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Clinical and Molecular Epidemiology of Cancer Miquel Porta

Cancer is a complex set of processes that result from the interaction of genetic, clinical and environmental factors, "environmental" including the physical environment, as well as the public health, cultural, economical and political environments.

We believe that studies on the molecular basis of cancer:

• must be taken beyond the laboratory and into the clinical and population contexts, using a scientifically rigorous methodology (usually, in our case, molecular-epidemiological methods).
• must try to get "closer to the bedside", and their usefulness for clinical practice must be assessed properly.
• sometimes they may be integrated with studies on the environmental causes of cancer, and it may be possible to assess the extent to which they may contribute to improve the effectiveness of prevention programs.

We also think that the so-called "schism" among basic, clinical and public health sciences impacts negatively on all three domains both in practical terms and in terms of scientific knowledge.

The aim to know the etiology of pancreatic cancer is perhaps the most ambitious scientific objective in the study of this clinically aggressive disease; it seems so both from the biological and from the public health perspectives, for two main reasons:

• First, knowledge on causes is an essential pre-requisite for primary prevention. This is the only type of prevention that results in a decrease in the incidence of the disease (incidence is the number of new cases in a specific population and time).By contrast, secondary prevention can only be applied to already existing, prevalent cases, and it is thus of limited use in pancreatic cancer.
• Second, interactions between genetic and environmental factors may constitute a relevant area for ethiopathogenic research in pancreatic cancer, as well as in other cancers. The study of such interactions is an excellent opportunity to produce new scientific knowledge on the molecular basis of the carcinogenic processes.

Thus, integrative studies on the causes of cancer are a natural meeting point between molecular biology and epidemiology. Our aim is to achieve an optimal integration of professional cultures, scientific knowledge, methodologies and techniques from public health, clinical medicine and the biological sciences.

We are a team that has worked across several disciplines for more than a decade, one of the pioneer and leading groups in Spain on clinical and molecular epidemiology.

Lines of research

Clinical and molecular epidemiology of exocrine pancreatic cancer, chronic pancreatitis and cancer of the extrahepatic biliary system. This line of work is fundamentally focused on two projects, the PANKRAS I and PANKRAS II studies. They are a joint collaboration with –first and foremost– the Unit of Cellular and Molecular Biology of IMIM, as well as with other organizations such as CSIC, University Miguel Hernandez from Elx-Alacant, the International Agency for Research on Cancer (IARC), the Finnish Institute of Occupational Health, and the Harvard School of Public Health - Channing Laboratories, among others. Indicators of quality of oncological care.

Analysis of out patient and inpatient phases of the "Symptom to treatment interval" (STI) and its impact on survival. Early detection of breast cancer. This line of work is based on the Tumour Registry Working Group at the Hospital del Mar and on the "Breast Cancer Prevention Program" (IMAS/SCS).