EPID 620: Cancer Epidemiology
EPID 620 Resa M. Jones, PhD, MPH
Cancer Epidemiology
Semester course; 3 lecture hours. 3 credits. Prerequisite: EPID 571. The course
will cover the use of epidemiologic methods to study cancer in populations.
Students will review and critique studies that have led to preventive medicine
campaigns. Causation versus association will be discussed in depth as risk
factors associated with lung, colon and breast cancer and mesothelioma are
defined. Spring semester
Course Director: Resa M. Jones, MPH, PhD
Room L-11 McGuire Hall Annex
628-2519
Prerequisites: PMCH/NUR 571 – Principles of Epidemiology or permission from the instructor
Instructor’s Background:
Resa M. Jones has Bachelor’s degrees in Biology and Physiology from the University of Minnesota as well as a MPH (in Epidemiology) and a PhD from the same institution. She has always had a strong desire to be involved in cancer-related health research. This desire in part stems from an academic, research, and professional career in the health sciences and epidemiology. Resa’s research interests in cancer are focused in behavioral epidemiology, specifically cancer prevention and control in adult populations. Prior to joining the faculty within the Department of Preventive Medicine and Community Health, Resa was the Project Director on a community-based intervention study to increase colorectal cancer screening in five rural Minnesota counties. She has also conducted research on mammography screening; the creation, promotion, and implementation of model policies for tobacco-free recreational environments; and interventions to prevent youth tobacco use.
Communication:
To reach Resa:
Please feel free to call or e-mail regarding any concerns relating to the course that you may have. I am also available to meet with you in person. I am generally in my office from 9:00 a.m. to 5:00 p.m. Since I often have scheduled meetings, it is best to set up an appointment by e-mailing me in advance or arranging a time before or after class.
Course Atmosphere:
You are a very diverse group of students. Diversity is strength in our society at large and also here at the Virginia Commonwealth University. In this class, we will ask you to maintain an open mind to the differences around you, and we encourage you to place positive value on those differences. Although we may disagree on a particular point, we will strive to be respectful of each other.
In Epidemiology, it is often the case that there is not necessarily a right answer or only one approach to a research question. Sometimes, we must choose among various alternatives the one that would seem to be most appropriate for the problem posed. Sometimes we choose the best answer, given the alternatives, although it is not necessarily the only answer. This can be particularly aggravating for students, who might prefer that all questions have either right or wrong answers. And it is this reason that makes epidemiology a difficult subject to teach and to learn. Because epidemiology is immersed in the gray areas of human health, it is possible that you may pose a question that we are unable to answer immediately, or if we answer it, we may change our mind upon further reflection. We also expect that some of you will come up with answers that had not occurred to us. We welcome such an exchange of ideas and look forward to learning from you.
Course Content:
- Cancer surveillance and cancer screening, and their relation to cancer prevention
- Domestic and international patterns in cancer incidence and mortality
- Knowledge of epidemiologic characteristics and risk factors for cancers of the lung, breast, prostate, gastrointestinal tract, pancreas, bladder, endometrium, ovary, cervix, as well as cancer in children and young adults
- Public health implications of cancer
- Critical evaluation of different methodological approaches used to study etiologic hypotheses in cancer research
- General principles of genetics and cancer
- General principles of the molecular and cellular basis of carcinogenesis
Learning Objectives:
At the end of the course, students will be able to: Describe the incidence, mortality and 5-year survival of the types of cancer covered during the semester Identify the risk factors for the types of cancer covered during the semester Describe carcinogenesis as well as the molecular biology and genetics of cancer Critically analyze the appropriateness of methodologies used within published studies on cancer topics Explicate the importance of cancer prevention and control Published journal literature will be used for course material. Students will be graded on homework, class participation, in-course exams and a presentation.
Teaching Format:
Teaching will be in lecture format and seminar-type group discussions that will involve student input. There will be assigned readings. Readings should be completed prior to class. Students should come to class with two written questions with answers based on the re adings. These will be submitted electronically prior to class and are described in detail later. In addition, students should be prepared to discuss and critically analyze the assigned articles during the group discussion.
Evaluation and Grading Policy:
Student performance requirements: 30% - midterm; 10% - student participation and discussion; 10% - written questions and answers handed in prior to lectures (based on readings); 20% - student debate presentation; and 30% - final exam (to be comprehensive).
Course grading may be taken either as A/F or S/N. The minimum A/F equivalent for an S frade is a C; the requirements will be identical for students taking the course A/F and S/N.
Grading Criteria:
Letter grades and associated points are awarded in this course as follows below, and, will appear on the student’s official transcript.
