Fred Hutchinson Cancer Research Center began a new collaboration with Chinese researchers this week by signing an agreement to establish a tumor tissue repository with the Henan Cancer Research Institute in central China’s Henan Province and the China Centers for Disease Control and Prevention. Scientists at the Hutch will be able to use the repository to do research involving the molecular analyses of surgical and other biological specimens and will also have access to demographic and follow-up data.
The collaboration is set to begin in January with a pilot study on breast cancer biomarkers. Eventually, the repository will collect tissue samples from all types of cancers, making it a rich resource for researchers.
“We’ll accrue several dozen cases, stop, do a review, and adjust,” said Dr. Steve Self, associate director of the Fred Hutch Vaccine and Infectious Disease Division and an architect of the collaboration. “At that point we’ll be ready to open the flood gates for cases. We’ll hear from researchers here what kind of projects may make use of this repository.”
About a dozen leading researchers from China and across the United States came to the Fred Hutch campus this week for a two and a half day workshop to talk about just that.
China is increasingly becoming a major player in cancer research. The Chinese government has made huge investments in biomedical research at a time when the United States is cutting its budget due to sequestration, and government grants are becoming harder to get. The Chinese investments are paying off in well-supported specialized cancer programs at major cancer and academic centers.
And then there’s the sheer number of people in China, which has 19 percent of the world’s population. Although it has a lower cancer rate than the United States, its raw numbers are higher—around 3 million people newly diagnosed yearly, compared with about 1.6 million in the United States.
“They have 1.3 billion people, so any problem is a big problem,” said Dr. Jonathon Samet, director of the University of Southern California Institute for Global Health, who attended this week’s workshop.
Take the number of smokers in China. More than 300 million people – mostly men – smoke, which is nearly one-third of the world’s smokers, according to the World Health Organization. About one in every three cigarettes smoked in the world is smoked in China.
If China has a huge population of smokers — and a correspondingly high rate of lung cancer — to study, it won’t be alone in reaping the benefits of any research done there.
Although smoking rates have fallen dramatically in the United States – from 43 percent in 1965 to 18 percent today – lung cancer remains the leading cause of cancer death here and the second most common cancer among both men and women, accounting for almost 157,000 deaths a year, according to the U.S. Centers for Disease Control and Prevention. An estimated 42 million Americans aged 18 and over still smoke. More than 16 million Americans suffer from a disease caused by smoking.
Another area ripe for research is the effects of pollution on lung and other cancers. China’s rapid industrialization over the last 30 years has left its major cities shrouded in brown smog so dense that flights get canceled and people run marathons in gas masks.
Again, research on pollution can benefit both countries, collaboration organizers said. U.S. researchers have an opportunity to study a population with varied exposures to pollutants, and Chinese researchers have a chance to learn from past U.S. research.
“[China is] where we were the 1950s” with increasing industrialization and pollution, said Dr. Terrance Kavanagh, director of the Center for Ecogenetics and Environmental Health at the University of Washington. “They can learn from us, but they don’t want to take 50 years to do so.”
Another area of interest is the effect of indoor pollution, which is suspected of contributing to the rising rates of lung cancer in Chinese women, who use tobacco at much lower rates than men. Dr. Xin Sun, deputy director of the National Institute of Occupational Health and Poison Control at the China CDC, said that smoky coal or wood is traditionally used for household cooking and winter heating, despite efforts by the Chinese government to get people to switch to cleaner-burning stoves. Readily available coal is cheap, and even wealthier households resort to “stove-stacking,” or keeping a coal-burning stove available to use on days when the electricity goes out.
Close to 3 billion people in the world cook in a similar manner, so understanding how stoves and other indoor pollutants contribute to lung and other cancers can be put to broad use, Dr. Edmund Seto, a University of Washington associate professor of Environmental and Occupational Health Sciences.
It used to be that environmental cancers were considered local problems, said Fred Hutch’s Self. “There is increasingly an appreciation that these are global problems,” he added. “The goal here is to do research on problems that are important not only to China but to the United States and the world.”
"The question is not 'why China?'" said Dr. Lena Yao, the Hutch's senior project manager for China programs. "It's 'Why aren't you in China?'"
Self and others at Fred Hutch have worked over the past five years to build relationships with many of the Chinese researchers attending the workshop. In 2010, the Hutch signed a memorandum of understanding with the China CDC to undertake scientific research and training projects that support and contribute to the prevention, early detection, diagnosis and treatment of cancer, infectious diseases and other related health concerns in China and the United States.
Other global programs include the Hutchinson Centre Research Institute - South Africa, a nonprofit, South African entity established by Fred Hutch with support from the Bill & Melinda Gates Foundation. It includes the Cape Town HVTN Immunology Laboratory, a state of the art immunology laboratory and training facility.
In 2004, Dr. Corey Casper of Fred Hutch initiated collaboration with the Uganda Cancer Institute to develop effective prevention and treatment strategies for infection-associated cancers, conduct research and train clinicians and support staff. Early next year, the partners will open a new state-of-the-art research center, clinic and training center, the first comprehensive cancer center constructed by U.S. and African cancer institutions in sub-Saharan Africa, with funding from the U.S. Agency for International Development.
Solid tumors, such as those of the lung, are the focus of Solid Tumor Translational Research, a network comprised of Fred Hutchinson Cancer Research Center, UW Medicine and Seattle Cancer Care Alliance. STTR is bridging laboratory sciences and patient care to provide the most precise treatment options for patients with solid tumor cancers.
Mary Engel is a former staff writer at Fred Hutchinson Cancer Center. Previously, she covered medicine and health policy for the Los Angeles Times, where she was part of a team that won a Pulitzer Prize for Public Service. She was also a fellow at the Knight Science Journalism Program at MIT. Follow her on Twitter @Engel140.