clinical practice and care for cancer patients.