The “S” grade does not carry point, but, the credits will count toward completion of the student’s degree program if permitted by the college or program:
A 4.00 Represents achievement that is outstanding relative to the level necessary to
meet course requirements.
B 3.00 Represents achievement that is significantly above the level necessary to
meet course requirements.
C 2.00 Represents achievement that meets the course requirements in every respect.
D 1.00 Represents achievement that is worthy of credit even though it fails to meet fully
the course requirements.
F 0.00 Represents failure and signifies that the work was completed but not at a level of
achievement worthy of credit.
S Represents achievement that is satisfactory, which is equivalent to a C or better unless
specifically designated in writing by the instructor at a higher level of acceptable
performance.
N Represents no credit and signifies that the work was not completed at a level of achievement and carries no grade points.
Sample of Grading Criteria:
S/N option must complete all assignments to a C level (80%) and letter grade will be
determined by total effort as follows:
A = 94 – 100 percent
B = 87 – 93 percent
C = 80 – 86 percent
D = 70 – 79 percent
F = less than 78 percent
F (or N) – Represents failure (or no credit) and signifies that the work was either 1) completed but at a level of achievement that is not worthy or credit or 2) was not completed and there was no agreement between the instructor and the student that the student would be awarded an “I”.
S – Achievement that is satisfactory will be expected to complete all assignments and receive a minimum of 80% to receive a passing score (achievement required for an “S” is at the discretion of the instructor but may be no lower than an 80%).
I – (incomplete) Assigned at the discretion of the instructor when, due to extraordinary circumstances, e.g., hospitalization, a student is prevented from completing the work of the course on time. Requires a written agreement between instructor and student. Extension for completion of the work will not exceed one year, after which time the “I” converts to an “F” or “N”.
Scholastic Dishonesty and Plagiarism:
Students are responsible for knowing the Virginia Commonwealth University policy on student conduct and scholastic dishonesty. All students are expected to conduct themselves in accordance with the VCU Honor Code, the full text of which can be found at: www.vcu.edu/safweb/rg/policies/rg7honor.html.
In brief, appropriate conduct includes, but is not limited to:
- refraining from committing any act of cheating, plagiarizing, facilitating academic dishonesty, abusing academic materials, stealing, lying, or soliciting others to engage in any of the above;
- refraining from acts of intimidation, threats of physical harm, or threats of retribution in an attempt to prevent the testimony of another member of the University Community at any time after charges have been made; and
- reporting every instance in which there is suspicion or knowledge that academic conduct, which violates this policy or its spirit, has taken place to the faculty member responsible for instruction, or to a member of the MCV Honor Council.
In addition, original work is expected in this course. It is unacceptable to hand in assignments for this course for which you receive credit in another course unless by prior agreement with the instructor. Building on a line of work begun in another course or leading to a thesis, dissertation, or final project is acceptable.
If you have any questions, consult the instructor.
Students with Disabilities:
The Americans with Disabilities Act (ADA) of 1990 requires Virginia Commonwealth University to provide a "reasonable accommodation" to any individual who advises us of a physical or mental disability. If you have a physical or mental limitation that requires an accommodation or an academic adjustment, please arrange a meeting with faculty at your earliest convenience. You are requested not to divulge the specific nature of your disability to faculty or classmates. Any student with a documented disability (e.g., physical, learning, psychiatric, vision, hearing, etc.) who needs to arrange reasonable accommodations must contact the instructor and VCU Services for Students with Disabilities at the beginning of the semester. All discussions will remain confidential. For further information contact:
VCU Services for Students with Disabilities
Coordinator: Cheryl Chesney-Walker (clchesneywal@vcu.edu)
Campus location: VMI Building, 1000 E. Marshall Street, Room 301
Mailing address: PO Box 980124 , Richmond, Virginia 23298-0214
Voice: 804-828-9782 | TTY: 804-828-4608 | FAX: 804-828-4609
Web: www.vcuhealth.org/vp/dss
Sexual Harassment:
University policy strictly prohibits sexual harassment against any member of the University community. Acts of either verbal or physical sexual harassment will not be tolerated and will subject the person who commits such acts to disciplinary action under these guidelines and, possibly, other University policies and procedures. In addition, such acts could subject the violator to sanctions under federal and state laws and policies, including Titles VII and IX of the federal civil rights laws. Specific sexual harassment policy information can be found at: www.students.vcu.edu/rg/policies/rg7harass.html
Readings :
Copies of selected, mandatory readings on specific topics will be provided throughout the semester. Additional reading material may be sought from textbooks, which are available in the Tompkins-McCaw Library such as:
Cancer Epidemiology and Prevention (Schottenfeld and Fraumeni)
Human Cancer: Epidemiology and Environmental Causes (Higginson, Muir, Munoz)
Fundamentals of Cancer Epidemiology (Nasca and Pastides)
Textbook of Cancer Epidemiology (Adami, Hunter, Tricholpouls)
Student Written Questions and Answers:
Prior to each class session, students will read the required material and write two questions, with answers, on the subject matter. These questions should be provided electronically to the instructor. Selected questions will be distributed to all of the class to aid in understanding the course material and in studying for exams. Students are encouraged to be creative in this process. Include graphs, tables or other data for illustration. Questions can be in any format, e.g., multiple choice, true-false, fill in the blank, short answer, or essay. Complete answers must accompany the questions. All sources of information for the questions should be cited. Textbooks in cancer epidemiology have example questions. Students may use such questions as examples but they may not be simply copied to fulfill the assignment requirement. Students may embellish or modify existing questions; if so, they must provide the original question with full information on the source. Questions should be designed to address the course learning objectives. Students are encouraged to work together to refine and clarify their questions, but each student is responsible for handing in their own questions. If students will miss a class, the questions must be submitted early to receive credit. The instructor will grant exceptions, for illness or emergencies.
