Washington University in Saint Louis
St. Louis, Missouri
Niess-Gain Professor of Surgery and Professor of Medicine
Associate Director Prevention and Control
Alvin J. Siteman Cancer Center
Deputy Director, Institute for Public Health
Understanding how early life behaviors influence future breast cancer risk and refining risk assessment methods.
Improved breast cancer risk estimates are urgently needed to deliver personalized prevention. In his continued efforts to study the relationship between benign breast disease and risk of breast cancer, Dr. Colditz and his team are analyzing archived mammograms from routine screening of large cohorts of patients over time in hopes to develop refined models to predict when benign breast disease evolves to become breast cancer. These improved methods should identify high-risk women earlier and reassure women remaining at low risk.
In the past year, Dr. Colditz has been evaluating how mammographic data can be used to monitor the progression of breast cancer. He and his team have shown that while breast density generally decreases with age, the rate of density decrease was significantly slower in a breast that was later diagnosed with cancer compared to breasts that remained cancer-free. They are currently collecting and analyzing mammogram data from 10,000 women to develop a model to predict cancer development.
Building on their findings, the team will further refine their model to predict risk of developing second lesions in patients with ductal carcinoma in situ (DCIS). They will create a dynamic risk prediction model using their large dataset of mammograms that can be updated as new mammograms are gathered to reflect the patient’s latest prognosis. Lastly, they plan to develop a model to include benign breast legions, DCIS, and invasive breast cancer to better understand how risk factors over the entire lifetime drive or protect against the progression of DCIS to invasive breast cancer.
Graham A. Colditz, MD 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, based on 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.
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