Director, Cancer Epidemiology Unit
Nuffield Department of Population Health (NDPH)
Tell us a bit about your role
As Director of the Cancer Epidemiology Unit, I lead a group of around 40 researchers, students, and support staff involved in a range of research projects, primarily aimed at improving our understanding of the aetiology of specific cancers and common chronic conditions. I am also responsible for overall management of the Million Women Study, a large cohort study of over 1.3 million UK women.
I initially studied Maths and Chemistry as an undergraduate before completing an MSc, and PhD, in Statistics at Imperial College. Having realised that I was much more interested in the data itself, than in devising new statistical methods, I took up a post as medical statistician at the Imperial Cancer Research Fund Cancer Epidemiology Unit, in Oxford. Working with epidemiological illuminaries such as Richard Peto and Valerie Beral, I soon became the lead statistician for several international collaborations on breast and other female cancers. This experience cemented my interested in cancer epidemiology and gave me the skills to develop my own research which has since focussed on factors affecting breast cancer incidence, detection, and survival.
Epidemiology naturally spans many different aspects of medicine, and I work closely with a diverse range of clinical specialists (including pathologists, radiologists and surgeons). In many cases, we use our large ongoing studies to address questions raised by other medical professionals regarding the role of potential risk factors, by generating and analysing the necessary data. Similarly, my work often involves translating the results of statistical models into tools that can be applied within a specific clinical setting (for example, development of risk stratification models to inform the feasibility of targeted screening interventions).
What is the most meaningful aspect of your work?
I would say that the most meaningful aspect of my work is the idea that what I do is likely to bring about a small but definite decrease in the number of people diagnosed with cancer over the next few decades. This may be through establishing the effect of a particular behaviour or trait on the risk of a certain cancer, but equally, it could be through maintaining and enhancing valuable data resources like the Million Women Study, to ensure that the wider scientific community has the information it needs to continue making such advances.
Can you tell us about something you've done, contributed to that you're most proud of?
Shortly after joining the Unit, I was fortunate enough to be involved in setting up a new initiative to bring together relevant epidemiological studies worldwide in order to address a longstanding concern that oral contraceptive use might increase breast cancer risk. Although this approach had been successfully used to combine data from clinical trials of treatments, it had never before been applied to large observational studies. It was an enormous effort, both scientifically and logistically and the final results demonstrated clearly that oral contraceptives only resulted in a small increase in risk while women were taking them and were, reassuringly, not associated with any material long term risk. Perhaps more importantly, this collaboration went on to generate many other important findings and provided the first reliable evidence that hormone replacement therapy caused breast cancer, a finding that influenced clinical practice.
What changes would you most like to see in the Medical Sciences in the next 100 years?
There is no doubt that there have already been significant advances in the last decade or so in terms of the scale and the nature of the data that we can collect on individuals, and our ability to follow them up remotely for all manner of health outcomes. I would hope that over the next 100 years, this explosion in data, and increasing interaction between medical professionals and other scientific disciplines, especially data scientists, will yield substantial benefits for prevention and treatment of disease. Ideally, the focus will no longer be on living longer, but on living well for longer.