Trends in 21st Century Epidemiology:
From Scientific Discoveries to Population Health Impact
December 12-13, 2012
Bethesda, MD
Overview
Toward the end of the 20th century a rapid growth occurred in epidemiologic research on genetic and environmental determinants of cancer occurrence and outcomes in populations. Large-scale case-control and cohort studies have been instrumental in assessing risk factors for almost all cancer types, cancer precursors as well as response to interventions, survivorship, and outcomes. Cohort studies have also been used to examine risk factors for common diseases other than cancers, as well as the relationships between cancer and non-cancer health outcomes.
Epidemiology success stories driven by new technologies, large consortia and cohorts, multi-level interventions, translation epidemiology research and knowledge integration have led to improved policy and practice. These include the unraveling of cigarette smoking as a cause of lung and many different types of cancer, the role of HPV in cervical and other cancers, and the discovery of hundreds of genetic loci as risk factors for various types of cancer. In spite of these successes, observational epidemiology has methodologic limitations that affect the ability to infer causation. Many challenges remain in the proper applications and interpretations of the epidemiologic method to understanding the biology of cancer and how to reduce its burden in populations.
More than ten years into the 21st century, we are at a major crossroads in our understanding of cancer. Tools of molecular biology, genomics, and other high throughput "omic" technologies are increasingly integrated into epidemiologic investigations. In a 2011 town hall meeting, Dr. Harold Varmus, NCI Director, said, "I expect to see a pretty dramatic revolution in epidemiology... defining cancers by genetic subsets. I expect to see molecular tools brought more forcefully into the realm of cancer diagnosis... talking about ways to discriminate among early lesions and pre-cancerous lesions that may have malignant potential."
Along with these emerging tools come refined social, behavioral, and environmental exposure measurements at the individual, community, and health system levels and the ability to assess gene-gene and gene-environment interactions. There is an increased focus on complex "systems" approaches in understanding the occurrence of cancer and intervening at multiple levels. All this has been influenced by tremendous advances in bioinformatics and information technology, allowing us to collect, analyze, and synthesize information from multiple disciplines at an ever increasing pace.
With these opportunities, however, come the major challenge of dealing with the data deluge and uncovering true causal relationships from the millions and millions of observations that are background noise. At the same time, increased consumer awareness and education has led to enhanced participation and co-ownership of research and research output. Thus, epidemiology now confronts important challenges and opportunities in the study of cancer and other diseases, and must make choices of direction, as it responds to rapid changes in the environment.
Purpose
On December 12-13, 2012, NCI's Epidemiology and Genomics Research Program (EGRP) sponsored a workshop titled "Trends in 21st Century Epidemiology: From Scientific Discoveries to Population Health Impact" in Bethesda, MD. Researchers and thought leaders presented their perspectives on major facets of the epidemiologic enterprise. The product of the meeting will be a peer-reviewed scientific publication and an epidemiology manifesto that will inform future research directions and funding opportunities.
Agenda and Presentations
During the workshop, a panel of experts with diverse perspectives offered brief assessments of the main challenges and most attractive opportunities for the five areas outlined below. Moderators led discussions among the panelists and workshop participants. Links to the presentations are included in the agenda (below) in the Topic column.
At the end of the meeting, workshop participants held an open discussion to help clarify and prioritize recommendations that will enhance the contribution of epidemiology in the next decade.
View agenda for Wednesday, December 12 and links to presentationsWednesday, Dec. 12 | Topic |
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12:00 p.m. - 1:00 p.m. | Registration |
1:00 p.m. - 1:10 p.m. |
Welcome
Robert T. Croyle, Ph.D. |
1:10 p.m. - 1:30 p.m. |
Charge to Participants [ PDF (1.45 MB), HTML ]
Muin J. Khoury, M.D., Ph.D. |
Session 1: Setting the Stage: The Evolution of Epidemiology and its Applications to Cancer Moderator: Robert T. Croyle, Ph.D., DCCPS, NCI |
