Adjunct Associate Professor of Epidemiology
Adjunct Associate Professor of Medicine, Harvard Medical School
The focus of my research is to enhance ovarian cancer prevention, using an integrative approach involving collaborations with biostatisticians, pathologists, and oncologists; this constitutes a powerful method for improving understanding of ovarian carcinogenesis. I lead the ovarian cancer research efforts in the Nurses’ Health Studies (NHS/NHSII). Additionally, I co-lead a new international, NCI-sponsored research effort, the Ovarian Cancer Cohort Consortium (OC3).
My work in ovarian cancer falls into three primary areas: (a) identifying new risk factors, (b) evaluating disease heterogeneity, and (c) elucidating early carcinogenic changes. Most known risk factors for ovarian cancer are not easily modifiable; however, this cancer’s poor prognosis makes it important to identify methods for prevention. My interests in this area include diet (flavonoids, acrylamide) and novel risk factors, such as beta-blocker medications, psychosocial stress, and inflammation. Further, considering all ovarian tumors as a single disease might cause us to miss important associations. Thus accounting for the heterogeneity of ovarian cancer (e.g., by histology, time to death, etc.) is critical to identify new risk factors and elucidate the etiologic pathways.
A common thread in my research is a strong interest in optimal integration of biologic markers into epidemiologic studies through my role as Director of the BWH/Harvard Cohorts Biorepository. This core maintains the scientific integrity of and uses nearly three million biospecimens from nearly 200,000 individuals across 5 large cohort studies. My primary responsibilities include assisting investigators with the scientific aspects of incorporating biomarkers into their studies, managing laboratory and data management personnel, overseeing new sample collections, and investigating new technologies.
PhD, Epidemiology, University of Washington, Seattle, WA
1. Tworoger SS, Eliassen AH, Sluss P, Hankinson SE. A prospective study of plasma prolactin concentrations and risk of premenopausal and postmenopausal breast cancer. J Clin Oncol. 2007;25:1482-1488.
2. Tworoger SS, Lee IM, Buring JE, Rosner B, Hollis BW, Hankinson SE. Plasma 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D and risk of incident ovarian cancer. Cancer Epidemiol Biomarkers Prev. 2007;16:783-788.
3. Hecht JL, Kotsopoulos J, Gates MA, Hankinson SE, Tworoger SS. Validation of tissue microarray technology in ovarian cancer: results from the Nurses’ Health Study. Cancer Epidemiol Biomarkers Prev. 2008;17:3043-3050.
4. Tworoger SS, Lee IM, Buring JE, Hankinson SE. Plasma androgen concentrations and risk of incident ovarian cancer. Am J Epidemiol. 2008;167:211-218.
5. Saleemuddin A, Folkins AK, Garrett L, Garber J, Muto MG, Crum CP, Tworoger S. Risk factors for a serous cancer precursor (“p53 signature”) in women with inherited BRCA mutations. Gynecol Oncol. 2008;111:226-32.
6. Hecht JL, Kotsopoulos J, Hankinson SE, Tworoger SS. Relationship between epidemiologic risk factors and hormone receptor expression in ovarian cancer: results from the Nurses’ Health Study. Cancer Epidemiol Biomarkers Prev. 2009;18:1624-1630.
7. Gates MA, Rosner BA, Hecht JL, Tworoger SS. Risk factors for epithelial ovarian cancer by histologic subtype. Am J Epidemiol 2010;171:45-53.
8. Poole EM, Schernhammer ES, Tworoger SS. Rotating night shift work and risk of ovarian cancer. Cancer Epidemiol Biomarkers Prev. 2011;20(5):934-8.
9. Tworoger SS, Rosner BA, Willett WC, Hankinson SE. The combined influence of multiple sex and growth hormone on risk of postmenopausal breast cancer: a nested case-control Study. Breast Cancer Res 2011 Oct 21;13(5):R99.
10. Poole EM, Gates MA, High BA, Chanock SJ, Cramer DW, Cunningham JM, Fridley BL, Gayther SA, Goode EL, Iversen ES, Lissowska J, Palmieri Weber RT, Pharoah PD, Phelan CM, Ramus SJ, Schildkraut JM, Sutphen R, Tsai YY, Tyrer J, Vierkant RA, Wentzensen N, Yang HP, Terry KL, Tworoger SS. ABO blood group and risk of epithelial ovarian cancer within the Ovarian Cancer Association Consortium. Cancer Causes Control. 2012 Nov;23(11):1805-10.
11. Poole EM, Merritt MA, Jordan SJ, Yang HP, Hankinson SE, Park Y, Rosner B, Webb PM, Cramer DW, Wentzensen N, Terry KL, TworogerSS. Hormonal and reproductive risk factors for epithelial ovarian cancer by tumor aggressiveness. Cancer Epidemiol Biomarker Prev. 2013:(in press).
12. Kotsopoulos J, Terry KL, PooleEM, Rosner B, Murphy MA, Hecht JL, Crum CP, Missmer S, Cramer DW, Tworoger SS. Ovarian cancer risk factors by tumor dominance, a surrogate for cell of origin. Int J Cancer. 2013:(in press).