Theme 1: Cancer Etiology
Focused on novel approaches to better understand the causes and risks of cancer to inform interventions.
Laura Fejerman, PhD and Elad Ziv, MD, PhD discovered variations in susceptibility to breast cancer in a genome-wide association study (GWAS) of Latinas using Ancestral Informative Markers that revealed that Native Americans are at highest risk. Their work was published in Nature Communications and covered by the New York Times, Washington Post, and TIME. Another example was work to assess the etiology of postmenopausal breast cancer using a novel complex modeling approach. Hiatt with Allan Balmain, PhD, FRS; Dejana Braithwaite, MS, PhD; Mark Moasser, MD; and Zena Werb, PhD took a transdisciplinary approach to incorporate evidence of both the strength of association and the quality of the evidence, operationalizing it through a mathematical simulation; this work was published in Cancer Epidemiology, Biomarkers, and Prevention.
Theme 2: Cancer Prevention
Focuses on developing and testing interventions to translate what is known about cancer prevention into practice.
Highlights include two randomized controlled trials (RCTs) conducted by Tung Nguyen, MD; Janice Tsoh, PhD; Rena Pasick, DrPH; and Susan Stewart, PhD (UC Davis) showing that lay health workers (LHWs) were highly effective in promoting colorectal cancer (CRC) screening among Chinese and Vietnamese Americans, two large populations in the HDFCCC catchment area. This work led to an NCI-funded grant with UC Davis, UCLA, and University of Hawaii that successfully tested similar approaches among Filipino, Hmong, and Korean Americans. Another high-impact study was led by Michael Potter, MD and Judith Walsh, MD, MPH, who created and studied a highly innovative and effective FLU-FIT program, an NCI Research-Tested Intervention Program, which combined the delivery of CRC screening with annual flu shot campaigns. They successfully implemented FLU-FIT at Kaiser Permanente, a major healthcare organization in the catchment area with over three million members, in an RCT with over 6,200 participants. ACS has adopted and branded FLU-FIT, and ACS staff and others have promoted and implemented it in community health centers and hospitals in nearly all 50 states and in tribal and migrant worker communities. For cervical cancer screening, George Sawaya, MD led a national effort to revise recommendations, authored the American College of Physicians’ guidelines, and was a key contributor to the US Preventive Services Task Force (USPSTF) recommendations.
Theme 3: Cancer Treatment and Survivorship
Addresses crucial challenges in the care of cancer patients and survivors.
Eleni Linos, MD, DrPH and Mary-Margaret Chren, MD contributed to an important emerging area, over-diagnosis of cancer, by providing guidelines in a JAMA article on the diagnosis of basal cell carcinoma among patients with limited life expectancy. Michael Rabow, MD, a pre-eminent researcher in symptom management and palliative care, along with colleagues from Roswell Park, Moffitt, and Stanford Cancer Centers, surveyed 22 cancer centers in the National Comprehensive Cancer Network (NCCN) and found that most provided palliative care in a setting where demand exceeded capacity, and that opportunities exist to expand palliative care for patients with hematologic malignancies. Anna Nápoles, MPH, PhD showed that a community-based, translational stress management program delivered by peer educators improved health-related quality of life in Spanish-speaking Latinas with breast cancer.
The San Francisco Cancer Initiative (SF CAN; http://www.sfcancer.org/), created in 2016 and described in the Director’s Overview and the COE, is the HDFCCC’s most ambitious effort to address cancer control in the heart of the catchment area through collaborative interventions with communities, government, and healthcare providers. CC Program members are prominent leaders within SF CAN, with Hiatt being the overall faculty lead; four of the five Task Forces are led by CC Program members: Breast (Fejerman); Colorectal (Potter and Ma Somsouk, MD, MAS); Liver (Nguyen); and Prostate (Pasick and Nynikka Palmer, DrPH). Important interactions have been created via the Tobacco Task Force with the TO Program led by Stanton Glantz, PhD and Joseph Guydish, PhD. SF CAN is currently funded by a philanthropic gift to the HDFCCC and will serve as an exciting population laboratory for the CC Program to create, innovate, implement, and disseminate research.