Graham A. Colditz, DrPH, MD, MPH
St. Louis, Missouri
Niess-Gain Professor of Surgery and Professor of Medicine
Chief, Division of Public Health Sciences, Department of Surgery
Associate Director Prevention and Control
Alvin J. Siteman Cancer Center
Deputy Director, Institute for Public Health
To understand how early life behaviors influence future breast cancer risk and to refine risk assessment methods.
It is estimated that nearly a third of breast cancers could be prevented by lifestyle choices, particularly those that support and maintain a healthy weight, including diet and exercise. Dr. Colditz’s research has focused on how those choices (including diet, alcohol use, exercise, and sleep), when made during childhood and adolescence, impact a person's future risk of breast cancer. His findings showed that higher nut intake in adolescence (including peanut butter) was associated with lower subsequent risk of benign breast disease and this protection persisted among women who drank alcohol. Adolescents who drank alcohol in high school or had a low intake of fiber almost doubled their risk of benign breast disease. This risk, however, could be attenuated by consuming nuts. His studies may lead to strategies that promote a healthy lifestyle in young adults to reduce the risk of breast cancer. In his continued efforts to study the relationship between benign breast disease and risk of breast cancer, Dr. Colditz and his colleagues are analyzing mammograms accumulated from routine screening of large cohorts of patients over time and hope to develop refined models to predict when benign breast disease evolves to become breast cancer—these studies will improve risk management and inform personalized prevention strategies.
Dr. Colditz continues to examine how modifiable factors such as diet affect the rate of transition between breast cancer states such as the progression from benign breast disease to breast cancer. In the past year, his team has been evaluating how mammographic data can be used to monitor this progression. They have assembled over 9,000 mammograms obtained from screening of 954 women for over ten years, analyzed the images, and applied several sophisticated modeling techniques. They have demonstrated, for the first time, that analysis of repeated mammograms over 10 years can detect a divergence in breast density more than 6 months prior to a breast cancer diagnosis.
Building on their findings, the team will expand their analysis and include a questionnaire and genetic marker assessment to further refine their risk prediction model, while also working to enhance the models to predict risk of ductal carcinoma in situ (DCIS) and triple-negative breast cancer. These studies may provide insight into the dynamic transition that occurs as normal breast tissue evolves to become breast cancer. Moreover, Dr. Colditz results will demonstrate that mammograms that are routinely available can be used to understand an individual’s personalized risk over time.
Graham A. Colditz, DrPH, MD, MPH is an epidemiologist and public health expert with a longstanding interest in the causes and prevention of chronic disease, particularly among women. With a commitment to identifying strategies for prevention of breast cancer, Dr. Colditz studies benign breast disease and other markers for risk of breast cancer. Dr. Colditz described the increase in risk of breast cancer with use of combined estrogen plus progestin therapy and a significant increase in risk with increasing duration of use. Mortality from breast cancer was also elevated among current users (NEJM 1995). These data were confirmed by the WHI. He documented in prospective data the importance of proliferative benign lesions and risk of subsequent breast cancer (JAMA 1992; NEJM 1999) and the potential for childhood and adolescent diet, alcohol, and adiposity to modify risk of premalignant and invasive breast cancers. His research continues to focus on this time period in women’s lives and prevention of breast cancer. He is among the most highly cited medical researchers in the world.
Dr. Colditz developed the award-winning Your Disease Risk website (www.yourdiseaserisk.wustl.edu) which communicates tailored prevention messages to the public. He has published over 1100 peer-reviewed publications, six books and contributed to reports for the National Academy of Medicine and National Academies of Science.
Dr. Colditz has served in numerous leadership roles. He was the editor-in-chief of the journal Cancer Causes and Control and has contributed to reports of the Surgeon General on Tobacco and Health. In October 2006, on the basis of professional achievement and commitment to public health, Dr. Colditz was elected to membership of the Institute of Medicine (now National Academy of Medicine), an independent body that advises the U.S. government on issues affecting public health. He received the ACS Medal of Honor in 2011, the AACR-AACS award in 2012, and the ACSO-ACS award in 2014, all recognizing his research in cancer prevention and control.
The Macy's Award
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