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School and Program Updates

School and Program Updates

Columbia’s Cancer Prevention Initiatives

Faculty at Columbia University Mailman School of Public Health are collaborating on a variety of studies on cancers of the breast, prostate, and colon, and the effects of environmental exposures, the association of obesity and physical activity, and the interactions between HIV and cancer on treatment options, outcomes, and survival rates.

Following a cohort of men at the Henry Ford Health System who underwent a prostate biopsy and received a benign diagnosis, Drs. Andrew Rundle, epidemiology, and Deliang Tang, environmental health sciences, are studying the effects of environmental exposures, prostate inflammation, and obesity on prostate cancer risk and prostate cancer outcomes.  The study is designed to also illuminate causes of racial disparities in prostate cancer risk and outcomes between African American and White men.

A study by Dr. Heather Greenlee, epidemiology, and co-investigators published in the Journal of the National Cancer Institute examined associations between body mass index and lifestyle factors with chemotherapy-induced peripheral neuropathy (CIPN) in the Pathways Study, a prospective cohort of women with invasive breast cancer. Obesity and low moderate-to-vigorous physical activity were associated with CIPN in breast cancer patients who received taxane treatment.

Recent data from continuing collaborative studies of Drs. Al Neugut, epidemiology, and Regina Santella, environmental health sciences, with Dr. Marilie Gammon, University of North Carolina Gillings School of Global Public Health, on environmental risk factors and breast cancer have determined that residential exposure to vehicular traffic, a major source of PAH exposure, or the burning of synthetic logs were associated with increased breast cancer incidence. High intake of grilled/barbecued and smoked meat may increase mortality.

Drs. Alfred Neugut and Judith Jacobson, epidemiology, have established several collaborative studies with investigators from the University of the Witwatersrand and Chris Hani Baragwanath Hospital in Soweto, Johannesburg in South Africa to study the interactions between HIV and cancer. In this population, the prevalence of HIV positivity is 20%; studies are ongoing to explore how this affects the presentation, treatment, and survival of breast cancer, prostate cancer, and colorectal cancer.

Collaborative studies by Drs. Santella, Wei-Yann Tsai, biostatistics, and Hui-Chen Wu, environmental health Sciences, with investigators in Taiwan have demonstrated that gene-specific DNA methylation in prospectively collected blood samples is associated with later development of hepatocellular carcinoma.

In a follow-up study of more than 59,000 exposed individuals 10 years after 9/11, Dr. Steven D. Stellman, epidemiology, and his associates at the NYC Department of Health and Mental Hygiene and NYS Department of Health reported that rescue and recovery workers had an 11 percent greater overall cancer risk compared to New York State background rates, and that residents and workers in lower Manhattan experienced an 8 percent increase. The increases for both groups were most noteworthy for cancers of the prostate and melanoma of the skin. Rescue/recovery workers also experienced higher rates of thyroid cancer, while other survivors had higher rates of non-Hodgkin lymphoma and female breast cancer. These findings update those of an earlier paper in JAMA, in which Dr. Stellman and colleagues reported after 7 years of follow-up elevated thyroid and prostate cancer and multiple myeloma among first responders and recovery workers.

In a related paper in Public Health Reports, Dr. Stellman and colleagues validated self-reports of cancer against state cancer registry data; their findings of high specificity and sensitivity provide increased confidence in the validity of self-reports of many other chronic diseases.

Social capital and its implications for health and access to health care among Latinos in the U.S. are not well understood. Dr. Rachel Shelton, Sociomedical Sciences, and colleagues examined associations between social capital and breast and cervical cancer screening adherence among a sample of 394 predominately Puerto Rican and Dominican women attending screening education programs in Buffalo, New York and New York City in 2011-2012. Social capital was higher among Latinas who were older, better educated, insured, and spoke English. A one unit increase in social capital index score was associated with greater adherence to Pap test, clinical breast exam and mammography screening.

Dr. Parisa Tehranifar, epidemiology, was awarded an ROI grant of $2.78 million from the National Institutes of Health/ National Institute on Minority Health and Health Disparities (NIH/NIMHD) to study the impact of disclosure of clinical breast density information in racially diverse populations. Dr. Tehranifar and colleagues plan to enroll and follow a large sample of women to prospectively examine how breast density notification relates to a broad range of screening-relevant psychological outcomes and subsequent screening behaviors.

The Breast Cancer Family Registry (BCFR) (www.bcfamilyregistry.org) consisting of six international sites, has enrolled 14,000 families and ~40,000 individuals, whose data and specimens are available to Program members. It is currently funded through an NCI U01 to support cancer cohorts. Five of the six are sites also participating in studies of young girls from these high-risk families as well as from families at average risk of breast cancer (Lessons in Epidemiology and Genetics of Adult Cancer from Youth, LEGACY, www.legacygirlsstudy.org).   Dr. Mary Beth Terry, epidemiology, and colleagues are following over 30,000 high risk women to evaluate the performance of existing clinical risk assessment tools and to extend these tools for improved discrimination and accuracy.