by Victoria A. Fisher, M.P.H.
In September 2014, DCEG welcomed Visiting Scholar Dr. David Hunter, the Vincent L. Gregory Professor in Cancer Prevention in the Departments of Epidemiology and Nutrition and Dean for Academic Affairs at the Harvard T.H. Chan School of Public Health. His principal research interest is the etiology of breast cancer, with a focus on genetic susceptibility and gene-environment interactions.
Robert N. Hoover, M.D., Sc.D., Director of the Epidemiology and Biostatistics Program, welcomed Dr. Hunter, “[He] has been a friend and supporter of DCEG for a very long time. He was instrumental in developing the Cohort Consortium and the Cancer Genetic Markers of Susceptibility (CGEMS) initiative, and continues to be an essential collaborator.”
Dr. Hunter presented a seminar titled “Global cancer trends and what we can do about them.” His talk touched on a pivotal issue for all cancer epidemiologists: what steps can be taken to reduce cancer incidence and death?
The number of worldwide cancer deaths is increasing, largely due to population growth and aging. “Much of the population growth is happening in developing parts of the world, so the cancer spectrum in those countries will dominate future cancer deaths,” Dr. Hunter said.
Dr. Hunter challenged the audience to think broadly about ways to attenuate this trend. For example, certain cancer risk factors like smoking, infections, and obesity are modifiable and could theoretically be reduced or eliminated. In doing so, how much worldwide cancer may be prevented?
“If we eliminated smoking and made plausible reductions in hepatitis B and C, human papillomavirus, and Helicobacter pylori infections, we could reduce world cancer incidence by about 30 percent,” Dr. Hunter said. Though his estimates have limitations, they indicate that a significant portion of cancer incidence could be prevented by modified behavior and interventions.
Next, Dr. Hunter looked at how many worldwide cancer deaths could be decreased if current therapies were widely available. There are large disparities in cancer survival rates, in part because many developing countries don’t have access to modern treatment. Dr. Hunter speculated that if every country had U.S. cancer survival rates, worldwide cancer mortality would decrease by 43 percent. If smoking, infections, and obesity were also eliminated, worldwide cancer mortality would decrease by 66 percent.
“I would suggest that we can do a lot about these trends in cancer deaths,” Dr. Hunter said. “None of this is simple, but I think it can be done.”
Dr. Hunter also participated in several lively meetings with DCEG investigators and fellows over his two-day visit. Discussion topics included career advancement for young investigators, DCEG’s role in future breast cancer research, and the transformation of epidemiology in the era of consortia and data sharing.
Cancer Genetic Markers of Susceptibility (CGEMS) Project