Amy Trentham-Dietz
· Professor of Population Health Sciences, Associate Director of Population Science, Carbone Cancer CenterUniversity of Wisconsin-Madison · Community and Environmental Health Sciences
Active 1996–2024
About
Dr. Amy Trentham-Dietz is a Professor of Population Health Sciences and the Associate Director of Population Science at the Carbone Cancer Center at the University of Wisconsin–Madison. As a cancer epidemiologist, her research focuses on breast cancer prevention, early detection, and outcomes. She employs both novel and traditional epidemiologic approaches, complemented by methods from health services research and simulation modeling. Her work concentrates on understanding modifiable lifestyle factors such as obesity, physical activity, and environmental influences to better understand breast cancer etiology and identify avenues for prevention. Additionally, she studies ductal carcinoma in situ (DCIS) of the breast, a non-obligate precursor for invasive breast cancer often detected through mammography, and utilizes simulation modeling to examine risk-based screening approaches aimed at maximizing benefits while reducing harms.
Research topics
- Gynecology
- Internal medicine
- Oncology
- Medicine
- Environmental health
Selected publications
Estimation of Cancer Deaths Averted From Prevention, Screening, and Treatment Efforts, 1975-2020
JAMA Oncology · 2024 · 68 citations
- Medicine
- Gynecology
- Oncology
Importance: Cancer mortality has decreased over time, but the contributions of different interventions across the cancer control continuum to averting cancer deaths have not been systematically evaluated across major cancer sites. Objective: To quantify the contributions of prevention, screening (to remove precursors [interception] or early detection), and treatment to cumulative number of cancer deaths averted from 1975 to 2020 for breast, cervical, colorectal, lung, and prostate cancers. Design, Setting, and Participants: In this model-based study using population-level cancer mortality data, outputs from published models developed by the Cancer Intervention and Surveillance Modeling Network were extended to quantify cancer deaths averted through 2020. Model inputs were based on national data on risk factors, cancer incidence, cancer survival, and mortality due to other causes, and dissemination and effects of prevention, screening (for interception and early detection), and treatment. Simulated or modeled data using parameters derived from multiple birth cohorts of the US population were used. Interventions: Primary prevention via smoking reduction (lung), screening for interception (cervix and colorectal) or early detection (breast, cervix, colorectal, and prostate), and therapy (breast, colorectal, lung, and prostate). Main Outcomes and Measures: The estimated cumulative number of cancer deaths averted with interventions vs no advances. Results: An estimated 5.94 million cancer deaths were averted for breast, cervical, colorectal, lung, and prostate cancers combined. Cancer prevention and screening efforts averted 8 of 10 of these deaths (4.75 million averted deaths). The contribution of each intervention varied by cancer site. Screening accounted for 25% of breast cancer deaths averted. Averted cervical cancer deaths were nearly completely averted through screening and removal of cancer precursors as treatment advances were modest during the study period. Averted colorectal cancer deaths were averted because of screening and removal of precancerous polyps or early detection in 79% and treatment advances in 21%. Most lung cancer deaths were avoided by smoking reduction (98%) because screening uptake was low and treatment largely palliative before 2014. Screening contributed to 56% of averted prostate cancer deaths. Conclusions and Relevance: Over the past 45 years, cancer prevention and screening accounted for most cancer deaths averted for these causes; however, their contribution varied by cancer site according to these models using population-level cancer mortality data. Despite progress, efforts to reduce the US cancer burden will require increased dissemination of effective interventions and new technologies and discoveries.
Coordinating Centers as a Strategy for Accelerating Cancer Epidemiology Consortia: Best Practices
Current Epidemiology Reports · 2022 · 3 citations
- Political Science
- Computer Science
- Engineering ethics
Purposeof Review: This review highlights six "best practices" for cancer epidemiology coordinating centers to facilitate the success of a research consortium. Recent Findings: Evidence from emerging literature regarding the Science of Team Science suggests that coordinating centers can more effectively foster collaborative cancer epidemiology research in consortia by (1) establishing collaboration as a shared goal at the start, (2) providing scientific expertise complementary to the research sites that adapts over the course of the project, (3) enacting anti-racist and inclusive approaches in all consortium decisions and activities, (4) fostering early-stage investigator career development, (5) engaging stakeholders including cancer survivors as peers, and (6) delivering reliable logistical support and technology tools with planned process evaluation so that researchers can collaboratively focus on the science. Summary: By drawing on the Science of Team Science, coordinating centers can accelerate research progress and increase the impact of cancer epidemiology consortia.
