by Jennifer K. Loukissas, M.P.P.
In February 2015, the Division welcomed Christopher Wild, Ph.D., Director of the International Agency for Research on Cancer (IARC), as a DCEG Visiting Scholar. Over the course of his two-day visit, Dr. Wild participated in two round-table discussions, a lunch discussion with current DCEG Fellows, and gave an inspiring keynote lecture entitled “Necessity is the mother of prevention: Responding to the growing cancer burden worldwide.” Michael B. Cook, Ph.D., served as host during his visit. DCEG Director Stephen J. Chanock, M.D., welcomed Dr. Wild, stating “The shared goals of IARC and DCEG have led to close ongoing collaborations.”
Dr. Wild began his seminar with a personal story—an experience that shaped his research career and steered him toward cancer prevention. In 1988 he made his first visit to Africa, going to The Gambia with Dr. Andrew Hall for the start of a field study of hepatitis B virus (HBV) vaccination for the prevention of liver cancer, which was endemic in the region. In the clinic, Dr. Wild came face-to-face with a patient in the late stage of the disease.
“There was no morphine. There was nothing to offer this suffering man,” he said. Some days later, the man had died; he was in his early 30s. Dr. Wild cites his feeling of inadequacy in that moment as a critical motivating factor in his career. “[I thought] maybe I can offer something to the next generation through research.” “This,” he stressed, “is the necessity of prevention,” especially in low-resource settings. “We cannot treat our way out of the cancer problem. Instead, we need a balanced, integrated approach to prevention, early detection, and treatment.”
He went on to describe the overall picture of cancer incidence and prevalence today—with data made available from IARC’s global effort to develop cancer registries—as well as key areas where small interventions could have a major impact on cancer risk. “Prevention works, but it takes time,” he said. “It’s important to recognize how much has been achieved over the past five or six decades.”
Looking to the future, Dr. Wild cited the importance of novel approaches and technologies—in particular metabolomics and molecular epidemiology—to not only confirm findings from observational studies of etiologic factors but also to inform hypotheses for future research. “Can the tumor reveal some of the secrets of its origins?” he asked. In particular Dr. Wild discussed how evidence from ecological studies, paired with molecular research in the laboratory, has led to a new hypothesis for renal cancer etiology in a particularly high-risk region, a finding that IARC investigators are now attempting to replicate.
Toward the end of his talk, Dr. Wild praised DCEG and stressed the need for further coordination between DCEG and IARC in the arena of prevention. “The work you are doing is critical,” he said. In closing, Dr. Wild came back to the study in The Gambia: “Prevention has been a huge success. Prevalence of childhood HBV infection is lower there today than in London.” While there has been success for liver cancer in The Gambia, there are countless communities around the world where we have yet to scratch the surface of their cancer problems. “We have a duty to care for patients of today, and to populations of tomorrow.”