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Profile - Dr. James R. Hebert, Sc. D

Issue: Vol.3, No.4 - October 2004

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Article Type: Profile

Dr.James R. Hebert, Sc.D

Dr. James R. Hebert is one of the leading Epidemiologists in the world. Much of his work over the past tow decades has focused on either cancer or nutrition or both.

As a Nutritional Epidemiologist, most of Dr.Hebert's career has been devoted to studies aimed at investigating the role of diet in cancer and cardiovascular disease (CVD). This work has been based in a number of different settings (including in the U.S and India) and has employed a variety of epidemiological and bio-statistical techniques designed specifically to overcome existing, often serious, methodologic problems. A major theme of his methodological research over the past 15 years has been on improving ways to assess diet so as to obviate errors in self-report that can cause major problems with interpreting results of statistical analyses and drawing inferences from epidemiological studies. Because the patho-physiology of CVD is understood better than that of cancer, some of his teams' work in the area of assessment has focused on the relationship between diet and known disease-related intermediate endpoints, such as serum lipids. Knowledge of these physiological relationships has enabled Dr. Hebert's research team to employ methods of construct validity to improve methods of assessing diet. Construct validation makes use of well-known physical and biological relationships [constructs] in identifying errors patterns in self-report data. This work has led to identifying biases in self-reports, mainly due to social approval and social desirability (1-5). The error coefficients have been used to refine estimates of the effect of the diet on health-related outcomes and to improve methods of intervening on diet (and other health-related behaviours) in primary and secondary prevention trials. Work conducted with colleagues in India has produced breakthroughs in dietary self-assessment methods for use in India (6-10) and has helped to identify areas where more methodologic work will be needed (11).

After working overseas on the epidemiology of child growth and in humanitarian aid (for the UN and centered primarily on nutrition) on and off for about 7 years, Dr. Hebert returned to the US to work in cancer research. His first job in this arena, in 1985, was with the American Health Foundation, now known as the Institute for Cancer Prevention, in New York City. He convinced its Director, Ernst Wynder, that he could be the Head of the Section of Nutritional Epidemiology, as the world in which he had worked earlier was at least as 'messy' as was (and is) this field. Dr. Wynder wrote one of the first papers on smoking and lung cancer (12), and was the founder of the American Health Foundation. Dr. Hebert is grateful for the opportunity to have worked with Dr. Wynder and other wonderful colleagues around the world and over the years. Cancer epidemiology affords him a fantastic opportunity to make a difference in people's lives because it calls for an ability to analyze, write and persuade. It also requires a willingness to learn about a variety of topics ranging from molecular genetics to public policy. Like most disciplines in public health, it also requires an appreciation of the social dimensions of health-related problems.

Dr. Hebert came to South Carolina, in 1999, because of the superb fit between the needs of the people and his career trajectory. Cancer rate disparities in this state are the largest in the U.S., and for some cancers proportionally much larger than for any other disease. Even with the encumbrance of being Chair of the Department of Epidemiology and Biostatistics he managed to get numerous studies funded in this arena. Currently, Dr. Hebert is Principal Investigator on nine federally funded cancer-related grants, including Cancer Research Network (CRN), which is the first initiative ever co-funded by the U.S. Centres for Disease Control and Prevention and the National Cancer Institute. Over the past year, Dr. Hebert has worked with leaders from the University of South Carolina, the Medical University of South Carolina, and the Hollings Cancer Centre to develop a Statewide Cancer Prevention and Control Program. The develop a Statewide Cancer Prevention and Control Program. The Memorandum of Understanding that created this program and naming him as the Founding Chair was signed in July 2003. It is the first such agreement between these universities in South Carolina's history. It also is the first such collaborative program in the US.

In addition to being the P.I. on the Cancer Research Network, Dr. Hebert is the Chair of the Research Task Force of the South Carolina Cancer Alliance (SCCA). The SCCA is an organization unlike any other in the United States. Collaborators represent every constituency in the state: every university with a research presence, every medical system that treats cancer patients, virtually all grass roots organizations focusing on cancer or important cancer-related risk factors (e.g.tobacco), all state agencies that house geo-coded data, major NGOs (e.g.,the American Cancer Society), and a wide variety of consumer advocates. It is Dr. Hebert's intention to lead this effort in such a way that the SCCA can plan and advocate for things that really matter in people's lives.

Over the next five years, Dr. Hebert's intention is to make the cancer research and treatment efforts in South Carolina coalesce into an NCI-designated Comprehensive Cancer Center. This will require a lot of cooperation between the major universities, healthcare facilities, and community groups in the state. He wants to devote himself to this, as it provides excellent opportunities to address on of its most pressing public health needs in one of the US's poorest States.

