Black Women's Cohort: A Follow-up Study for Causes of Illness in Black Women

The investigators are continuing the largest follow-up study of the health of African-American women yet undertaken, the Black Women's Health Study (BWHS). The aim is to determine the effects on the incidence of breast cancer, other cancers, and other serious illnesses of a variety of potential risk factors, including:

• obesity,
• physical activity,
• alcohol consumption,
• diet,
• oral contraceptive use, and
• postmenopausal female hormone use.

Many of these factors have not been studied in black women. In addition, factors specific to African-American women, including experiences and perceptions of racism and use of hair relaxers, will be assessed. Because prevention programs require an understanding of the determinants of risk factors, the investigators also will assess correlates of important risk factors.

The BWHS cohort was established in 1995 when 59,000 black women ages 21 to 69 years from all regions of the United States completed mail questionnaires providing data on:

• demographic factors,
• medical and reproductive history,
• use of oral contraceptives and other drugs,
• physical activity,
• smoking,
• alcohol use,
• diet, and
• other factors.

Methods for following participants, collecting, processing, and managing the data, and validating cancer outcomes have been developed, and results of analyses of the baseline data have been published. The women have been followed through biennial mail questionnaires, with follow-up frequencies exceeding 80% in each round. By the end of this grant period (2004), 600 cases of breast cancer will be available for analysis.

African-American women suffer a greater burden of cancer morbidity than white women, but few studies have been conducted on them. The BWHS will contribute to the effort to improve the health of African-American women by providing insight into causes and preventives of breast cancer and other cancers, and useful information for intervention programs.