Graham A. Colditz, MD, Dr.PH

2009-2010 BCRF Project:
The density of tissue on a mammogram is one of the strongest risk factors for breast cancer, yet we know little about the factors that influence the level of breast density. In aim 1, Dr. Colditz and colleagues are analyzing genetic markers that may give us insight to factors that predict breast density. This study uses data form the Nurses' Health Study.

In their second aim, they are assembling a series of cases of ductal carcinoma in situ (DCIS) to study the markers of cell function that might help predict recurrence or development of invasive breast cancer. This study is assembling cases from the archives at Washington University School of Medicine and from the Nurses' Health Study. The researchers have approximately 150 cases of DCIS in which women have subsequently developed invasive breast cancer. Growing evidence points to exposures early in life, including childhood and adolescence as important for risk accumulation as the breast tissue develops in adolescent girls.

In a third aim, they are exploring early life exposures and risk of benign breast disease (a marker of increased risk of subsequent breast cancer) among a cohort of 6,000 women. They have followed these women since 1996 when they were 9 to 14 years of age. The women have provided details of their diet, physical activity, weight and height during adolescence, and 69 have reported a diagnosis of benign breast disease. Being heavier and later age at onset of menstrual cycles reduce the risk of benign breast disease.

In the upcoming year, the Colditz team proposes to continue to evaluate new markers for risk of progression from DCIS to invasive breast cancer. This may identify a subset of women with DCIS who are at increased risk of progression and change their management. The researchers will also evaluate adolescent diet and risk of benign breast disease (a precursor lesion for breast cancer). While much evidence points to early life exposures as important for breast cancer risk, such as radiation among atomic bomb survivors, there is little data on actual diet or physical activity in this time frame for evaluation of risk for precursors or malignant breast lesions.

The scientists now propose to evaluate fiber and nut consumption in two unrelated research projects. This project proposes analysis of existing data to determine whether early life exposures (such as diet in adolescent years) increase risk of developing BBD. In addition, they will assemble an independent data set that has already had rigorous pathology classification by Dr. D. Craig Allred to evaluate adolescent diet and risk of BBD in middle-aged women. This study should establish an approach to adolescent exposure assessment in the clinical setting and facilitate additional routine collection of such data preferably prior to any diagnostic procedure classifying women as cases (BBD) or controls (no important lesion). These findings could identify new strategies for prevention.

Bio:
Dr. Colditz was born in Australia and received his B.Sc. and medical degree from the University of Queensland, Australia, and his M.P.H. and Doctorate in Public Health from Harvard University School of Public Health. In 1990 he was elected a Fellow in the Australian Faculty of Public Health Medicine, Royal Australasian College of Physicians.

For 25 years Dr. Colditz was at Harvard University where he served in a number of positions. From 1996-2006 he was principal investigator on the Nurses' Health Study, a longitudinal study established in 1976, of 121,701 nurses, investigating risk factors for major chronic diseases in women. He established and was the founding principal investigator on the Growing Up Today Study relating diet and lifestyle of 16,883 adolescents ages 9 to 14 at entry to their growth and health outcomes. In 1998, he was promoted to full professor of medicine at Harvard Medical School and professor of epidemiology at the Harvard School of Public Health.

Dr. Colditz was also associate director of Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School from 2005-2006. He was director of the Harvard Center for Cancer Prevention at HSPH and within the Dana-Farber/Harvard Cancer Center he was deputy associate director for shared resources and leader of the Cancer Epidemiology Program.

With longstanding interest in the causes and prevention of chronic disease, particularly among women, Dr. Colditz has evaluated numerous lifestyle factors, documenting that current use of postmenopausal hormone therapy increases the risk of breast cancer. He has developed statistical models to more accurately classify levels of risk for several cancers. Other areas of his expertise include tobacco and obesity in relation to cancer. He also documented that smoking increases risk of stroke and total mortality among women, and that weight gain increases the risk of diabetes. He has focused extensively on the validation of self-report information for use in large scale epidemiologic studies and refined diet assessment tools for use in public health settings such as WIC. He has devoted much effort to the application of scientific advances in cancer prevention to broader population programs working with the American Cancer Society and the Massachusetts Cancer Control Program. He also developed the website, www.yourdiseaserisk.wustl.edu, to communicate tailored prevention messages to the public.

Dr. Colditz has filled many professional leadership roles. He served as editor-in-chief of the journal Cancer Causes and Control from 1998 to 2006. In 2004, Dr. Colditz was awarded the American Cancer Society-Cissy Hornung Clinical Research Professorship. He has contributed to reports of the Surgeon General on Tobacco and Health, and served on committees of the National Academies of Science addressing Health Effects of exposure to herbicides in Vietnam Veterans (1992-1995 and 1995-1996), and the Committee to Assess Potential Health Effects from Exposure to Pave Paws Low-Level Phased Array Radiofrequency Energy. He also contributed chapters to the report from the National Academy of Science, "Fulfilling the Potential of Cancer Prevention and Early Detection".

He has served on the National Cancer Institute scientific peer review committees; Subcommittee E (program projects) and Subcommittee A (Cancer Center Support Grants); and is currently a member of the Center for Scientific Research EPIC study section. In October 2006 on the basis of professional achievement and his commitment to public health, he was elected to membership of the Institute of Medicine, an independent body that advises the U.S. government on many issues affecting public health.

Dr. Colditz is a highly cited medical researcher. He has edited numerous books on cancer prevention and health promotion, including the Encyclopedia of Cancer in Society.