A growing operation
Over the next several decades, cancer is expected to overtake heart disease as the leading cause of death in the United States. Yet, according to the Harvard Center for Cancer Prevention, 50 percent of all cancers can be prevented by maintaining a healthy weight, not smoking, protecting oneself from the sun, and taking other steps to lower cancer risk.
For this reason, the Center for Community-Based Research was established in 1992, after Sorensen joined Dana-Farber from the University of Massachusetts Medical School in Worcester. The idea was to bolster the prevention arm of the Institute's mission — required for Comprehensive Cancer Center status — and to explore how lifestyle and community can affect health behaviors. The center's purpose reflects Dana-Farber founder Sidney Farber, MD's, belief that "prevention is better than cure."
Center faculty leaders (left to right) Karen M. Emmons, PhD, Glorian Sorensen, PhD, MPH, and Elizabeth M. Barbeau, ScD, MPH, confer about a project in their Smith building offices.
A staff of nine working on one project has grown to roughly 70 people, with more than seven studies completed, 10-plus currently under way, and even larger ones pending approval. Part of the Population Sciences unit within Adult Oncology, the center draws faculty and staff from many social sciences, among them psychology, occupational health, nutrition, epidemiology, biostatistics, and anthropology. Sorensen, a sociologist by training, is one of three faculty leaders, along with Karen Emmons, PhD, a clinical psychologist; and Elizabeth Barbeau, ScD, MPH, a specialist on tobacco-control research.
In addition, the CCBR works closely with Dana-Farber's many treatment programs, its outcomes experts (for help applying findings to the general population), and its Community Benefits unit, which provides cancerrelated outreach services in the community. It also teams with institutions in and around the Longwood Medical Area.
"We build bridges with other Harvardaffiliated hospitals and programs," says Emmons. In one breast cancer effort, center staffers Jennifer Dacey Allen, ScD, and Roberta Goldman, PhD, are joining Bruce Chabner, MD, of Dana-Farber and Massachusetts General Hospital to probe why some women don't seek follow-up care when their mammograms show abnormalities. "There's an alarmingly high prevalence of this in low-income and minority communities," observes Emmons. "It could be due to access to treatment, fear, religious beliefs, or any number of reasons. We don't know why."
Among the center's notable collaborations are those involving labor unions. In July, Barbeau traveled to Washington, D.C., to help unveil a national consortium aimed at reducing smoking and secondhand-smoke exposure among working families. The project, spearheaded by DFCI, the University of Massachusetts at Lowell, and the American Legacy Foundation, will study strategies for reaching young workers through unionbased training and apprentice programs.
Explains Barbeau, "We're trying to bring these two very powerful movements — labor and tobacco control — closer together toward the goal of reducing class-based differences in health related to tobacco, which is linked to lung cancer and other diseases."
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