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School and Program Updates

School and Program Updates

Columbia’s Cancer Prevention and Treatment Initiatives

Faculty at the Mailman School of Public Health are using a variety of perspectives to study cancers of the cervix, blood, breast, and colon; thyroid and prostate cancer and multiple myeloma among rescue/recovery workers and residents and area workers at the World Trade Center; and factors that influence treatment decisions.

Epidemiologists at the Mailman School with colleagues at Columbia University Medical Center are partnering with the University of Cape Town and the diagnostics company Cepheid to develop new technologies for cancer prevention in low and middle-income countries.  Dr. Louise Kuhn received a two-year cooperative agreement from the National Cancer Institute to develop an algorithm for a point of care HPV test that can be used in a screen-and-treat approach making cervical cancer prevention services accessible to women in low and middle income countries.

MicroRNAs (miRs) control cell growth, and therefore play a key role in carcinogenesis. A study by professor of Environmental Health Sciences, Dr. Regina Santella showed that the expression of miR-375 and miR-214-3p together with age and gender identified high-risk individuals who had significantly shorter time to relapse and until death. This model of a two-miR panel with age and gender may be useful in identifying early stage patients with poor prognosis who would benefit from a subsequent aggressive treatment regimen. Mailman School co-authors are Drs. Shuang Wang,and Jing Shen with colleagues from Columbia University Medical Center, the New York Genome Center and University of Chicago.

Drs. Lissette Delgado-Cruzata, Mary Beth Terry, Regina Santella, and Parisa Tehranifar collaborated on a study that supports the importance of considering the source of DNA in epidemiologic studies of white blood cell DNA methylation.Read more

Several papers published by Drs. Mary Beth Terry, Parisa Tehranifar, J.A. McDonald, and Katherine Crew examine the contribution of common chronic disease risk factors to mammographic breast density, a marker of breast cancer risk, including metabolic risk factors (read more), alcohol consumption (read more) passive and active smoke exposure in different life periods (read more) and serum measures of vitamin D (read more).  Understanding the associations of these potentially modifiable factors in relation to mammographic density, which can be easily be assessed and monitored through routine clinical mammogram, is important to informing breast cancer risk reduction and prevention efforts.

A study by Drs. Christine Sardo- Molmenti, Heather Greenlee, and Al Neugut assesses the relationship between physical activity and colorectal adenoma recurrence and suggests that sedentary behavior is associated with a higher risk of colorectal adenoma recurrence among men. Males with the highest levels of sedentary time experienced 47% higher odds of adenoma recurrence. No similar association was observed for women.

At least 400,000 persons are estimated to have been exposed to asbestos, silica, and other carcinogens in the 9-11 World Trade Center terrorist attacks. In a 2012 JAMA report, Dr. Steven Stellman reported on elevated thyroid and prostate cancer and multiple myeloma among rescue/recovery workers tracked through 2008. Because most cancers have longer latency periods, the research team has updated linkages through 2011 and is currently analyzing associations that might be evident with three further years of elapsed time. Studies will cover lower Manhattan residents and area workers, as well as rescue/recovery workers.

In collaboration with investigators at UNC, Mt. Sinai School of Medicine, and Consulting in the Public Interest, Dr. Stellman is studying exposure to environmental sources of polycyclic aromatic hydrocarbons (PAH) as risk factors for breast cancer, with special attention to early-life exposures, such as traffic and once-common home heating sources such as coal.

A study by Dr. Rachel Shelton analyzed whether obesity influences receipt of screening colonoscopy among lower-income Latinos and African Americans and found that rates of colonoscopy screening were high (~80 %), regardless of weight status. Adjusting for age, gender, race/ethnicity, family history of colorectal cancer, smoking status, comorbid conditions, income, marital status, insurance, and education, obesity status was not significantly associated with screening behavior among the entire sample or among stratified race/ethnicity and gender groups. The findings suggest that further studies are needed to determine whether this finding will be observed in other populations.

Through a Mentored Research Scholar Grant from the American Cancer Society, Dr. Sheltonhas also been examining factors that influence treatment decisions for stage II colon cancers. Dr. Shelton used in-depth interviews to collect qualitative data among stage II colon cancer patients and their providers, and will begin examining multi-level factors that shape patient decisions and outcomes. Dr. Shelton will also be publishing her work from an R03 study from The National Cancer Institute that helps elucidate how cancer prevention Lay Health Advisor programs in African American communities contribute to building individual, social, organizational, and community capacity.

In response to a call for more research on Latino subgroups by the Institute of Medicine, Dr. Ana Abraído-Lanza, and colleagues Drs. Mariana Martins, Rachel Shelton, and Karen Flórez are studying the determinants of breast cancer screening among Dominican women, including the extent to which culturally-based beliefs impede breast cancer screening among Dominicans and other Latina women. The investigators interviewed 318 Dominican women living in northern Manhattan and found that the strongest predictor of decreased screening was perceived barriers such as pain, cost, and logistical problems on how to obtain a mammography. Notably, almost 80% had obtained a mammogram in the past year.  These results add to the growing debate about fatalism, and highlight the role of psychosocial and logistical barriers to screening.