Answering Urgent, Neglected Questions: Program-Initiated Research
In 2005, the CBCRP’s council voted to allocate 30% of the Program’s funding to program initiated research endeavors and launched the Special Research Initiatives to investigate two research areas that have not received enough attention, but that hold great promise against breast cancer:
- Why are some groups of women—based on characteristics such as their ethnic group, race, or where they work or live—more likely to get, or die from, breast cancer?
- What is the role of the environment in this disease?
Building on the initial success of these initiatives, during 2010, the council decided to devote 50% of funding to program-initiated research and added a third area of research:
- Breast cancer prevention
Funds are being targeted to research that will most quickly lead to major breakthroughs. The initiatives are designed not only to increase scientific knowledge, but also to create solutions that will move toward the goal of ending the suffering caused by breast cancer.
The CBCRP launched the Special Research Initiatives because the Program’s previous efforts to increase research addressing these questions had not led to enough progress. California is an ideal laboratory for these under-researched questions. The state has varied geography and development, which includes heavily industrialized as well as large agricultural areas. It has a mix of urban, suburban, small town, and rural communities. The state’s population is very ethnically and racially diverse. California also has communities with some of the highest rates of breast cancer in the nation.
To build on the most current findings, the CBCRP commissioned a review of previous research into the environmental links to breast cancer and the reasons why some groups of women bear a greater burden of the disease. A draft of this extensive scientific review, Identifying Gaps in Breast Cancer Research, is posted on the CBCRP web site.
First Completed Initiative Draws Attention from Policy Makers
During 2010, the first study funded under the Program's Special Research Initiatives was completed. This study, the California Breast Cancer and Chemicals Policy Project, developed an approach for identifying and prioritizing the testing of chemicals—including those found in the environment, consumer products, or workplaces—to see if they may raise the risk of breast cancer. A multidisciplinary panel of experts identified biological processes relevant to breast cancer and evaluated existing tests to detect if a chemical affects those processes. From this, they developed a framework for prioritizing chemicals to be tested. They also created the Hazard Identification Approach, a structured method for chemicals testing. The California Breast Cancer and Chemicals Policy Project's recommendations are already drawing attention, including from those developing a policy to protect Californians from toxic chemicals through the Green Chemistry Initiative, a key Institute of Medicine working group, and leaders in the U.S. Congress working to reform the decades-old Toxic Substances Control Act.
Three Special Research Initiative Studies Funded in 2010
Three Special Research Initiatives studies were funded this year:
- California Breast Cancer Survivorship Consortium/Understanding Racial and Ethnic Differences in Stage-Specific Breast Cancer Survival. Women from some racial and ethnic groups are less likely to survive breast cancer than others, even when they are diagnosed at the same stage and with the same kind of cancer. This study aims to find out why and identify ways to decrease breast cancer deaths among the most affected racial and ethnic groups. The project leverages resources found only in California: diverse ethnic and racial groups, plus expert researchers conducting ongoing investigations of breast cancer among a number of those groups. This study is based on the success of a pilot project the CBCRP funded in 2009 as one of our first Special Research Initiatives. It gave researchers heading seven different projects the impetus to combine their resources for the first time.
- Persistent Organic Pollutants and Breast Cancer Risk: Chemicals Old and New. Persistent organic pollutants are a large group of chemicals that include the banned pesticide DDT and newer compounds still used as flame retardants. This project leverages data already collected about a large population of women over many years through the ongoing California Teachers Study. This is the first large-scale study to investigate whether exposure to common flame retardants and their replacements play a role in breast cancer.
- Partnership to Advance Breast Cancer Research. Researchers are working with the CBCRP to plan the coming five years of the CBCRP's program-initiated research. They will assemble a team to build on progress so far and develop further initiatives to study the environmental causes of breast cancer and ways to lift the burden on groups of women who suffer disproportionately from the disease. They will also recommend initiatives to advance primary breast cancer prevention (steps that can be taken to keep women and men from getting breast cancer.
Ongoing Special Research Initiatives
Special Research Initiatives funded previously and underway during 2010 include:
- Demographic Questions for California Breast Cancer Research. The state of California, researchers, and clinicians all collect data about who gets breast cancer. This study investigates the best way to improve these data. The goal is to better understand which groups of women suffer disproportionately from breast cancer and work to reduce their burden.
- Biological/Ecological Models of Breast Cancer Causation and Prevention. Scientists too often study only one possible cause of breast cancer at a time. A different approach is needed to make progress in uncovering the environment's role in breast cancer and in understanding why some groups of women bear a greater burden of the disease. This project is bringing together experts from many fields to develop better tools to raise awareness of and investigate—collectively—many co-existing and inter-related factors that are likely to affect breast cancer risk.
- The Environmental Causes of Breast Cancer across Generations. In the first-ever "womb to breast cancer" study in women, rather than in lab animals, CBCRP-funded researchers are finding out if women exposed to certain chemicals while they were developing in the womb are more likely to get breast cancer. The study is based on growing scientific evidence that women exposed to toxic chemicals at critical periods in their lives are more likely to get breast cancer years later.
- New Statistical Models to Address Disease Complexity. It takes complex math—made possible by new, more powerful computers—to evaluate the impact of many complex factors that may affect our risk of breast cancer. The CBCRP is funding research teams to develop new statistical methods that will allow researchers to better measure the many factors that act in combination across a woman's life span, increasing or lowering her risk of getting breast cancer.
Special Research Initiatives Result in the CBCRP Providing Statewide and National Environmental Leadership
As a result of the CBCRP’s leadership in research into the role of the environment in breast cancer, the Program’s director, Marion H.E. Kavanaugh-Lynch, serves on the nine-member California Environmental Contaminant Biomonitoring Program Scientific Guidance Panel. The panel assists the Department of Health Services and California Environmental Protection Agency by providing scientific peer reviews and making recommendations regarding the design and implementation of the California Environmental Contaminant Biomonitoring Program. Dr. Kavanaugh-Lynch also serves on the oversight committee of the Breast Cancer and Environment Research Centers (BCERC). BCERC is a network of four national centers, created by the National Institute of Environmental Health Sciences and the National Cancer Institute. The network supports research into the impact of prenatal-to-adult environmental exposures that may predispose a woman to breast cancer.
