Disentangling the effects of poverty, race, and geography on health is a multifaceted problem. Now a Texas researcher is using large databases to figure out how these factors interact to affect cancer survivability, as well as to monitor the health of vulnerable populations.
Sandi Pruitt was recruited in 2012 to the University of Texas Southwestern Medical Center and Harold Simmons Comprehensive Cancer Center with the help of a First-Time Tenure-Track Award from CPRIT. She was a postdoctoral fellow at the Washington University School of Medicine, and joined the faculty of the Department of Clinical Sciences.
Cancer death rates vary widely from place to place, even within Texas. Pruitt seeks to understand why people in some places bear a heavier cancer burden than others. “Is it the social environment, the physical environment, the economic environment?” she asks. “What is it about ‘place’ that causes these different outcomes?”
In Dallas County, for example, Pruitt is studying patterns of cancer screening. She is looking particularly at populations served by Parkland hospital, which is a safety net for Dallas and provides care for under- or uninsured people. In a separate prevention-services project funded by CPRIT, colorectal screening kits are being sent to all eligible Parkland patients. Pruitt and her team are currently randomizing the distribution of kits across ZIP Codes so she can sort out the effects of social interactions, race, and economic status, and find out more about how these neighborhood factors impact health.
In another area of research, Pruitt is improving access for patients to clinical trials. Influenced by the death of her mother from lung cancer, Pruitt examined entry requirements for clinical trials for the disease.
“People who have had prior cancers are typically excluded from clinical trials, because they are expected to die quickly and won’t contribute meaningful data to the study,” Pruitt said. “But what we’ve shown is that is not actually the case.”
Lung cancer is the most deadly cancer in the U.S., and as many as 18% of people who develop lung cancer have had a prior incidence of an unrelated cancer. “Lung cancer is typically a disease of older people, and there is a good chance that sometime in their lives they’ve had a prior cancer,” she said, “but we found that it didn’t impact their ability to survive lung cancer compared to other lung-cancer patients.”
This is the first time anyone had looked at this question. Now, because of Pruitt’s work with her collaborator, oncologist Dr. David Gerber, clinical trials for lung cancer have opened up to patients who previously would have been excluded. Because lung cancer is the most commonly diagnosed cancer among men and women in the U.S., these changes in clinical-trial eligibility may have a large impact. Each year, approximately 36,000 people who have previously survived cancer will be newly diagnosed with lung cancer.
Pruitt is currently expanding this research to include other types of cancer, including breast, colorectal, liver, pancreas, non-Hodgkin’s lymphoma, and kidney.
“I’m incredibly grateful to CPRIT, because it really kick-started my first independent faculty position,” Pruitt said. “I love to think about 170 new cancer researchers here in Texas; it’s a huge opportunity for biomedical research here in the state.”
Pruitt received her undergraduate degree from The Evergreen State College, and then studied at the University of Texas Health Science Center at Houston, where she received her Ph.D. in behavioral science and her M.P.H. in health promotion and health education. She began her postdoctoral fellowship at Washington University in 2008.
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