Spotlight On: Jack Cuzick Phd

Issue 21, Summer/Fall 2013

JACK CUZICK, PHD

Jack Cuzick, PhD
Director
Cancer Research UK Centre for Epidemiology, Mathematics and Statistics
Wolfson Institute of Preventive Medicine
Queen Mary, University of London
London, U.K.

It was perhaps a love of pure mathematics as a boy that started Dr. Jack Cuzick down the road to his receipt of the 2012 American Association for Cancer Research -- Prevent Cancer Foundation Award for Excellence in Cancer Prevention Research.

Cuzick, raised in sunny California, played baseball as a child and kept close track of the batting and pitching statistics of his favorite players. That fondness for statistics propelled him to a mathematics undergraduate degree and then onward in the field until he attained his PhD.

Cuzick began his academic career working on the mathematical analysis of clinical trial methodology as a faculty member at Columbia University in New York City in the late 1970s. It was then that he began to wonder if the data in these studies might teach us more than whether a particular treatment worked or not.

He moved to Oxford University in the U.K. in 1978, where he worked with renowned cancer epidemiologist Richard Doll to expand the intellectual reach of clinical trials, mining the data to answer questions about the risk factors that give rise to disease.

Speaking to The Lancet a few years ago, Cuzick said that this kind of analysis "is something that's still not as exploited as well as it should be."

Over the years, his research into the causes -- and potential prevention -- of malignancy has yielded some breakthrough discoveries. Starting his own lab in London in 1982, Cuzick began to focus on risk factors for the etiology and progression of breast cancer, from which he put forth the notion that an estrogen-suppressing drug, such as tamoxifen, might be used to prevent tumor spread. That set the stage for a number of clinical trials (some conducted by Cuzick) that have definitively confirmed that theory and helped millions of patients worldwide.

Cuzick's work in breast cancer research continued, as he helped establish pivotal trials focused on aromatase inhibitors, the next generation of breast cancer chemopreventive agents. His insights into the clinical importance of breast tissue density have also helped mark it as a key modifiable mammographic indicator of cancer risk and response to endocrine treatment.

Other trials are planned that will look at the potential chemopreventive role of agents such as the diabetes drug metformin or a class of osteoporosis medications known as bisphosphonates.

Cuzick's work in the field extends beyond breast cancer, however. Much of his research has provided important new insights into screening for malignancies of the colon, prostate and cervix, and he was one of the earliest and most vocal proponents of widespread testing for HPV. His efforts to identify and quantify the health risks posed by radiotherapy helped spur safer standards for radiation exposures from various medical technologies.

Harkening back to his roots as a statistician, Cuzick has recently helped organize the largest cohort ever of men with early, localized prostate cancer, with the aim of spotting important factors that drive more aggressive disease.

Cuzick believes that the key to controlling cancer lies in first identifying and then reducing factors that give rise to the disease in the first place.

In a 2006 essay in The Lancet, he urged the cancer research community to do what has worked so well for cardiology. Cardiologists no longer simply wait for heart disease to be diagnosed and treated, he pointed out. Instead, they work with patients to try and lower risk factors such as hypertension or high blood cholesterol in an effort to prevent cardiovascular illness. "This model needs to be used to develop the optimum form of cancer control," he wrote.

Besides winning the 2012 AACR award, Cuzick is also the recipient of the EUROGIN award for distinguished service to cervix cancer. He is an Honorary Fellow of the Royal College of Physicians of London and his numerous papers remain among the most cited by cancer researchers worldwide. He is currently president of the International Society of Cancer Prevention, of which he is a founding member.