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Discovering the causes of cancer and the means of prevention

DCEG Hosts Symposium on Applying Epidemiology

Mark Schiffman chaired the Symposium's organizing committee, and co-moderated the first session, “The intersection of etiologic epidemiology and application: Where we stand and visions for improvement.”

In June 2015, nearly 200 scientists from NCI, NIH, and other organizations gathered for the “Applying NCI Etiologic Epidemiologic Discoveries to Reduce Cancer Burden” symposium. The event, hosted by DCEG, targeted the etiologic epidemiologist considering the earliest steps of new discovery application.

Etiologic epidemiologists at NCI study the patterns, determinants and development of cancer. The successful identification of a causal agent or informative biomarker raises hopes of application to reduce cancer incidence and mortality, but a strong association does not necessarily mandate or assure application. The formal study of how best to apply such findings is not new, but methods are evolving and this topic merits increased collaborative attention from etiologists and translational researchers.

The symposium featured interactive, participatory sessions with ample time for questions from the audience. Margaret A. Tucker, M.D., Director of DCEG’s Human Genetics Program, welcomed attendees and set the stage for a day of engaging discussion.

Dr. Tucker and Mark Schiffman, M.D., M.P.H., moderated the first session, “The intersection of etiologic epidemiology and application: Where we stand and visions for improvement.” Stephen J. Chanock, M.D., Director of DCEG, Mark Sherman, M.D., NCI Division of Cancer Prevention, and Robert Croyle, Ph.D., Director of the NCI Division of Cancer Control and Population Sciences (DCCPS), presented the perspective of the ir respective Divisions.

The next session, “Deciding on the adequacy of evidence: illustrated by case studies,” was moderated by Dr. Joe Selby, Patient-Centered Outcomes Research Institute (PCORI), and Dr. Christine Berg, Johns Hopkins School of Medicine. Dr. Selby, Amy Berrington de González, D.Phil., Chief of the Radiation Epidemiology Branch, Aaron Blair, Ph.D., M.P.H., Demetrius Albanes, M.D., Dr. Ruth Etzioni, Fred Hutchinson Cancer Research Center, and Robert N. Hoover, M.D., Sc.D., Director of the Epidemiology and Biostatistics Program, spoke about a variety of topics, including PCORI; case-studies on the application of findings to reduce exposure to radiation, occupational, and environmental carcinogens; the evolution of prostate cancer screening programs; and clinical use and management of menopausal hormone therapy.

After lunch, Sholom Wacholder, Ph.D., and Lisa McShane, Ph.D., NCI Division of Cancer Treatment and Diagnosis, moderated “Evolving foundational statistical and epidemiological methods.” Dr. Wacholder, Nicolas Wentzensen, M.D., Ph.D., and Hormuzd A. Katki, Ph.D., discussed the importance of considering absolute risk and new statistical tools for assessing the utility of biomarkers.

Dr. Croyle and Muin Khoury, M.D., Ph.D., DCCPS, led the session “Applying evidence from epidemiologic studies,” during which Dr. Jane Kim, Harvard School of Public Health, and Dr. David Ransohoff, University of North Carolina in Chapel Hill, spoke about improving interactions among epidemiologists, clinical trialists, guideline developers, and health care providers, as well as the role of epidemiology in post-discovery research.

Peter Garrett, Director of the NCI Office of Communications and Public Liaison, and Bradford Hesse, Ph.D., DCCPS, moderated “Communicating with diverse audiences.” Dr. Paul Han, Maine Medical Center Research Institute, discussed the challenges of communicating about risk, and George Johnson, author of The Cancer Chronicles and columnist for the New York Times, spoke about his experiences writing about cancer research and interpreting information produced by epidemiologists that may have clinical implications. The following day, Mr. Johnson also presented a seminar to NCI staff on “Reporting on cancer research: A journalist’s perspective.”

The final session, “Application of rare, moderate, and common germline variants,” was moderated by Mark H. Greene, M.D., and Mitchell H. Gail, M.D., Ph.D. Dr. Kenneth Offit, Memorial Sloan Kettering Cancer Center, discussed rare high-penetrance alleles, while Nilanjan Chatterjee, Ph.D., Chief of the Biostatistics Branch, spoke about common low-penetrance alleles. Dr. Chanock offered closing remarks and thanked all participants for a day of productive, collaborative, scientific discourse.

One objective from the symposium was to leave attendees “wanting more,” leading to a series of more focused interdisciplinary seminars that will pursue symposium topics in greater depth. The longer-range goal is to enrich the continuum of research conducted and funded by NCI through increased attention on taking full advantage of basic discoveries in the context of improved patient care and public health outcomes.

The symposium’s organizing committee included Dr. Schiffman, Dr. Berg, Jackie Feenster, Julia C. Gage, Ph.D., M.P.H., Dr. Greene, Dr. Katki, Jennifer Loukissas, M.P.P., Dr. Wacholder, and Dr. Wentzensen.