Abstract A7: Use of the Janus Biobank in cancer prevention
Authors: Langseth Hilde 
Published: June 2012

Abstract
Background: In recent years there has been an increased interest in utilizing biorepositories in cancer research. More specifically to detect novel cancer biomarkers for early detection, treatment and prognosis, and to investigate etiological factors. This demands large series of cases including high quality biospecimens and their associated data. The present study communicate the potentials in combining information from a high quality cancer registry with analytical information from the population-based Janus biobank of Norway. It was established in 1973 with the intention to collect premorbid serum for future use in cancer research. The philosophy is to make valuable biological samples and data available to researchers worldwide. Studies of cancer etiology and early cancer detection typically measure biochemical and immunological changes several years before cancer diagnosis. Most human cancer studies involve data from patients after the tumor has been diagnosed. The opportunity to detect important factors in the pathogenesis or etiology of cancer may then be lost. Use of the Janus biobank facilitates evaluation of the preclinical stage, the latent period before the cancer has been diagnosed. For a small sub-group of the Janus donors both pre-diagnostic and diagnostic samples from the same individuals are available.
Cancer incidence and scientific results: Today the Janus biobank is one of the world's largest and oldest population-based biobanks. The repository consist of prediagnostic serum samples from 317 000 individuals of whom 52 464 have developed cancer at a later point in life. In male donors prostate cancer is the most common cancer (n=7468), followed by cancer of the lung (n=3222), colon (n=2205), bladder (n=2040) and malignant melanoma (n=1663). Breast cancer is the most common cancer in female donors (n=6774) followed by genital organs (cervix uteri, corpus uteri and ovaries combined n=4176), colon (n=1707), lung (n=1650) and malignant melanoma (n=1423). A considerable number of rare cancer cases have developed among Janus donors, for instance 179 cases of liver cancer and 660 multiple myeloma cases, giving opportunity to set up valid studies of cancers with poor prognosis, and where the knowledge of etiology is limited. Predictions of the future cancer burden indicates that the aging Janus cohort will generate a considerable number of new cancer cases in the years to come. The biobank has been used in a large number of studies investigating biomarkers of susceptibility, exposure and effect. Important contributing results for cancer prevention were early observations of the association between PSA, CA125, HPV, Helicobacter pylori and risk of prostate, ovarian, cervical and stomach cancer respectively. Furthermore, important quality and stability studies have shown that the sample quality in the Janus repository is good for a number of components after long-term storage at −25°.
Future potentials: The Janus biobank comprises samples stored over a long period of time and present the opportunity to investigate accumulated, prospectively occurred cancer cases. The samples accessibility to a large number of healthy controls make it very timely to set up large studies with adequate statistical power to demonstrate contrasts in exposure between cancer cases and healthy controls, and to address the long-term effect of past exposure profiles, individual susceptibility and time-lag effects. An important future perspective is to utilize modern technology to enable the use of the Janus biobank in gene-environment-interaction studies, microRNA profiling, and omics-based studies.
Statement of conclusion: The unique arrangement of the integration between the Janus biobank and the Cancer Registry of Norway, and the comprehension of this type of resources in the scientific milieus, makes the use of the biobank in cancer prevention and care very timely.
Citation Information: Cancer Prev Res 2011;4(10 Suppl):A7.