Since the late 1980s, Dr. Hebert has been a strong proponent of conducting epidemiologic studies (13) of diet and cancer in places with potentially high information, as opposed to purely outcome, yield. Consistent with this view, since the early 1990s he has worked with Dr. Prakash C.Gupta and colleagues at the Tata Institute for Fundamental Research in Mumbai and their various field operations on a multi-site study on the role of dietary factors in oral precancerous lesions (11, 14,15). Currently Dr. Hebert works with Dr.Gupta on the Mumbai Cohort Study (16). Dr. Hebert's article in this issue of the journal addresses philosophical and methodologic issues as they relate to the epidemiologic study of cancer from an international perspective.

Through his career Dr. Hebert has advocated for a very expansive view that very much includes an international perspective on local, regional, and national problem. His work in India and Africa will continue to be central to the overall research mission. Dr. Hebert is quoted as saying, 'As long as I am here (or anywhere for that matter), I will not just talk the talk. This will require being mindful of both the social and scientific imperative of the work to which I am called'.

REFERENCES

1. Hebert JR, Clemow L, Pbert L, Ockene IS, Ockene JK, Social desirability blas in dietary self-report may compromises the validity of dietary intake measures. Int J Epidemiology 1995;24-389-98.
2. Hebert JR, Ma Y, Clemow L, Ockene IS, Saperia G, Stanek EJ, Merriam PA, Ockene JK, Gender differences in social desirability and social approval bias in dietary self report. Am J Epidemiology 1997;146:1046-55.
3. Hebert JR, Peterson KE, Hurley TG, Stoddard AM, Cohen N, Field AE, Sorensen G. The effect of social desirability trait on self reported dietary measures among multi-ethnic female health center employees. Ann Epidemiology 2001;11:417-27.
4. Hebert JR, Patterson RE, Gorfine M, Ebbeling CB, St. Jeor ST, Chlebowski RT. Differences between estimated caloric requirements and self-reported caloric intake in the Women's Health Initiative. Ann Epidemiology 2003;13:629-37.
5. Hebert JR, Ma Y, Ebbeling CB, Matthews CE, Ockene IS. Self. Report data. In: Ockene IS, Burke LE, eds. Compliance in Healthcare and Research. Armonk, NY: Futura; 2001:163-79.
6. Hebert JR, Gupta PC, Bhonsle R, Verghese F, Ebbeling C, Barrow R, Ellis S, Ma Y. Determinants of accuracy in estimating the weight and volume of commonly used foods: A cross-cultural comparison. Ecol Food Nutr 1999;37:475-502.
7. Hebert JR, Gupta PC, Bhonsle RB, Murti PR, Mehta H, Verghese F, et al. Development and testing of a quantitative food frequency questionnaire for use in Kerala, India. Public Health Nutr 1998;123-30.
8. Hebert JR, Gupta PC, Bhonsle RB, Sinor PN, Mehta H, Mehta FS. Development and testing of a quantitative food frequency questionnaire for use in Gujarat, India. Public Health Nurt 1999;2:39-50.
9. Hebert JR, Gupta PC, Mehta H, Ebbeling CB, Bhonsle RR, Varghese F. Sources of variability in dietary intake in two distinct regions of rural India: implications for nutrition study design and interpretation. Eur J Clin Nutr 2000;54:479-86.
10. Gupta PC, Hebert JR. Quantitative food frequency questionnaires-applicability in India [letter;comment]. Natl Med J India 1999;12:138-9.
11. Hebert JR, Gupta PC, Bhonsle RB, Mehta H, Zheng W, Sanderson M, Teas J. Dietary exposures and oral precancerous lesions in Srikakulum District, Andhra Pradesh, India, Public Health Nutr 2002;5:303-12.
12. Wynder EL, Graham EA. Tobacco smoking as a possible etiologic factor in bronchiogenic carcinoma: A study of six hundred and eighty-four proved cases. JAMA 1950;143:329-36.
13. Hebert JR, Miller Dr. Methodologic considerations for investigating the diet-cancer link. Amt J Clin Nutr 1988;47:1068-77.
14. Gupta PC, Hebert JR, Bhonsle RB, Murti PR, Mehta H, Mehta FS. Influence of dietary factors on oral pre-cancerous lesions in a population-based case-control study in Kerala, India. Cancer 1999;85;1885-93.
15. Gupta PC, Hebert JR, Bhonsle RB, Sinor PN, Mehta H, Mehta FS. Dietary factors in oral leukoplakia and sub-mucous fibrosis in a population-based case-control study in Gujarat, India. Oral Dis 1998;4:200-6.
16. Shukla HC, Gupta PC, Mehta HC, Hebert JR, Descriptive epidemiology of body mass index of an urban adult population in Western India. J Epidemiol Comm Health 2002;56:876-80.
Expression of P53, Ki-67 and bcl-2 Oncoproteins in Human Breast Cancer and Their Clinicopathologic Significance

Wang Qiangxiu1, Ephata E. Kaaya2, Chen Lihua1 and Wang Jiayao
1 Department of Pathology, Shandon Provincial Hospital, Jinan, China.
2 Department of Pathology, Muhimbili University College of Health Science, University of Dar es Salaam, Tanzania.

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