Titles and Affiliations
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
Research area
Understanding how early life behaviors influence future breast cancer risk and refining risk assessment methods.
Impact
Breast cancer incidence is rising in those under age 50 which may mean that early life, adolescent, and young adult exposures can drive this increase in risk. Dr. Colditz hopes to define modifiable risk factors from childhood, adolescence, and early adult years that may be associated with breast cancer diagnosis before age 50. His recent research has focused on using breast biopsies from a diverse population of women with ductal carcinoma in situ (DCIS) to predict future risk of breast cancer. In addition his team will examine diet, activity, height, and other markers of energy balance in relation to breast cancer risk using data from the Nurses’ Health Study II and Washington University database. Results from these efforts can inform care for all women.
Progress Thus Far
Dr. Colditz and his colleagues have shown that age-specific five-year risk estimates derived from screening images can be used to guide how frequently individual women should be screened. Dr. Colditz is now refining approaches to risk prediction and classification in younger women to focus on breast cancer diagnosed before age 50. His team is using prospective data from Nurses’ Health Study II and Washington University.
What’s next
Dr. Colditz is now working to construct a unique risk score he’s calling HERS (H&E Risk Score) that can indicate the likelihood of benign lesions or DCIS progressing to invasive breast cancer. Further, his team will quantify absolute risk of subsequent breast events after DCIS using the available databases as well as identify molecular classifiers of high-risk vs. very-low-risk DCIS. This work involves incorporating mammogram image-based risk and histologic features of breast biopsy and will form the foundation for developing clinically actionable prediction model for women with benign breast lesions to better align with risk reduction guidelines—In addition, Dr. Colditz and his team will integrate classical pathology, deep-learning whole-slide-imaging, and molecular markers e on benign breast disease to improve prediction of subsequent breast cancer in younger and racially diverse women. Examining diet, activity, height, and other markers of energy balance in relation to breast cancer risk will round out the picture and provide insights into potentially actionable pathways for breast cancer development and prevention.
Biography
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.