Annals of Internal Medicine · 2021 · 73 citations
- Medicine
- Demography
- Gerontology
BACKGROUND: Screening mammography guidelines do not explicitly consider racial differences in breast cancer epidemiology, treatment, and survival. OBJECTIVE: To compare tradeoffs of screening strategies in Black women versus White women under current guidelines. DESIGN: An established model from the Cancer Intervention and Surveillance Modeling Network simulated screening outcomes using race-specific inputs for subtype distribution; breast density; mammography performance; age-, stage-, and subtype-specific treatment effects; and non-breast cancer mortality. SETTING: United States. PARTICIPANTS: A 1980 U.S. birth cohort of Black and White women. INTERVENTION: Screening strategies until age 74 years with varying initiation ages and intervals. MEASUREMENTS: Outcomes included benefits (life-years gained [LYG], breast cancer deaths averted, and mortality reduction), harms (mammographies, false positives, and overdiagnoses), and benefit-harm ratios (tradeoffs) by race. Efficiency (benefits per unit resource), mortality disparity reduction, and equity in tradeoffs were evaluated. Equitable strategies for Black women were defined as those with tradeoffs closest to benchmark values for screening White women biennially from ages 50 to 74 years. RESULTS: Biennial screening from ages 45 to 74 years was most efficient for Black women, whereas biennial screening from ages 40 to 74 years was most equitable. Initiating screening 10 years earlier in Black versus White women reduced Black-White mortality disparities by 57% with similar LYG per mammogram for both populations. Selection of the most equitable strategy was sensitive to assumptions about disparities in real-world treatment effectiveness: The less effective treatment was for Black women, the more intensively Black women could be screened before tradeoffs fell short of those experienced by White women. LIMITATION: Single model. CONCLUSION: Initiating biennial screening in Black women at age 40 years reduces breast cancer mortality disparities and yields benefit-harm ratios that are similar to tradeoffs of White women screened biennially from ages 50 to 74 years. PRIMARY FUNDING SOURCE: National Cancer Institute at the National Institutes of Health.
A Population-Based Study of Genes Previously Implicated in Breast Cancer
New England Journal of Medicine · 2021 · 851 citations
- Genetics
- Biology
- Medicine
BACKGROUND: Population-based estimates of the risk of breast cancer associated with germline pathogenic variants in cancer-predisposition genes are critically needed for risk assessment and management in women with inherited pathogenic variants. METHODS: In a population-based case-control study, we performed sequencing using a custom multigene amplicon-based panel to identify germline pathogenic variants in 28 cancer-predisposition genes among 32,247 women with breast cancer (case patients) and 32,544 unaffected women (controls) from population-based studies in the Cancer Risk Estimates Related to Susceptibility (CARRIERS) consortium. Associations between pathogenic variants in each gene and the risk of breast cancer were assessed. RESULTS: , were not associated with an increased risk of breast cancer. CONCLUSIONS: This study provides estimates of the prevalence and risk of breast cancer associated with pathogenic variants in known breast cancer-predisposition genes in the U.S. population. These estimates can inform cancer testing and screening and improve clinical management strategies for women in the general population with inherited pathogenic variants in these genes. (Funded by the National Institutes of Health and the Breast Cancer Research Foundation.).
Supportive Care in Cancer · 2021 · 33 citations
- Medicine
- Physical therapy
- Physical medicine and rehabilitation
Frequent coauthors
- 8 shared
The GENICA Network
Heidelberg University
- 6 shared
Amy B. Knudsen
Massachusetts General Hospital
- 4 shared
Montserrat García‐Closas
Institute of Cancer Research
- 4 shared
Katrina A.B. Goddard
National Institutes of Health
- 4 shared
Julia A. Knight
Public Health Ontario
- 4 shared
Philip E. Castle
National Institutes of Health
- 4 shared
Nadia Howlader
National Cancer Institute
- 4 shared
Natasha K. Stout
West Virginia University
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