Student Debate Presentations:
Topics have been selected where a level of controversy exists. Students will select a topic of interest and form teams (1 person per team with 2 teams for each topic). The position to be argued (i.e., pro or con) will be randomly assigned to each team (via coin toss).
The objective is to provide the most convincing case for the position assigned using supportable facts from the scientific literature, lay press, etc.
Presentations will be in debate style format. Students are encouraged to use visual aids in their presentations. Handouts prior to the presentation are required. Students are responsible for making this material available to all students. If the material is sent electronically to the Instructor at least by noon two days prior to the scheduled debate, she will provide the copies necessary for the class. Beyond that time, it is the students’ responsibility to provide class copies. The sequence of presentation for the pro or con position will be based on a flip of a coin. Each team will be allowed 20 minutes to state their case, followed by a total of 10 minutes for rebuttals and 10 minutes for questions from the class.
Topics for Debate:
Screening for prostate cancer
Widespread screening of the general male population using PSA and other detection methods is sound public health policy for reducing morbidity and mortality from prostate cancer.
Self-breast exam for reducing breast cancer mortality
Widespread application of self-breast examination is sound public health policy for reducing breast cancer mortality.
Genetic testing for cancer risk
Widespread application of genetic testing to establish an individual’s cancer risk is sound public health policy.
Role of chemoprevention in reducing cancer incidence
Identification and implementation of chemopreventive strategies provides one of the most promising avenues for future reduction in cancer incidence.
Impact of epidemiology in establishing causes of cancer
Previous and future epidemiologic research has and will continue to provide important insights into the etiology of cancer and result in substantial decreases in cancer incidence, morbidity, and mortality.
Mammography for reducing breast cancer mortality
Widespread application of mammography is sound public health policy for reducing breast cancer mortality.
Lecture: 10:00 – 11:00 a.m. (unless designated as a 2-hour lecture)
Critical Discussion of Assigned Reading: 11:10 – 11:55 a.m.
Tuesday / Thursday
May 24/May 26
Introduction Descriptive Epidemiology
Critical discussion of articles
May 31/June 2
NO CLASS Cancer Control
Critical discussion of articles
June 7/ June 9
Cancer Screening Molecular & Cancer Biology
Critical discussion of articles 2-hour lecture
June 14/June 16
Genetics in Cancer Carcinogenesis
Critical discussion of articles Critical discussion of articles
June 21/June 23
Cancer Registry Breast Cancer
Critical discussion of articles Critical discussion of articles
June 28/June 30
Prostate Cancer Cervical Cancer
Critical discussion of articles Critical discussion of articles
July 5/July 7
Ovarian and Endometrial Cancer MIDTERM EXAM up to and
Critical discussion of articles including June 28 lecture
July 12/ July 14
Colorectal Cancer Lung
2-hour lecture Critical discussion of articles
July 19/July 21
Pancreatic Cancer Bladder Cancer
Critical discussion of articles Critical discussion of articles
July 26/July 28
Pediatric Cancer Leukemia/Lymphoma
Critical discussion of articles Cancer Survivorship
August 2/August 4
Tobacco Chemoprevention Nutrition
DEBATE 1 DEBATE 2
August 9/August 11
Skin Cancer NO CLASS
DEBATE 3
August 16
FINAL EXAM (comprehensive)
