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School & Program Updates

School & Program Updates

Columbia’s Cancer Prevention Initiatives

Faculty at the Columbia University Mailman School of Public Health are using a variety of perspectives to study cancers, cancer screening, and cancer support options. This includes the effects of environmental exposures and behaviors, and the association of diet and physical activity on cancer treatment, outcomes, and survival rates.

Drs. Mary Beth Terry (epidemiology), Regina Santella (environmental health sciences) Jasmine McDonald (epidemiology) and Lauren Houghton (epidemiology) are studying the influence of behavior, environment and diet on pubertal growth in girls aged 6 to 13 years as part of The LEGACY Girls Study, funded by the National Cancer Institute. The five-year multi-site cohort study is following more than one thousand girls and their parent or guardian, contacting them every six months for information on progression of growth and development, diet and lifestyle factors. Half of the girls come from families with a history of breast cancer, and the other half come from families without breast cancer. The results will provide insight into the relationship between lifestyle factors, puberty and development, and breast cancer risk. Dr. Terry is the principal investigator.

[Photo: Dr. Mary Beth Terry]

The Metropolitan New York Registry of families with a history of breast and/or ovarian cancer is also part of ongoing, multi-site cohort studies led by Drs. Terry (epidemiology) and Santella (environmental health sciences). The data and biospecimens donated by more than 8,000 high-risk families around the world are being used by cancer researchers to identify new avenues for prevention, detection and treatment of breast cancer. Located at Columbia University Mailman School of Public Health, the Registry is one of twelve international registries in the National Cancer Institute’s program of Cancer Family Registries for Breast and Colon Cancer Studies. Their most recent study was published on “Dependence of cancer risk from environmental exposures on underlying genetic susceptibility: an illustration with polycyclic aromatic hydrocarbons and breast cancer.”

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Over 30,000 women and men from nearly 12,000 families from the U. S., Canada, and Australia participate in the Breast Cancer Family Registry, a resource used by researchers around the world to reduce the global impact of the disease.

Dr. Terry is principal investigator.
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Through a grant from the National Institute on Minority Health and Health Disparities (NIMHD), Dr. Parisa Tehranifar (epidemiology) and colleagues examine how the transformation of mammographic density into a clinically actionable information — through sweeping state level legislation that mandate the release of this information to patients — affect breast cancer screening in socially diverse populations. Working with the Avon Foundation Breast Imaging Center in Washington Heights, this study will follow 1,000 women for a year after their mammograms, gauging what they know about breast density, how they feel about their screenings, how well they understand their results, and if they are accessing any additional medical services as a result of their mammogram reports.

In another grant funded by NCI, Drs. Tehranifar and Terry are building on the Sister Study, a prospective national study of over 50,000 women with at least one sister diagnosed with breast cancer at enrollment and has the potential to inform risk stratification, resulting in more precise and risk-based clinical care and surveillance in women with family history of breast cancer.

Through four NIH and NCI funded projects, Dr. Grace Hillyer (epidemiology) is studying strengthening community outreach capacity in a study titled, “Administrative Supplement to Strengthen NCI-Supported Community Outreach Capacity through Community Health Educators (CHE) of the National Outreach Network.” The goal of this research is to educate members of the Upper Manhattan, Washington Heights community about the importance of understanding what is meant by the term “genetics”, why genetics is relevant to their everyday life, and how genetics impact risk for cancer and response to cancer treatment. The NCI Community Oncology Research Program, “Columbia University Minority/Underserved Site (MU/NCORP),” a program through the Herbert Irving Comprehensive Cancer Center, brings cancer prevention clinical trials and cancer care delivery research to the Washington Heights community. Research is focused on addressing the most serious, prevalent cancers and cancer-related problems which disproportionately impact racial/ethnic minorities and underserved populations.

