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Identifying What Puts People at Risk for Cancer

Environmental, behavioral, familial, and genetic factors can all play a role in determining someone’s risk for cancer. Through ongoing research, our understanding of these risk factors and their connection to this disease continues to evolve and along with it, our ability to better prevent, diagnose, and treat cancer.

From left, Lawrence Ingrassia and Dr. Emily Vogtmann

Credit: National Cancer Institute

Lawrence Ingrassia

Documenting the impact of a rare, cancer susceptibility syndrome on his family

At 69, Lawrence Ingrassia became the longest living member of his family. His mother, three siblings, and nephew all had malignant tumors in their 40s or earlier and passed away from cancers linked to Li-Fraumeni syndrome, a rare hereditary condition. Ingrassia’s family first learned they had the genetic mutation that causes the syndrome after his late brother took a genetic test. This mutation affects just 1 in 20,000 people. Determined to understand a condition that afflicted much of his family without their knowledge, Ingrassia set out to learn more and is now writing a book documenting his research odyssey. It’ll incorporate the discovery of the syndrome by Drs. Frederick Li and Joseph Fraumeni, Jr., present additional findings by other scientists, and weave in revelations from Ingrassia’s own family story. He hopes the book, part history and part memoir, will raise awareness of the syndrome and honor the work of these pioneering scientists, as well as his family’s memory.

Dr. Emily Vogtmann

Looking at the role of the human microbiome in cancer risk and progression

Feces, number two, caca—whatever you call it, poop can tell us a lot about our health and maybe even our risk for cancer. Using fecal and oral samples, Dr. Emily Vogtmann is analyzing people's microbiomes (the collection of microorganisms that live in our bodies) to see how the microbiome changes over time, and if those changes have any effect on cancer risk and response to treatment—particularly in the mouth, stomach, and intestines. Along with this research, she also helped coordinate the MicroBiome Quality Control project, which evaluated how the microbiome is measured to ensure that the quality and processing of research samples are consistent. Using poop to address disease isn’t new—fecal transplants have been part of traditional Chinese medicine since the 4th century, for instance—but Dr. Vogtmann is excited about the potential of this research to help improve cancer detection and treatment for the future.

From left, Drs. Laura Beane Freeman and Sam Mbulaiteye

Credit: National Cancer Institute

Dr. Laura Beane Freeman

Determining the potential cancer risk associated with agricultural exposures

Having grown up on a farm, Dr. Laura Beane Freeman knows something about pesticides and other agricultural exposures she now studies. Most of her work has been through the Agricultural Health Study, which has followed nearly 90,000 people living and working on farms in Iowa and North Carolina for the past 25 years to evaluate the potential impact of farming-related exposures on health (including cancer risk). Over one million Americans work in agriculture, but the health risks of farming aren’t well understood. Worldwide, even people who don’t farm may be exposed to similar pesticides and other chemicals that may increase cancer risk. Dr. Beane Freeman’s research could help determine not only what chemicals may harm health, but also how they may cause cancer or other diseases. Ultimately, she wants to make farming as safe as possible, but also emphasizes that this work could advance understanding of cancer risk for the benefit of everyone.

Dr. Sam Mbulaiteye

Helping us understand how certain infectious agents can cause or increase the risk of cancer

Reflecting on his childhood in Uganda, Dr. Sam Mbulaiteye recalls the mosquitoes at night, some of which carried parasites that cause malaria and infected many children in his village, including him. Getting malaria increases the risk for Burkitt lymphoma (BL), a type of cancer that affects about 5 children per 100,000 each year in equatorial Africa. Dr. Mbulaiteye wanted to know why some children get acute malaria but others develop BL. To find out, he developed EMBLEM, a study of BL in children in malaria-endemic regions of Tanzania, Kenya, and Uganda. Guided by the belief that research should address the questions and needs of a community, he also brought much-needed services to these regions through this study—like cancer screenings, treatments, and more health provider training. BL research can change the lives of children at risk, he says, and also inform future discoveries in tumor biology and viral oncology.

From left, Drs. Cristine Delnevo and Scarlett Lin Gomez 

Credit: National Cancer Institute

Dr. Cristine Delnevo

Using population-level data on patterns of tobacco use to help inform tobacco control policies

Dr. Cristine Delnevo is a self-proclaimed “survey geek.” This means she’s interested in how surveys are designed, from the way a question's wording impacts estimated levels of disease to whether getting a $10 gift card or $10 cash gets better response rates. It was her early work surveying 15,000 youths for New Jersey’s Tobacco Control Program that introduced her to the impact of comprehensive tobacco control programs on reducing tobacco-related health problems, including certain cancers. She now studies tobacco control policy and focuses on products like menthol cigarettes and flavored cigars, which have broad appeal among young people and certain racial and ethnic minorities. Dr. Delnevo’s research also examines barriers to health equity—like the heavy marketing of tobacco products to vulnerable populations—and she hopes to use it to draw attention to and educate the public about the disproportionate harm of tobacco in minority and economically disadvantaged communities worldwide.

Dr. Scarlett Lin Gomez

Improving data collection and analysis of risk factors for cancer across specific ethnic groups

Dr. Scarlett Lin Gomez is fond of details, particularly when studying possible links between cancer risk, social and environmental factors, and variations within and across ethnic groups. Cancer registries collect detailed data on Asian Americans, Native Hawaiians, and Pacific Islanders, but Dr. Gomez wants to shift from using these broad racial and ethnic groupings. Herself a Taiwanese immigrant, she’s seen the problems this can generate. When her grandmother was diagnosed with cancer, her family never told her grandmother due to strong cultural stigma. This stigma, shared by some Asian Americans, comes partly from perceptions that cancer risk is low among Asians. Dr. Gomez found, however, that this risk isn’t uniformly low across Asian American groups. For example, US-born Filipinas have seen a higher increase in the rate of breast cancer than other groups. Dr. Gomez believes that culturally specific research will help increase community awareness and target cancer control efforts.

The signing of the National Cancer Act of 1971 began an era of progress against cancer, including in areas of research looking at the causes and risk factors for the disease. Find out more about the act.