WHI Cancer Survivor Cohort (CSC) Multiple PIs: Garnet Anderson, Bette Caan, and Electra Paskett Funded by the NCI 1

Life and Longevity After Cancer (LILAC) Specific Activities: Obtain information on cancer treatment and outcomes from multiple sources for women with selected cancers Self-report (Baseline and annual questionnaires) Medicare Medical record review Collect tumor tissue (FFPE blocks/slides) Conduct survivorship research among women who complete baseline and annual surveys

Potential Cancers Under Study Cancer Site Incident Cases (2010-2015) Prevalent Cases (2010) Total Cases (2015) Breast 2373 9756 12,129 Colorectal 624 2337 2961 Endometrial 328 1331 1659 Ovarian 256 875 1131 Lung 1371 2115 3486 Melanoma 792 1314 2106 Lymphoma 590 975 1565 Leukemia 399 523 922 Total 6,733 19,226 25,959 3

LILAC Survey Response Baseline (Form 340) Annual (Form 370) Cancer Site Mailed Completed % Breast 5,352 4,291 80.2 Colorectal 1,053 802 76.2 Endometrial 847 661 78.0 Fallopian 28 24 85.7 Leukemia 260 186 71.5 Lung 568 415 73.1 Lymphoma 595 452 76.0 Melanoma 1,206 864 71.6 Ovarian 206 171 83.0 Peritoneum 25 20 80.0 Total 10,140 7,886 77.8 Cancer Site Mailed Completed % Breast 3,870 3,570 92.2 Colorectal 726 643 88.6 Mlt Primary 10 9 90.0 Endometrial 602 537 89.2 Fallopian 21 18 85.7 Leukemia 154 126 81.8 Lung 339 291 85.8 Lymphoma 409 361 88.3 Melanoma 451 403 89.4 Ovarian 137 123 89.8 Peritoneum 17 15 88.2 Total 6,736 6,096 90.5

LILAC Tissue Collection Cancer Site Tissue Eligible1 Requested Received Destroyed Slides Only2 Breast 3,471 2,295 1,237 249 1,041 Colorectal 946 874 537 96 284 Endometrial 619 335 173 49 186 Lung 836 228 103 31 251 Melanoma (in situ) 334 258 137 22 100 Melanoma (invasive) 444 362 195 38 133 Ovarian 409 273 122 37 123 Total 7,059 4,625 2,504 522 2,118 1. Cases for ppts living and consented or deceased. Diagnosed 2002 or later, tumor size > 3 mm, excluding sarcomas. New cases to be enrolled Jan. 2016. 2. Estimated. Requests starting in Dec. 2015, beginning with colorectal cases.

Update on Treatment Information 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 Leukemia 615 363 Total 14,002 10,618 3,173 7,445 Medical Records 1st pass final Total Available for Done in CMS analysis Breast cancer 2630 2863 1528 3286 4814 Colorectal cancer 772 521 966 1487 Endometrial Cancer 459 556 Lung Cancer 1169 1098 Ovarian Cancer 446 119 46 334 380 Leukemia 244 312 Melanoma 330 28 3 363 366 NHL 438 530 * Cases consented to LILAC or deceased, who were diagnosed ≥2000 or in CMS FFS

Selected Characteristics of Survivorship Cohort Variable* Breast (n=3349) Ovary (n=120) Endomet (n=502) Colon (n=580) Lung (n=245) Melano (n=352) NHL (n=321) Leukemia (n=114) Yrs from Dx (mean) 8.3 6.8 8.2 7.9 5.6 7.7 6.6 Chemo** 30% 91% 10% 34% 23% 3% 70% 40% Recur-rence** 9% 31% 5% 8% 20% 17% 18% 6% *Women who completed both F340 and F370 **Self-reported data

Renewal plans March 2017 submission Infrastructure to include Tissue collection, and where necessary medical records collection of prospective cases Follow-up of cohort for cancer outcomes Analytic and general resource support Methodology Statistical methods Continued efforts on validation of CMS cancer outcomes

Potential motivating science Diet/PA/body composition & survival Stress/sleep/inflammation/immune system Host and tumor genomics Cancer among the elderly Comorbidities, non-cancer outcomes Patterns of care Other?

Timeline Solicit concept (2 pages) by November 1 Organize working groups around themes (Nov/Dec) Determine infrastructure needs (budget) for these R01s (Dec 1) Submit LOI by January 10 EAB review in late January March 10, 2017 submission