Genetic Susceptibility to Cancer
The prospect that all human genes will be cloned and sequenced in the next decade presents the major challenge of determining how these genes affect our health. Epidemiologists will be responsible for assessing the proportion of specific diseases associated with particular genotypes, and how these genotypes interact with environmental and lifestyle factors in disease causation. Large, population-based cohort studies can be particularly helpful in studying these issues, and we are working with colleagues in the Nurses' Health Studies, Health Professionals Follow-up Study and the Physicians' Health Study, to conduct nested cases-control studies of cancer, cardiovascular disease, diabetes, and osteoporosis. Laboratory collaborators include Karl Kelsey with whom we are studying polymorphisms in carcinogen-metabolizing genes and breast and colon cancer, and Mary-Claire King of the University of Washington with whom we are studying BRCA1 and breast cancer.
Cancer Epidemiology in Women
We are also studying the causes of cancer, particularly breast, colon, and skin cancer in two large prospective cohorts of U.S. nurses. In the Nurses' Health Study I, we are conducting a prospective study of the association of blood organochlorine pollutant levels and risk of breast cancer. In the Nurses' Health Study II, a younger cohort, we are studying breast cancer risk factors, including oral contraceptive use, among mainly premenopausal women.
Prospective Pooling Project
To expand the range of dietary intake observable in any individual cohort, as well as the power to detect small risks, we are pooling the primary data from nine large prospective studies of diet and cancer. We anticipate this will help introduce some consensus in diet and cancer prevention recommendations.
AIDS Studies
We have been conducting studies of risk factors for HIV acquisition in Kenya and Tanzania, and now, in collaboration with Wafaie Fawzi and members of the Department of Nutrition and Muhimbili Medical Center, we are studying the relation of nutritional factors in HIV progression and perinatal transmission.