Titles and Affiliations
John Snow Professor of Epidemiology
Research area
Assessing the utility of biomarkers to improve breast cancer risk assessment and predict response to preventive treatment.
Impact
Tamoxifen and some aromatase inhibitors are known to reduce the risk of breast cancer in some, but not all, women who are at high risk. His earlier studies found that postmenopausal women with low levels of estrogen in the blood received little benefit from the aromatase inhibitor anastrozole. Lifetime exposure to estrogen is a known risk factor for the development of breast cancer, yet circulating estradiol, the most potent form of estrogen, is not routinely measured or integrated into breast cancer risk prediction models. Likewise, the role of estradiol levels in predicting response to preventive therapy with aromatase inhibitors. Dr. Cuzick aims to determine whether blood hormone levels can be used to better identify women at high risk of ER-positive breast cancer and to guide the use of preventive drugs. He seeks to develop improved approaches for communicating risk and prevention strategies, with the ultimate goal of creating a more precise tool for breast cancer risk prediction and prevention.
Progress Thus Far
Dr. Cuzick and his team have analyzed data from thousands of participants, including not only estradiol levels but several factors that contribute to increased risk. The team is using these data to accurately integrate estradiol level into the Tyrer-Cuzick model—a risk model developed by Dr. Cuzick and Dr. John Tyrer that estimates a woman’s risk of developing breast cancer within the next ten years and over her lifetime by considering various factors such as age, family history of breast or ovarian cancer, personal history of breast cancer or biopsies, BRCA gene mutations, and other risk factors.
What’s next
Dr. Cuzick and his team will continue to validate the updated Tyrer-Cuzick model that includes estradiol levels to improve risk prediction. The team is now analyzing initial results to determine whether circulating estradiol level can predict the response to tamoxifen and the anastrozole in a preventive setting.
Biography
Jack Cuzick, PhD is the John Snow Professor of Epidemiology at Queen Mary, University of London. He holds a PhD in Mathematics and has previously worked at Oxford University and Columbia University, New York.
His current interests are in cancer epidemiology and clinical trials, with special interest in prevention and screening. He is currently Chairman of the International Breast Cancer Intervention Study (IBIS) Steering Group and the ATAC trial. He has worked extensively in breast cancer and was the first to report the effect of tamoxifen on contralateral tumors as an indicator of its potential chemo preventive role and has demonstrated that a change in mammographic breast density on endocrine treatment is a biomarker for its effectiveness. He is involved in studies on the use of HPV assays for cervical screening, the use of flexible sigmoidoscopy for colorectal cancer screening and markers for the behavior of early prostate cancer.
Dr. Cuzick is a Fellow of the Academy of Medical Sciences, the Royal Statistical Society, the Institute of Mathematical Statistics, the Royal Society, and an Honorary Fellow of the Royal College of Physicians and was awarded a CBE by the Queen in 2017. In 2007, he was chosen by Thompson Scientific as one of the twelve hottest researchers in all of science and this has been re-awarded for several years thereafter. He was awarded the AACR Cancer Prevention Prize in 2012. He is the author of more than 650 peer-reviewed papers and has published in all the major medical journals.
