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The final chapter of Otis W. Brawley, MD, is distinguished by his illustrious career in cancer prevention and control that began earlier this month when he began working as Bloomberg Distinguished Professor. at Johns Hopkins University in Baltimore.
During an exclusive interview with Onco's Zine, Brawley, 59, followed up on his promise in November to share information about what he described as "a terrific opportunity to stay in business." to increase my impact on health disparities and cancer screening and how health care is applied. "
He said his appointment to Hopkins would also imply that he would devote more time to the issue of public policy in Washington, DC, and he forcefully proclaimed that this position would give him "more freedom to speech and academic independence. "
In November, Brawley, a medical oncologist and leading cancer prevention and control expert, resigned after serving as Medical and Scientific Director and Executive Vice President of the Canadian Cancer Society. American Cancer Society since 11 years.
At that time, he did not detail the circumstances relating to the time of his departure, but he told me in our recent telephone interview that Hopkins had started recruiting him as a Bloomberg Distinguished Professor. in February 2018.
Professor Bloomberg
The Bloomberg program was created in 2015 through a $ 350 million donation from a philanthropist and former mayor of New York City. Michael R. Bloombergwho graduated from Hopkins.
Brawley is the 39th recipient of this title, which will ultimately be awarded to 50 academics in total responsible for studying major global issues and teaching the next generation of physicians, scientists and academics.
He will lead an interdisciplinary research effort focused on reducing racial, economic and social disparities in cancer prevention, detection and treatment in the United States and around the world. He will also hold positions at Hopkins Bloomberg School of Public Health and his full program Sidney Kimmel Complete Cancer. Center.
He will also serve as badociate director of the Kimmel Cancer Center for community outreach and engagement, leading outreach programs for disadvantaged populations in Maryland and Washington DC.
Brawley said he was also considering continuing his clinical activities at the cancer center and that he would teach cancer epidemiology to undergraduate and graduate students of the health school. public, as well as at the Faculty of Medicine.
Why Hopkins?
"It's really a fabulous job that will allow me to work day after day with the many great people I've respected and who are already raising awareness in the Hopkins community," he said, noting that he had been able to collaborate with many people. from among them in the past during his time with the American Cancer Society.
"And one of Hopkins' greatest attractions is his spectacular faculty, his amazing students and the opportunity to help shape the next generation of cancer prevention and control scientists," he said.
The Bloomberg Chair will allow Brawley to merge all his professional pbadions into unhindered capacity.
"I tend to attract attention," he admitted, "and cancer prevention and disparities are areas that need special attention."
After starting his career in the Cancer Prevention Division of the National Cancer Institute, he moved to Atlanta in 2001 to become Deputy Director of Cancer Control at Emory's Winship Cancer Institute and Medical Director of the Grady Memorial Cancer Center. Hospital, before joining American Cancer Society in 2007 as a doctor and chief scientist.
"I spent time in the public service, serving a foundation, and now I'm back in academia. Although I did not work in the industry, I had experience in drug development. "
"I had the opportunity to run a cancer center in several locations and run institutes that look at health outcomes and disparities and, of all these choices, I chose that", was -he explains.
Rational medicine
Brawley has long criticized over-detection, over-diagnosis and over-treatment of cancer, and fiercely defended what he calls "rational medicine."
"I'm not talking about rationing drugs, but rationally applying what we already know about cancer."
He said that with the high costs of health care and the unnecessary use of many medical interventions, he intends to continue to be an "informed leader" in the fight against cancer , to strive to change the behavior in the community and to encourage scientific research application of good science.
Future testimony
In addition to helping educate the public and practitioners about rational medicine and the need to strengthen cancer prevention, he intends to convey this message to Congress.
Brawley stated that he had already testified many times before Congress and that he was encouraged by Hopkins to continue to appear before lawmakers and to appeal to lawmakers for issues related to cancer prevention and disparities.
"American culture is more focused on individuals than on group dynamics, and one of the lessons I learned from many congressional testimony is that congressmen are not interested in statistics. and population rates, but by anecdotes, "he said, adding that it was so particularly important to increase understanding of population medicine and epidemiology, not just for the public and Congress, but also for doctors and make them understand that prevention and control can reduce the risk of cancer.
Disparities
For Brawley, there are disparities when people do not receive the same health care as others.
An example that he cited is a study that he had done several years ago in Atlanta and that showed that 7% of black women and 3% of white women who had heard of a mammogram and who had been diagnosed with early-stage bad cancer were not receiving treatment during treatment. their first year of diagnosis.
He said that while he was at American Cancer Society he and his team began interventions to encourage people to continue treatment, including navigation programs and community education and awareness of health-related behaviors. He added that some of these programs were based on anti-smoking initiatives.
Here are some other examples of disparities in health:
- a study that showed that between 1988 and 2015, bad cancer mortality had been reduced from 44% to 51% in eight states, while in the same period, it had decreased by only 20 % to 29% during the same period;
- and a study that showed that the risk of dying from cancer in 2015 in Utah was 125 deaths per 100,000 population while in Kentucky, the risk was 195 per 100,000 people.
Brawley noted that the disparities may also exist in affluent communities where some people with health insurance may be over-screened, over-diagnosed and over-treated with bad or prostate cancer, resulting in "misapplication many existing technologies that can lead to huge disparities and increased costs … when they may not have been invited to exercise and monitor their diets. "
He also said that health care costs in the United States are about twice as high as those in many European countries and that the results are no better.
Vision of the 21st century
Brawley's vision for a 21 st century NCI cancer center is to create centers that serve the communities in which they are located.
"Not only by providing health care, but by actively defining the problems in the communities they serve and educating these communities to be healthy and prevent cancer." For example, he added, obesity has become a more important cause of cancer than tobacco in many communities in the United States, and many people do not realize it.
He was elected to the National Academy of Medicine (formerly the Institute of Medicine) in recognition of his expertise in cancer prevention and control in 2015, and was recently appointed to the Council of Scientific Advisors. from the NCI.
Brawley now hopes that his new Bloomberg-based tyrant chair will help him continue to advocate the importance of prevention and reduce disparities with the freedom to pursue a scientific program free of any other program.
This is the first in a series of new beginnings for distinguished members of the cancer community.
Last Review: January 23, 2019
The selected image: Otis W. Brawley, MD, at the 52nd Annual Meeting of the American Society of Clinical Oncology (ASCO) to be held at the McCormick Place Convention Center in Chicago, Illinois on Monday, June 6, 2016 . Courtesy: © 2010 – 2019 ASCO / Zach Boyden-Holmes. Used with permission. Photo 1.0: Gilman Hall, Johns Hopkins University, Baltimore, Maryland. Courtesy: © 2010 – 2019 Fotolia. Used with permission. Photo 2.0: Thomas Kornberg, PhD, Otis W. Brawley, MD, and Richard L. White, MD, FACS, address questions in General Session X: Health Policy: Opportunities and Challenges of the Breast Cancer Symposium, supported by ASCO, the American Society of Clinical Oncology, ASTRO, American Society of Radiation Oncology, SSO, Society of Surgical Oncology, ASBS American Society of Breast Surgeons and ASBC American Breast Cancer Society. Courtesy: © 2010 – 2019 ASCO / Todd Buchanan. Used with permission.
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