|
1:30 p.m. - 2:00 p.m. |
Historical Perspectives on the Evolution of Cancer Epidemiology [ PDF (1.53 MB), HTML ]
Robert N. Hoover, M.D., Sc.D. |
2:00 p.m. - 3:00 p.m. |
Panel and Audience Discussion [ PDF (538 KB), HTML ]
Panelists: Timothy Rebbeck, Ph.D. Margaret R. Spitz, M.D. |
3:00 p.m. - 3:15 p.m. | Break |
Session 2: The Impact of New Methods and Technologies on Epidemiologic Research Moderator: Stephen J. Chanock, M.D., DCEG, NCI |
|
3:15 p.m. - 3:45 p.m. |
Technology-Driven Epidemiology: A Paradigm Shift
Geoffrey S. Ginsburg, M.D., Ph.D. |
3:45 p.m. - 5:00 p.m. |
Panel and Audience Discussion [ PDF (1 MB), HTML ]
Panelists: Thomas A. Sellers, Ph.D., M.P.H. Michael Snyder, Ph.D. Georgia D. Tourassi, Ph.D. |
6:00 p.m. - 8:00 p.m. | Dinner at Local Restaurant (optional) |
View agenda for Thursday, December 13 and links to presentations
Thursday, Dec. 13 | Topic |
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7:30 a.m. - 8:00 a.m. | Registration |
Session 3: The Evolution of Epidemiologic Cohorts in the Study of Natural History of Cancer and Other Diseases Moderator: Deborah M. Winn, Ph.D., DCCPS, NCI |
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8:00 a.m. - 8:30 a.m. |
What Have We Learned From Epidemiology Cohorts and Where Should We Be Going Next? [ PDF (407 KB), HTML ]
Julie Buring, Sc.D., M.S. |
8:30 a.m. - 9:30 a.m. |
Panel and Audience Discussion [ PDF (706 KB), HTML ]
Panelists: Lyle Palmer, Ph.D. Leslie L. Robison, Ph.D. (unable to attend) Daniela Seminara, Ph.D., M.P.H. |
Session 4: Use of Epidemiologic Research to Advance Clinical and Public Health Practice: Bridging the Evidence Gap with Observational Studies and Randomized Clinical Trials Moderator: Sheri D. Schully, Ph.D., EGRP, DCCPS, NCI |
|
9:30 a.m. - 10:00 a.m. |
Epidemiology and Evidence-Based Cancer Prevention [ PDF (458 KB), HTML ]
David F. Ransohoff, M.D. |
10:00 a.m. - 11:00 a.m. |
Panel and Audience Discussion [ PDF (480 KB), HTML ]
Panelists: Michael Lauer, M.D. Jeffrey A. Meyerhardt, M.D., M.P.H. Olufunmilayo I. Olopade, M.D. F.A.C.P. |
11:00 a.m. - 11:15 a.m. | Break |
Session 5: Use of Epidemiology in Knowledge Integration and Meta-Research Moderator: Muin J. Khoury, M.D., Ph.D., EGRP, DCCPS, NCI |
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11:15 a.m. - 11:45 a.m. |
The Role of Epidemiology in Knowledge Integration and Meta-Research
John Ioannidis, M.D., D.Sc |
11:45 a.m. - 12:45 p.m. |
Panel and Audience Discussion
Panelists: Katrina Goddard, Ph.D. Robert A. Hiatt, M.D., Ph.D. Ann Zauber, Ph.D. |
12:45 p.m. - 1:15 p.m. | Lunch |
Session 6: Where Do We Go From Here? 12 Recommendations for Epidemiology in the Next 10-20 Years Moderator: Patricia Hartge, Sc.D., DCEG, NCI |
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1:15 p.m. - 2:30 p.m. | Working lunch and moderated discussion to come up with 12 broad recommendations for action in the next 10-20 years |
Online Participation
Prior to the workshop, EGRP invited the research community to comment on the topics listed in the agenda via the Cancer Epidemiology Matters Blog.
The meeting offered several ways for the research community to participate online. The proceedings were videocast live from http://videocast.nih.gov. The archived videocasts are available at the links below:
Online participants were invited to share their comments and questions via Twitter (by using the meeting hashtag, #trendsinepi, or @NCIEpi in their tweets) or email (nciepimatters@mail.nih.gov). Select questions from online participants were then used in the question and answer portions of the workshop sessions. An archive of tweets that include the #trendsinepi hashtag is also available for viewing.
Related Resources
Contacts
Workshop Planning Committee:
- Muin Khoury, M.D., Ph.D., Acting Associate Director, EGRP, Division of Cancer Control and Population Sciences (DCCPS), NCI
- Robert Hoover, M.D., Sc.D., Director, Epidemiology and Biostatistics Program, Division of Cancer Epidemiology and Genetics, NCI
- Timothy Rebbeck, Ph.D., Professor of Epidemiology, University of Pennsylvania
- Sheri Schully, Ph.D., Knowledge Integration Team Lead, EGRP, DCCPS, NCI
EGRP Workshop Advisory Group:
- Rao Divi, Ph.D., Program Director, Methods and Technologies Branch
- Joanne Elena, Ph.D., M.P.H., Program Director, Clinical and Translational Epidemiology Branch
- Christie Kaefer, M.B.A., R.D., Communications Coordinator, Office of the Associate Director
- Tram Lam, Ph.D., M.P.H., Program Director, Knowledge Integration Team, Office of the Associate Director
- Stefanie Nelson, Ph.D., Program Director, Host Susceptibility Factors Branch
- L. Joseph Su, Ph.D., M.P.H., Program Director, Modifiable Risk Factors Branch