Spotlight On: Dr. Graham Colditz

Issue 20, 2012

Graham Colditz, MD, DrPH

Graham Colditz, MD, DrPH
Niess-Gain Professor of Surgery,
Professor of Medicine
Chief, Division of Public Health Sciences,
Department of Surgery
Associate Director, Prevention and Control,
Siteman Cancer Center
Deputy Director, Institute for Public Health
Washington University School of Medicine,
St. Louis, MO

When Dr. Graham Colditz received this year's Award for Research Excellence in Cancer Epidemiology and Prevention from the American Association for Cancer Research/American Cancer Society, these organizations cited his “exceptional history” of investigation into the ways lifestyle factors can raise an individual's risk for cancer over the lifespan.

Many insights from research led by Colditz continue to influence and improve the lives of millions worldwide. His work in the field of breast cancer prevention, for example, is unparalleled. Soon after graduating with a doctorate from the Harvard School of Public Health in 1986, Colditz was appointed to head daily operations for the seminal Nurses' Health Study (NHS), which he led for the next two decades (the last 10 years as Principal Investigator).

During that time, Colditz worked with pathologists to confirm that proliferative, benign lesions in breast tissue were, in fact, strong predictors of breast cancer risk. His work has also led to other breakthroughs, including the finding that long-term use of estrogenplus-plus-progestin hormone replacement therapy can raise a woman's odds for breast cancer. That link was later confirmed by a decline in breast cancer incidence after women largely abandoned such therapies.

Colditz' work with the Nurses Health Study also helped show that weight control after menopause reduces a woman's risk for breast cancer. Other findings from the study shed important light on risk factors for other major killers, such as diabetes and stroke.

"The Nurses' Health Study is a massive undertaking," Colditz said, "but it really gave us an incredible opportunity to look at how diet, physical activity and other lifestyle factors influence a woman's risk of disease."

Still, Colditz' work in the 1980s and 1990s was only a starting point. Much of his work since then has focused on how exposures early in the lifespan might set the stage for cancer in adulthood. For example, some of Colditz’ more recent work has focused on adolescents, tracking how factors such as family history, diet, physical activity and alcohol intake might affect young women's risks for benign and malignant breast lesions in later life.

Other work is focusing on tobacco use and obesity as it relates to cancer, and how public policies might influence that relationship – for good or ill.

"We used to focus on diet, activity and weight in the year or two before the patient was diagnosed," Colditz explained. "But we now know that the process spans decades. More recently, we've started to examine what I would call the more appropriate time frame for looking at lifestyle and habits – adolescence and early adult years – 20 years or more before diagnosis."

Colditz began this journey as the son of a primary-care physician in Sydney, Australia. After graduating with a medical degree at the University of Queensland, he moved to Harvard in the early 1980s and remained there for 23 years, including six years as Program Leader in Cancer Epidemiology at Dana Farber/Harvard Cancer Center. Colditz moved to Washington University School of Medicine in 2006, and in 2011 was appointed Division Chief of the newly created Institute for Public Health, which has a strong focus on prevention.

Colditz is the recipient of numerous distinctions and awards. In 2006, he was appointed a member of the prestigious Institute of Medicine, and he is the recipient of both the American Cancer Society’s Medal of Honor and the American Society of Preventive Oncology’s Distinguished Achievement Award. Colditz has published over 800 original research manuscripts and contributed to more than 100 books on cancer prevention and health promotion, as well as serving as Editor-in-Chief of Cancer Causes and Control from 1998 to 2006.

According to Colditz, the steps he and other scientists have taken in illuminating pathways to cancer prevention are only the beginning.

"We actually know an enormous amount about the cause and preventability of cancer," he said. "It's time we made an investment in implementing what we know."