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Discovering the causes of cancer and the means of prevention

DCEG Hosts Visiting Scholar David Schottenfeld

July 2012 - Linkage Newsletter

by Victoria A. Fisher, M.P.H.

In May, DCEG welcomed Dr. David Schottenfeld as a Visiting Scholar. Dr. Schottenfeld is the John G. Searle Professor Emeritus of Epidemiology at the University of Michigan School of Public Health and Professor Emeritus of Internal Medicine at the University of Michigan Medical School in Ann Arbor. He is a renowned researcher whose contributions to the field of cancer epidemiology span the past 50 years. In addition, he is a prolific writer and co-edited the definitive textbook Cancer Epidemiology and Prevention with Joseph F. Fraumeni, Jr., M.D., Division Director.

Photo of Joseph Fraumeni, David Schottenfeld, and Robert HooverDr. Schottenfeld received his M.D. from Cornell University Medical College in New York, New York, and completed training in internal medicine, medical oncology, epidemiology, and preventive medicine. From 1963 to 1986, he directed research and training programs in cancer epidemiology and prevention at Memorial Sloan-Kettering Cancer Center and Cornell University Medical College, both in New York. In 1986, Dr. Schottenfeld was appointed chair of the Department of Epidemiology and John G. Searle Professor of Epidemiology at the University of Michigan School of Public Health.

Dr. Schottenfeld has received numerous honors throughout his career, including an Academic Career Award in Preventive Oncology from NCI, the Abraham Lilienfeld Award from the American College of Epidemiology, the John Snow Award from the American Public Health Association, the Harvard School of Public Health Alumni Award of Merit, and the James D. Bruce Memorial Award for distinguished contributions in preventive medicine from the American College of Physicians. Dr. Schottenfeld is a founding member and former president of the American Society of Preventive Oncology and past president of the Society for Epidemiologic Research.

Robert N. Hoover, M.D., Sc.D., Director of the Epidemiology and Biostatistics Program, welcomed Dr. Schottenfeld and applauded his achievements as a true generalist in the field of cancer epidemiology with seminal findings across a wide range of cancers and exposures. Dr. Schottenfeld began his two-day visit with a seminar titled “Quantitative assessment of avoidable causes of cancer in the United States: What have we learned since the 1981 Doll-Peto publication?” He gave an overview of the seminal report by Dr. Richard Doll and Dr. Richard Peto, which quantified the contributions of various environmental and lifestyle factors to cancer incidence and mortality. “It is a remarkable and thoughtful document that has been challenging us for years,” Dr. Schottenfeld said.

In their paper, Drs. Doll and Peto concluded that theoretically, 75 to 80 percent of cancer deaths in the United States could have been avoided. In an effort to reassess and update their findings, Dr. Schottenfeld conducted a comprehensive review of epidemiologic studies published since 1981. He analyzed relative risks of cancer for eight environmental and lifestyle exposures and compared estimated population attributable fractions (used to quantify the proportion of cases that would not have occurred in the absence of exposure) in the United States, the United Kingdom, and France to those estimated by Drs. Doll and Peto. Dr. Schottenfeld then offered a current assessment of selected avoidable causes of cancer, including tobacco, alcohol, infectious agents, and obesity and
physical inactivity.

Based on his research, Dr. Schottenfeld believes that as much as 50 to 60 percent of cancer deaths in the United States could be avoided today. “I hope that this effort will stimulate the public health community to recognize the need for more precise estimates if we’re going to advance our efforts of controlling cancer,” Dr. Schottenfeld said.

Later in his visit, Dr. Schottenfeld participated in a panel discussion with Dr. Fraumeni on “Cancer epidemiology over the last half-century and thoughts on the future.” Dr. Hoover moderated the event, which he described as “a unique opportunity to hear an oral history of the discipline of cancer epidemiology from two legends in the field.”

Drs. Fraumeni and Schottenfeld spoke candidly about their past mentors and colleagues, noteworthy contributions to the field, and how cancer epidemiology has evolved as a discipline during their lifetimes. They ended the discussion with a look toward the future. “Though we have made great strides during the past few decades, there are still so many opportunities in the field and so much that remains to be learned,” Dr. Fraumeni said.

During his visit, Dr. Schottenfeld also attended individual and group meetings with DCEG scientists. The Immune Markers Working Group hosted a roundtable discussion on DCEG efforts to evaluate immunologic and inflammation biomarkers of cancer risk. Several Division staff members gave updates on their research projects, including Clara Bodelon, Ph.D., M.S., Hormonal and Reproductive Epidemiology Branch; Anil K. Chaturvedi, Ph.D., Infections and Immunoepidemiology Branch (IIB); Allan Hildesheim, Ph.D., Chief of IIB; Wen-Yi Huang, Ph.D., M.S.P.H., Occupational and Environmental Epidemiology Branch (OEEB); and Mark Purdue, Ph.D. (OEEB). Dr. Schottenfeld also met with DCEG fellows during an informal brown-bag lunch, where he spoke about the highlights of his career, including his experience as a director of training programs and as co-editor of the book Cancer Epidemiology and Prevention.

“Though I have been to DCEG many times before, this visit seems very special,” Dr. Schottenfeld said. “I have so many colleagues and friends in the Division, and I always look forward to my return.”