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) and NHS P01 Ovarian Cancer Project. Additionally, I co-lead a new international, NCI-sponsored research effort, the Ovarian Cancer Cohort Consortium. My time is spent conducting research (~65%), teaching and mentorship including overseeing research by my mentees (~20%), and administrating a core laboratory (~15%).
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.
Considering ovarian cancer as a single disease might cause us to miss important associations. Thus accounting for the heterogeneity of ovarian cancer is critical to identify new risk factors and elucidate etiologic pathways. For example, I reported that oral contraceptive use is more strongly associated with a lower risk of tumors that are fatal within three years of diagnosis versus less aggressive disease, suggesting that targeted prevention could reduce risk of the most aggressive tumors. I also am considering novel risk factors for ovarian cancer including psychosocial stress and related biomarkers. In addition, I lead the Ovarian Cancer Cohort Consortium, which includes over 20 studies to increase statistical power for analyses by tumor heterogeneity. Further, I conduct research into the relationship between hormones, such as sex hormones, and breast cancer risk. My current work is incorporating hormones into risk prediction models.
A common thread in my research is a strong interest in optimal integration of biologic markers into epidemiologic studies through my role as Faculty Director of the BWH/Harvard Cohorts Biorepository. This core (annual budget ~$1.5 million) maintains the scientific integrity of and uses over 3 million biospecimens from over 200,000 individuals. My 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. I recently designed a study to collect blood, urine, timed saliva, toenails, hair, and stool samples from 200 participants, along with a battery of validated questions regarding exposure to and perception of psychosocial stress; the goal of the study is to identify new biomarkers of stress that can be used in epidemiologic research.
Finally, I mentor two doctoral students in Epidemiology (HSPH), one MPH student, two post-doctoral fellows, and two Instructors. I also co-teach a course on biomarkers and sample collection and give guest lectures in other courses.
Through making the best use of the invaluable resources of the NHS and related cohorts, applying the data obtained to reduce the morbidity and mortality of ovarian and breast cancers, and mentoring younger researchers, I intend to continue making meaningful contributions to the field of women’s cancer.