My major area of research and teaching is cancer epidemiology. I am the Director of the Cancer Epidemiology and Cancer Prevention Program (Area of Interest) within the Department of Epidemiology here at the Harvard T.H. Chan School of Public Health (HSPH). In addition, I am Deputy Associate Director for Population Science, Cancer Epidemiology Program at Dana-Farber/Harvard Cancer Center (DF/HCC), as well as the Director of Strategic Research Partnerships at the American Cancer Society.
After receiving my doctoral degree in epidemiology at the Harvard T.H. Chan School of Public Health (formerly the Harvard School of Public Health), I trained as a post-doctoral fellow in cancer epidemiology at the Karolinska Institutet, Sweden. At the Karolinska, I gained expertise in using nationwide health registries to examine cancer etiology and formed a long-term partnership with epidemiology colleagues in the Nordic countries. Since 2012, my primary faculty appointment has been at the Harvard Chan School, where my research uses integrative molecular epidemiology approaches within cohorts in the United States and globally to investigate research questions focused on cancer etiology, mortality, and survivorship. I serve as co-Principal Investigator for the Health Professionals Follow-up Study as well as IRONMAN (see below). Below is a summary of some major areas of interest.
I am the founding co-PI of this global disease registry of 5,000 men with advanced prostate cancer (https://ironmanregistry.org/
) and serve on the IRONMAN executive committee. We are enrolling men with advanced prostate cancer currently in 11 countries. The goal of this registry is to understand patterns of care for men with advanced prostate cancer, to identify optimal treatment sequences that improve survival and quality of life, as well as to identify biomarkers for subgroups of men who will respond well (or poorly) to specific therapy combinations. Another major initiative within IRONMAN is the Diversity Working Group, with the aim of recruiting a diverse patient population. The study is collecting information on treatments, demographics, clinical, lifestyle information, prospective biorepository, survival and patient-reported clinical outcomes.
I am on the Executive Committee for the Transdisciplinary Prostate Cancer Partnership (ToPCaP
), an international, multidisciplinary effort whose objective is to integrate prostate cancer tissue biomarkers to address questions in etiology, prognosis and treatment. The projects are undertaken in concert with the DF/HCC SPORE in Prostate Cancer, for which I lead the Population Science project and an active member of the leadership team. This research aims to use biomarkers to examine molecular subtypes of cancer, identify biomarkers of prognosis, as well as understand mechanisms underlying the link between risk factors and cancer incidence.
In the United States alone, more than 17 million individuals are cancer survivors. I am interested in epidemiological approaches to investigate factors to improve cancer survivorship. I am actively involved in several international studies of physical activity interventions that could improve survival, enhance the efficacy of therapeutic interventions, as well as improve overall health and quality of life would provide maximum benefit to men. I serve on the Scientific Advisory Committee for a global exercise intervention among men with metastatic prostate cancer funded by the men’s health organization, Movember. Within the IRONMAN registry, I am leading a number of studies to understand the trajectory of quality of life in men with advanced prostate cancer, and also to explore racial disparities in survivorship.
Disruption of the circadian system has been hypothesized to increase cancer risk, either because of direct disruption of the molecular machinery generating circadian rhythms or disruption of parameters controlled by the internal clock such as melatonin levels or sleep duration. As a primary investigator, I have led studies using integrative molecular epidemiology approaches to investigate circadian disruption as measured by questionnaire data, inherited genetic variants, and urinary biomarkers for prostate cancer, with a focus on advanced and lethal disease. To date, this body of work has demonstrated in U.S. and Icelandic cohorts that disrupted sleep, genetic variants in circadian rhythm genes, and low melatonin levels are all key risk factors for advanced prostate cancer. I am PI of a recently funded grant to investigate circadian disruption and prostate cancer within the Multiethnic Cohort study.
I am on the executive committee of the Nordic Twin Study of Cancer (NorTwinCan
), a population-based cohort of 300,000 twins from Sweden, Norway, Denmark and Finland. The unique disease registers in the Nordic countries have allowed us to link data from the nationwide twin registers with cancer, mortality and disease registers, as well as questionnaire data collected on the twins. This unique population has led to a detailed understanding of the familial risk and heritability of various cancers, as well as to examine the relative contribution of genetic and environmental factors in cancer survival.
Given the unprecedented COVID-19 pandemic, my research interests have turned to examining the potential link and impact of COVID-19 and cancer. In collaboration with colleagues from Memorial Sloan Kettering Cancer Center, Fred Hutchinson Cancer Institute, and Johns Hopkins, we published a review article describing TMPRSS2, the most commonly altered gene in prostate cancer, which is also a necessary gene for the uptake of SARS-CoV2 (the virus that causes COVID-19) as well as other coronaviruses and influenza viruses into cells (Cancer Discovery 2020). I also collaborated with colleagues from Wuhan, China to investigate whether cancer patients experienced increased disease severity from COVID-19 compared to infected individuals without cancer. With colleagues from Brigham and Women’s Hospital and Dana-Farber Cancer Institute, I am modeling whether delays in cancer care that have occurred due to COVID-19 will lead ultimately to worse survival outcomes for cancer patients down the road. We are also exploring the impact of COVID-19 for patients with advanced prostate cancer within the IRONMAN registry.
I am passionate about teaching and mentoring. I serve as the Faculty Director for the Epidemiology Master’s in Science Program and also serve on the department’s educational committee. I am course instructor of Epidemiology of Cancer (EPI213) together with Ed Giovannucci. For three years, I co-led a two-week bootcamp course at HMS entitled the Molecular Pathology and Epidemiology of Cancer for the graduate students, and this has resulted in a textbook Molecular Pathology and Epidemiology of Cancer.
I served as a faculty mentor for the T32 Cancer Epidemiology training grant and the Quantitative Sciences for Cancer Research at HSPH. Since 2012, I have served as a faculty member for the American Association for Cancer Research Integrative Molecular Epidemiology Workshop
, and in 2016 joined as co-Director . Additional mentoring activities include formal mentoring of doctoral and MPH students at HSPH – including in epidemiology, environmental health and biostatistics, research mentoring of numerous clinical fellows in urology, medical oncology, and radiation oncology at the Harvard teaching hospitals and the DF/HCC, creating educational opportunities, mentoring and career development for students and fellows through my role as head of the cancer epidemiology track at HSPH. Finally, I have spearheaded a number of efforts to support early-stage investigators in cancer population sciences through my role at the DF/HCC.
Education and Training
Postdoctoral Fellowship, 2003-2004 Karolinska Institutet
ScD, 2003, Harvard School of Public Health
MPH, 1998, Boston University School of Public Health
Other Affiliations and Leadership Roles
- Director, Cancer Epidemiology (Area of Interest), Department of Epidemiology, HSPH
- Deputy Associate Director for Population Science, Cancer Epidemiology Program at Dana-Farber/Harvard Cancer Center (DF/HCC)
- Director of Strategic Research Partnerships, American Cancer Society
- Faculty Director, SM2 in Epidemiology Program
- Executive Committee, U.S. Army Prostate Cancer Research Program Programmatic Panel
- Scientific Advisory Board, Prostate Cancer Foundation
- Co-Principal Investigator, Health Professionals Follow-up Study
- Co-Principal Investigator, IRONMAN