[Photo: Dr. Grace Hillyer]

Funded by the Brain Tumor Foundation, the “Population-based Brain Tumor Detection Study” led by Dr. Hillyer will examine the results of population-based brain MRI scans and assess the prevalence of brain tumors among asymptomatic individuals receiving free screening through the Brain Tumor Foundation “Drive to Early Detection” campaign. The study “Assessment of the lung cancer risk and screening needs among primary care patients in South Africa” seeks to gain an understanding of the clinical need for lung cancer screening among primary care patients (20 percent of whom are HIV positive) with low dose computed tomography in 2 distinct communities in South Africa – Johannesburg, a large urban center, and Kimberley, a rural mining community.

The American Cancer Society awarded Dr. Rachel Shelton (sociomedical sciences) a four-year Research Scholar Grant for advancing understanding of the sustainability of Lay Health Advisor programs centered on cancer screening in African American communities. This grant builds off Shelton’s 8-year partnership with a group of lay health advisors and cancer survivors from the National Witness Project. The grant also builds off of her recently published work in Translational Behavioral Medicine suggesting that contextual, organizational, and role-related factors (e.g. funding, leadership and champions, organizational capacity) may be particularly important in facilitating the long-term implementation of peer-led programs for cancer prevention and screening.

Dr. Daniel Giovenco (sociomedical sciences) and his research team recently collected data on tobacco product promotion from over 800 tobacco retailers across 188 NYC neighborhoods. They documented storefront advertising, product availability, and pricing for known carcinogenic products such as cigarettes, cigars, smokeless tobacco, and hookah, in addition to novel products such as electronic cigarettes and other “vaping” products. In collaboration with the NYC Department of Health and Mental Hygiene, Dr. Giovenco will link this ecological information with geocoded survey data from the NYC Community Health Survey to investigate the relationship between neighborhood-level tobacco retail and residents’ diverse tobacco product use behaviors.

In a study published in the Journal of Immigrant and Minority Health, “Social norms, acculturation, and physical activity among Latina women,” Dr. Ana Abraido-Lanza (sociomedical sciences) and colleagues examined whether occupational physical activity, acculturation, familism, and norms held by family and friends are associated with three types of physical activity:  vigorous and moderate leisure-time physical activity, and resistance training.  The results of interviews with 418 Dominican women indicated that most women reported no vigorous leisure-time physical activity or resistance training and about half reported no moderate activity. This is one of the few studies of Dominican women that explores the association between physical activity and acculturation, and the first study of this particular Latino group that also examined different types of physical activity, including leisure-time physical activity and occupational activity.

[Photo: Dr. Ana Abraido-Lanza]

As part of a collaborative study with epidemiologists from the VA Boston Healthcare System and Boston University School of Medicine, Dr. Jeanne Stellman (health policy and management) and Dr. Steven Stellman (epidemiology) are following a cohort of military and civilian personnel, including racial and ethnic minorities and women, who served in Vietnam during the Vietnam War in order to examine cancer, mental health, and other outcomes in relation to military exposures such as herbicides and combat.

Dr. Peter Muennig (health policy and management) and colleagues explored changes to the urban environment that have the potential to reduce pm 2.5, an important source of lung and other cancers produced by diesel engines. In their study, they estimated the costs and health benefits of burying urban freeways, building parks on top of freeways, and filtering the exhaust for pm 2.5. They found that there are huge benefits — both economic benefits and health benefits — associated with turning major road arteries into parks. Their study appeared in the American Journal of Public Health and is available as an open access document.

Dr. Regina Santella (environmental health sciences) is senior investigator on research that links Aflatoxin B1 exposure and an increased risk of cirrhosis and hepatocellular carcinoma in chronic hepatitis B virus carriers. Results are published in the International Journal of Cancer.

Dr. Manuela Orjuela (environmental health sciences) is a co-author on such studies as “Classical Hodgkin Lymphoma following organ transplantation in children; Dietary Intake and Childhood Leukemia; Socioeconomic status and global variations in the incidence of neuroblastoma; and an analysis of the occurrence of retinoblastoma. She also has presented her findings on sunlight exposure and retinoblastoma, and continuity of oncology care for Central American migrant children in the U.S.