With predictions of 1.9 million new cancer cases being diagnosed this year, and an estimated nearly 17 million cancer survivors in the population, the cancer burden in the United States is substantial.
Cancer control aims to lessen this burden by reducing the number of people who get cancer, and improving the lives of people who have it and survive it. These goals are realized through cancer control programs, which seek to develop and implement effective strategies to prevent cancer, reduce cancer risk, detect cancers early (when they are likely to be more treatable), improve cancer diagnosis and treatments, and improve the health and well-being of cancer survivors. Cancer control programs use evidence-based initiatives and interventions—that have been tested through research—to prevent and control cancer in the population.
One facet of cancer control research focuses on population health science, a research discipline that looks across the multiple levels of factors that affect human health—such as genetic determinants, environmental risk factors, socioeconomic circumstances and individual health behaviors, as well as health care, policies and outcomes—and uses the information to develop and implement policies, programs and other interventions to improve human health. Population health science research integrates knowledge and tools from multiple disciplines including epidemiology, behavioral science, communication science, biostatistics, health sciences, and outcomes and survivorship.
At UMass Cancer Center, the Cancer Population Health Sciences research program endeavors to investigate the complex multi-level determinants of cancer risk and treatment outcomes to inform the design and implementation of effective cancer screening, prevention, and treatment in health care and public health practice. The program is led by Sarah Cutrona, MD, MPH, professor and Interim Chief of the Division of Health Informatics and Implementation Science in the Department of Population and Quantitative Health Sciences, and Lori Pbert, PhD, professor in the Department of Population and Quantitative Health Sciences and Director of the UMass Center for Tobacco Treatment Research and Training.
Research in the CPHS program is focused on three areas:
Identify and characterize multi-level determinants of cancer risk, treatment, and survival and quality of life outcomes across community and clinical settings in diverse populations.
CPHS researchers are using database mining and cancer epidemiology approaches to identify determining factors of cancer risk and prevention. For example, Mara Meyer Epstein, ScD, is using databases derived from electronic health records (EHRs) to determine trends in cancer screening practices and to study the link between inflammation, immune function and cancer risk. Similarly, Jinying Chen, PhD, is using data mining methods to identify physicians’ EHR use patterns and their relationship with downstream cancer prevention outcomes. Feifan Liu, PhD, has developed DeepGeneMD, a machine learning model to extract information from medical literature to identify relationships between gene mutations and cancer, and is also using deep learning approaches to predict cancer progression and survivability.
Ann Moormann, PhD, MPH, is conducting epidemiology research into how co-infections can drive virus-associated cancers. UMass Amherst researcher Susan Hankinson, ScD, is evaluating novel biomarkers in breast cancer epidemiological research, and developing and validating improved breast cancer risk prediction models. Susan Sturgeon, DrPh, MPH, also a UMass Amherst researcher, is investigating environmental exposures and cancer in women. She is also leading a clinical trial studying whether increased fruit and vegetable intake in lactating women can reduce biomarkers of breast cancer risk.
Develop intervention and implementation science approaches to promote cancer screening and prevention (e.g., tobacco cessation, nutrition and physical activity).
Cancer research has identified a number of lifestyle decisions that people can make to reduce their risk of cancer, such as quitting smoking/tobacco, eating a healthy diet, exercising regularly, and undergoing recommended screenings. Researchers in CPHS aim to facilitate the application of these evidenced-based research findings into routine healthcare practice. A significant focus of the group lies in the use and development of technology-based eHealth (electronic health; electronic processes such as electronic health records and health claims) and mHealth (mobile health; the use of mobile devices, such as a phone or tablet) strategies to support cancer control measures.
Sarah Cutrona, PhD, studies the use of health information technologies to support implementation of cancer control and prevention strategies, and the role of social networks in promoting cancer screening, particularly for breast and colorectal cancer. Mayuko Ito Fukunaga, MD, is studying how the use of technology, such as electronic medical records and educational text messages, can facilitate effective communication between patients and healthcare providers about lung screening. Daniel Amante, PhD, MPH, and Rajani Sadasivam, PhD, are developing technology-based behavioral interventions for smoking/tobacco cessation, a highly preventive measure for lung cancer. They have developed innovative approaches to engage people to quit smoking such as Take a Break, an mHealth-based smoking pre-cessation challenge designed to engage people who are motivated to quit smoking, and Adapt2Quit, a collective intelligence system that provides tailored motivational messages to promote smoking cessation. Edwin Boudreaux, PhD, and Catherine Dubé, EdD, are also studying cancer prevention through tobacco cessation. Jamie Faro, PhD, is studying the use of technology-based patient- and provider-facing strategies to increase physical activity in cancer survivorship.
UMass Amherst researchers Zhenhua Liu, PhD, and Hang Xiao, PhD, are studying the link between nutrition and cancer prevention. Dr. Liu is investigating the interaction of dietary factors, such as B vitamins, in the development of cancer, while Dr. Xiao is identifying health-promoting food components, elucidating their molecular mechanisms, and enhancing their health benefits and chemical stability through novel food processing and nanotechnology.
Research in CPHS also focuses on behavior change and the role of communication to promote cancer prevention through a healthier lifestyle. For example, Lori Pbert, PhD, is developing health behavior change strategies for the prevention and management of cancer that can be integrated into clinical and community practice. Likewise, Judith Ockene, PhD, MEd, MA, is developing tools to assess the quality of physician-delivered interventions to help patients modify behaviors. Research from Kathleen Mazor, EdD, focuses on improving communication in cancer care, including patient-provider communication and comprehension of cancer-related health messaging. Finally, Elise Stevens, PhD, is identifying marketing techniques that promote the use of unhealthy products, such as tobacco, and developing health messages aimed at reducing risk behaviors.
Recruit, train and mentor the next generation of cancer-focused population scientists.
An educational cornerstone of CPHS is the National Cancer Institute (NCI)-funded training program PRACCTIS (Prevention and Control of Cancer, Training for Change in Individuals and Systems). The goal of PRACCTIS is to train predoctoral students and postdoctoral fellows to conduct research that addresses critical cancer prevention, effective health communication, control and care delivery issues across the cancer continuum, including primary prevention, cancer screening, diagnosis, treatment and survivorship. The program is led by Stephenie Lemon, PhD, MS, professor and Chief of the Division of Preventive and Behavioral Medicine in the Department of Population and Quantitative Health Sciences and Co-Director of the UMass Worcester Prevention Research Center, and Judith Ockene, PhD, MEd, MA, professor in the Department of Population Quantitative Health Sciences. PRACCTIS is one of about 20 cancer control-focused institutional training programs in the country.
