Among all of the many lists of influential people, TIME magazine’s annual selection is at the top. This year we are thrilled that TIME named two PCORI awardees as among the 100 most influential people in the world. So I thought I’d take a moment to celebrate their accomplishment.
Laura Esserman, MD, MBA, and Shelley Hwang, MD, MPH, of the University of California, San Francisco, and Duke University, respectively, are breast cancer surgeons who think we may be overdiagnosing and overtreating some breast cancer in our efforts to reduce its incidence and impact. Their PCORI-funded studies are aimed at discovering whether we can make breast cancer screening more personalized and avoid treatments such as surgery and radiation—with all their side effects—for women with a low chance of benefiting from them.
Esserman’s study focuses on mammography. Her team will begin this summer to randomly assign a very large number of women—100,000—to receive mammograms either annually or at a rate determined by each woman’s level of risk. In some cases, women will choose one approach or the other.
Hwang is the principal investigator of two PCORI studies, both examining alternatives to aggressive treatment for ductal carcinoma in situ (DCIS), a very early form of breast cancer in which abnormal cells have not spread outside the milk ducts. In one study using information from existing databases, Hwang and her team are comparing outcomes of treatment (surgery or radiation) versus active surveillance, in which patients delay treatment while doctors monitor them intensely for signs of progression. In a second study, Hwang will seek about 1,200 women with low-risk DCIS to participate in a randomized study comparing treatment (again, surgery or radiation) to active surveillance. The team will look for differences in cancer and in clinical and patient-reported outcomes.
As described in TIME, “these doctors’ groundbreaking research is starting to bear out the fact that women have more options.” For them and for PCORI, the goal is not to find one treatment that suits everyone but to find the right treatment for each person based on her or his individual circumstances and the outcomes important to them. That’s what we call “research done differently.”
At PCORI, we rely heavily on our patients and other healthcare stakeholders to help us decide which research questions are most important to study and how we can best answer them. Esserman and Hwang are just two of the creative, world-class researchers we rely on to help us achieve that goal. So from all of us at PCORI, congratulations to them and cheers to TIME for recognizing their pioneering work and its potential impact.