Epidemiology

One of the hallmarks of Chronic Disease Epidemiology at the Mailman School is the collaborative research that takes advantage of nearly 20 large on-going epidemiologic studies that include risk-factor data on almost 1,000,000 individuals and large biorepositories of blood, urine, and tissue specimens of breast, lung, liver, and several other cancers.

Our strength includes a targeted focus on underlying pathways linking exposures to cancer through molecular epidemiologic studies and lifecourse studies that measure exposures during key susceptibility periods. The program’s longstanding emphasis on these studies sets it apart from more traditional cancer epidemiology programs that focus primarily on risk-factor epidemiology.

Understanding similarities and differences in exposure-cancer associations across geographically diverse populations is a particular strength of our program. Most of these cohorts were established to answer important questions about how the environment shapes cancer risk. As a result, most investigations, if not all, include scientists from both the Departments of Epidemiology and Environmental Health Sciences; the research findings from these projects testify to the successful collaborations among these two Mailman School departments and the Herbert Irving Comprehensive Cancer Center.

New Research

New research focuses on clinical cancer and survivorship, specifically the development of new approaches to chemoprevention and early stage trials; the study of disparities with a focus on the elderly and race/ethnicity, both for screening and treatment; and the study of quality of life and health outcomes, especially long-term toxicity of treatment and second malignancies in cancer survivors. Two large NCI-funded training grants to Alfred Neugut through the Department of Epidemiology support numerous pre- and postdoctoral trainees and provide for a weekly seminar series that brings together faculty, students, and postdoctoral fellows.

There are, of course, multiple studies across the spectrum of research in cancer epidemiology and prevention, crossing into health services and health outcomes research and survivorship. Our program is unusually collaborative and interdisciplinary, both between epidemiology and the laboratory sciences and between epidemiology and the clinical sphere. Virtually every study and project resides at the interfaces among these areas – very few studies are “pure” epidemiology. Many cover all three areas. We are noted for, and indeed are virtually the birthplace of, molecular cancer epidemiology.

Clinical Work

On the clinical side, we have ten or more practicing cancer clinicians who undertake significant population sciences research as part of our overall program; most such clinicians have appointments in the Department of Epidemiology. This includes five current faculty in medical oncology, one in urologic oncology, a gastroenterologist, and a neuro-oncologist (with several additional recruitments currently pending). All see patients and have public health and epidemiology orientations and are thus critical in bringing the Mailman School perspective to the medical school faculty and, most importantly, to house staff and students.

The Herbert Irving Comprehensive Cancer Center

The Herbert Irving Comprehensive Cancer Center provides a structure and infrastructure with extensive resources for cancer epidemiology and prevention research and activities. It fosters the inter- and trans-disciplinary approaches that are crucial to a world-class center. It also provides resources and support for recruitment and conduct of research, e.g., shared resources for biostatistics and for recruitment of study participants. At the Irving Center’s most recent competitive renewal site visit, the Division of Cancer Epidemiology and its parent program, Population Sciences, were rated close to outstanding, as they have been for several renewal cycles. Thus, epidemiology and prevention are recognized as key strengths of our Cancer Center.

New Areas of Exploration

One major trend in this field is the growth of clinically oriented epidemiology. Having clinicians with such an orientation positions us to take full advantage of this new area of investigation. The resources of the Irving Cancer Center resources in molecular genetics and in bioinformatics (arguably the best in the country) provide an infrastructure that helps enable us to grow in this direction.

Another area that is on the upsurge but has not hit its apogee is complementary and alternative medicine. We have taken the first step and recruited to the Department of Epidemiology a naturopathic physician with a PhD in epidemiology to lead our efforts in this area. Already several projects are underway, and this will be a ground-breaking area for years to come.