Shelley S. Tworoger, PhD
Associate Professor, Department of Medicine, Harvard Medical School
Associate Professor, Department of Epidemiology, Harvard School Of Public Health
Associate Epidemiologist, Medicine, Brigham And Women's Hospital
DF/HCC Program AffiliationGynecologic Cancers
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. My interests in this area include diet (flavonoids, acrylamide) and novel risk factors, such as beta-blocker medications and inflammation.
Considering all ovarian tumors 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 the etiologic pathways. For example, I reported that hormonal risk factors may be associated with risk of estrogen receptor–positive and progesterone receptor–negative tumors. Similarly, identifying the causes of aggressive ovarian tumors is critical for prevention. Thus, I am evaluating risk factors for tumors by cell of origin (fallopian vs. ovarian) and those that are fatal within three years of diagnosis. With pathologist colleagues, I am studying the epidemiology of precursor lesions and launching studies to evaluate changes in normal ovarian and fallopian tissue in response to known risk factors.
Further, I conduct research into the relationship between hormones, such as sex hormones, and breast cancer risk. I have two R01 grants studying how prolactin increases risk. Future work will incorporate 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 Director of the NHS Biomarker Laboratory and Repository. This core (annual budget ~$1.5 million) maintains the scientific integrity of and uses nearly two million biospecimens from over 120,000 NHS/NHSII women. 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.
Finally, I am active in teaching and mentoring. I mentor one master’s and three doctoral students in Epidemiology (HSPH) and three post-doctoral fellows (two past and one current) as they conduct epidemiologic research. I also co-teach a course on biomarkers and sample collection in epidemiologic studies and give guest lectures in other courses.
Through preserving and making the best use of the invaluable resources of the NHS, applying the data obtained to reduce the morbidity and mortality of both ovarian and breast cancer, and mentoring younger researchers, I intend to continue making meaningful contributions to the field of women’s cancer.