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Cancer arises in predictable patterns within human populations determined in part by an individual’s constitution and exposure to harmful and protective agents. The overarching goal of the Cancer Epidemiology (CE) Program is to reduce the cancer burden through identification and confirmation of biological factors affecting carcinogenesis across the cancer continuum that contribute to disease development, progression, and outcomes, and to exploit learned knowledge to inform advances in clinical and public health practice.

CE members use robust methodologic and analytic approaches incorporating a broad array of biomarkers and integrative methods to conduct important population-level, cancer-relevant research. Our research encompasses three broad aims that often directly addresses cancers heavily impacting Moffitt’s catchment area and is conducted with an orientation toward understanding biological influences of cancer disparities.

 We discover inherited susceptibility markers of cancer risk, determine their function, and leverage this information for precision prevention. Program members engage in research to discover and validate inherited genetic markers of cancer risk and to understand the complex interplay among these markers and environmental factors. These research activities are often conducted within large cancer consortia in which multiple CE members serve in leadership capacities. CE members also conduct investigations to unravel the role of identified genetic loci in carcinogenesis and are at the forefront of functional research in the post-GWAS era. Efforts are ongoing to understand the complex effects imparted by genetic susceptibility to melanoma, lung and ovarian cancers, as well as brain, breast, prostate, and testicular germ cell cancers.

We identify and validate acquired biomarkers affecting the cancer continuum and use this knowledge to develop actionable cancer prevention strategies. Understanding how non-germline endogenous molecular markers and exogenous exposures and their biological markers influence cancer can provide insight into mechanisms influencing the trajectory of disease. Research focusing on acquired biomarkers can inform development of innovative strategies to prevent cancer or disrupt its natural history. Program members investigate how infectious agents, such as HIV and human papillomavirus (HPV), common medications (e.g., aspirin), and biologics (e.g., curcumin) contribute to cancer etiology. Translational research in this area takes many forms, including chemoprevention trials of prostate and lung cancers as well as pharmaceutical and federally-sponsored trials of the enhanced HPV vaccine to reduce the burden of HPV-related cancers.

We investigate features of tumors and premalignant conditions that influence early detection, progression, and outcomes and capitalize on these findings to inform novel clinical approaches. CE members incorporate a variety of measures derived from tumors and otherwise normal tissue with early carcinogenic changes to identify individuals at increased risk for disease development or progression with a goal to develop novel strategies for disease interception. CE members seek to develop prognostic markers for prostate cancer valid for use in underrepresented minority populations. Imaging data alone or in combination with other biomarkers are leveraged to distinguish indolent early pancreatic and lung lesions from aggressive phenotypes in need of immediate clinical intervention. CE members develop and apply novel methods to process digital mammography to more accurately determine risk of breast cancer; they also investigate the relationship of clonal hematopoiesis of indeterminate potential to hematological malignancy risk and outcomes.