Cancer Epidemiology Conference

I attended the lecture series on Gene Environment Interaction in Human Cancer Development at JABSOM. Lecturers from across the country presented on topics from the Impact of Host Susceptibility Factors on Tobacco Carcinogen Metabolism and Lung Cancer Risk to the Interaction between Tobacco Smoking and Genetic Susceptibility on Risk a& Survival of Bladder Cancer. The presentation that I found particularly appropriate to the field of epidemiology was presented by NCI’s, Dr. Nathan Rothman. He presented on the Gene-environment Interactions in Studies of Occupational, Environmental, and Tobacco-related Bladder Cancer. He really just told an investigative story that started with identifying a higher OR of bladder cancers in Northern states in the US. He then went on to explain that at the time they attributed this to varying NAT2 acetylation rates among people in this region of the country. However, it was determined that this could not be the sole cause of such an increased risk. In the end, a multitude of contributing factors from smoking to exposure to aromatic amines which activate/deactivate the p53 gene to an acidic urine environment to nocturia all contributed to this population being at greater risk.

Inside the Journal Club

A lot has happened since starting this blog and as such I have decided to explain everything in two parts. A few weeks ago I attended a Cancer epidemiology Journal Club that reviewed the following research paper and a corresponding newspaper article. The paper entitled, Incidence of Breast Cancer With Distant Involvement Among Women in the United States, 1976 to 2009 by R.H. Johnson, F.L. Chien, and A.B. Bleyer published in February 2013 and its newspaper review Advanced cancer in Young Women by Judy Peres reported that their was an increase in breast cancer incidence in women 25- to 39- years of age. This was based on data collected from SEER 9, SEER 13, and SEER 18, which represent 9.5%, 15%, and 28% of the US population since 1975, 1992, and 2009, respectively. For the most part, incidence rates for localized and regional breast cancers amongst all age groups, young and old, remained constant across the decades. However, in women diagnosed with breast cancers found in distal regions from the primary site, incidence has nearly from 1.53 per 100,000 in 1976 to 2.90 per 100,000 in 2009. In the 25- to 39- year old age group it was also reported that women with tumors that that women with ER+/PR- status (estrogen and progesterone receptor status) displayed a higher annual percent change (8.89) when compared with women with ER+/PR+ status (8.15), women with ER-/PR- status (5.44), and ER-/PR+ status (-0.51).

The paper raised some healthy discussion in the group. The debate included possible exposure and risk factors that people in the community may have encountered. They then went on to offer evidence of whether their proposed factors matched up with the timeline of disease. In addition, errors in the analysis of the data were discussed. Suggestions included: misidentification of a tumor’s primary site in older records, changing standards in stage classification, and the risk of drawing such damning conclusions when dealing with such a small sample size of young women with breast cancer.