Integrative Cancer Epidemiology—The Next Generation

Spitz, Margaret R.; Caporaso, Neil E.; Sellers, Thomas A.

doi:10.1158/2159-8290.cd-12-0424

Cited by 29 publications

(15 citation statements)

References 27 publications

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“…Advances in technology have created an environment where practitioners, researchers, as well as members of the public can access such epidemiologic information almost instantaneously. However, the large number of epidemiologic studies being published, often with seemingly inconsistent or conflicting findings, likely leads to confusion among decision makers and the general public (29). Social media and the increase in communication sources and channels might compound this challenge (and opportunity) even further (30).…”

Section: Resultsmentioning

confidence: 99%

Charting a future for epidemiologic training

Brownson

Samet

Chavez

et al. 2015

Annals of Epidemiology

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Purpose To identify macro level trends that are changing the needs of epidemiologic research and practice and to develop and disseminate a set of competencies and recommendations for epidemiologic training that will be responsive to these changing needs. Methods There were three stages to the project: 1) assembly of a working group of senior epidemiologists from multiple sectors, 2) Identifying relevant literature, and 3) conducting key informant interviews with 15 experienced epidemiologists. Results Twelve macro trends were identified along with associated actions for the field and educational competencies. The macro trends include: 1) “Big Data”/ informatics, 2) the changing health communication environment, 3) the Affordable Care Act/health care system reform, 4) shifting demographics, 5) globalization, 6) emerging high throughput technologies (“omics”), 7) a greater focus on accountability, 8) privacy changes, 9) a greater focus on “upstream” causes of disease, 10) the emergence of translational sciences, 11) the growing centrality of team and trans-disciplinary science, and 12) the evolving funding environment. Conclusion Addressing these issues through curricular change is needed to allow the field of epidemiology to more fully reach and sustain its full potential to benefit population health and remain a scientific discipline that makes critical contributions to ensuring clinical, social, and population health.

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Section: Resultsmentioning

confidence: 99%

Charting a future for epidemiologic training

Brownson

Samet

Chavez

et al. 2015

Annals of Epidemiology

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“…Spitz et al 379 have used the term “integrative epidemiology” to describe an integration of molecular analyses (on exposures and tumors) into epidemiology. Integrative epidemiology encompasses MPE and conventional molecular epidemiology.…”

Section: Note Added In Proofmentioning

confidence: 99%

Molecular pathological epidemiology of epigenetics: emerging integrative science to analyze environment, host, and disease

et al. 2013

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Epigenetics acts as an interface between environmental / exogenous factors, cellular responses and pathological processes. Aberrant epigenetic signatures are a hallmark of complex multifactorial diseases, including non-neoplastic disorders (e.g., cardiovascular diseases, hypertension, diabetes mellitus, autoimmune diseases, and some infectious diseases) and neoplasms (e.g., leukemias, lymphomas, sarcomas, and breast, lung, prostate, liver and colorectal cancers). Epigenetic signatures (DNA methylation, mRNA and microRNA expression, etc.) may serve as biomarkers for risk stratification, early detection, and disease classification, as well as targets for therapy and chemoprevention. DNA methylation assays are widely applied to formalin-fixed paraffin-embedded archival tissue specimens as clinical pathology tests. To better understand the interplay between etiologic factors, cellular molecular characteristics, and disease evolution, the field of “Molecular Pathological Epidemiology (MPE)” has emerged as an interdisciplinary integration of “molecular pathology” and “epidemiology”, with a similar conceptual framework to systems biology and network medicine. In contrast to traditional epidemiologic research including genome-wide association studies (GWAS), MPE is founded on the unique disease principle; that is, each disease process results from unique profiles of exposomes, epigenomes, transcriptomes, proteomes, metabolomes, microbiomes, and interactomes in relation to the macro-environment and tissue microenvironment. The widespread application of epigenomics (e.g., methylome) analyses will enhance our understanding of disease heterogeneity, epigenotypes (CpG island methylator phenotype, LINE-1 hypomethylation, etc.), and host-disease interactions. MPE may represent a logical evolution of GWAS, termed “GWAS-MPE approach”. Though epigenome-wide association study attracts increasing attention, currently, it has a fundamental problem in that each cell within one individual has a unique, time-varying epigenome. This article will illustrate increasing contribution of modern pathology to broader public health sciences, which attests pivotal roles of pathologists in the new integrated MPE science towards our ultimate goal of personalized medicine and prevention.

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“…A number of conceptual frameworks have been proposed that integrate information across levels of disease etiology, including the “web of disease” of MacMahon and Pugh (19), the “wheel” of Mausner et al (20), “systems epidemiology”(21), and more recent models of multifactorial etiology ((22-27), Multilevel approaches are generally characterized by three main levels: 1) macro-environment, referred to elsewhere as “eco-level” (23, 24); 2) individual; and 3) biology (Table 1). Each of these levels is further characterized by sub-levels (Table 1) that define domains of variables involved in cancer etiology or outcomes.…”

Section: Overview Of Current Multilevel Approachesmentioning

confidence: 99%

Bridging the Gap between Biologic, Individual, and Macroenvironmental Factors in Cancer: A Multilevel Approach

Lynch

Rebbeck

2013

Cancer Epidemiology, Biomarkers &Amp; Prevention

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To address the complex nature of cancer occurrence and outcomes, approaches have been developed to simultaneously assess the role of two or more etiological agents within hierarchical levels including the: 1) macro-environment level (e.g., health care policy, neighborhood, or family structure); 2) individual level (e.g., behaviors, carcinogenic exposures, socioeconomic factors and psychological responses); 3) biological level (e.g., cellular biomarkers and inherited susceptibility variants). Prior multilevel approaches tend to focus on social and environmental hypotheses, and are thus limited in their ability to integrate biological factors into a multilevel framework. This limited integration may be related to the limited translation of research findings into the clinic. We propose a “Multi-level Biological And Social Integrative Construct” (MBASIC) to integrate macro-environment and individual factors with biology. The goal of this framework is to help researchers identify relationships among factors that may be involved in the multifactorial, complex nature of cancer etiology, to aid in appropriate study design, to guide the develop statistical or mechanistic models to study these relationships, and to position the results of these studies for improved intervention, translation, and implementation. MBASIC allows researchers from diverse fields to develop hypotheses of interest under a common conceptual framework, to guide transdisciplinary collaborations, and to optimize the value of multilevel studies for clinical and public health activities.

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Integrative Cancer Epidemiology—The Next Generation

Cited by 29 publications

References 27 publications

Charting a future for epidemiologic training

Charting a future for epidemiologic training

Molecular pathological epidemiology of epigenetics: emerging integrative science to analyze environment, host, and disease

Bridging the Gap between Biologic, Individual, and Macroenvironmental Factors in Cancer: A Multilevel Approach

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