Studying Large Populations to Save Individual Lives
Garnet Anderson, Director of Public Health Sciences Division
Imagine a large family gathered around a table: a mom and dad, some aunts and uncles, a handful of grown kids and their spouses. Maybe an octogenarian grandparent is there, along with some grandkids and a few family friends.
Everyone at the table is in good spirits and in fairly good health — no cancer, no heart disease, no diabetes or stroke. But nobody’s really giving their glowing health much thought. Nor are they thinking about how that family table might be a bit less crowded if not for the work of public health researchers like Dr. Garnet Anderson.
For the last 25 years, Anderson lent her formidable skills as a scientist and biostatistician to designing, conducting and analyzing data from large population studies, collaborating with colleagues to make breakthrough discoveries that have helped save hundreds of thousands of lives, billions of dollars and untold amounts of suffering.
Yet the general public is often oblivious to her work.
“That’s the challenge of prevention,” she said. “Those saved by an intervention do not know it.
Anderson, who is loath to talk about herself despite extensive contributions to public health, grew up in a “very middle class, average family” in a small town in Colorado, where she learned to read and do math long before entering grade school.
“My mother was a teacher in a one-room schoolhouse for a short while and then a stay-at-home mom,” Anderson said. “She was my teacher and I enjoyed learning. That’s stayed with me.”
Anderson majored in math in college and briefly considered going into nursing or medicine. But applying her exemplary mathematical skills to medical issues seemed like a better fit.
“When I found biostatistics in graduate school, it was clear to me how that could play a valuable role in people’s lives,” she said. “It inspired me.”
Anderson joined Fred Hutchinson Cancer Research Center in 1989. She currently serves as the director of the Public Health Sciences Division and holds the Fred Hutch 40th Anniversary Endowed Chair. She is perhaps best known as principal investigator of the Women’s Health Initiative (WHI) Clinical Coordinating Center, which has been housed at Fred Hutch since 1992.
Her career is, in fact, closely entwined with the WHI, the largest and most ambitious clinical study ever conducted in the U.S. Dr. Ross Prentice, who preceded Anderson as PHS division director and was the initial principal investigator of WHI at the Hutch, called her “the glue that held it together.”
“I am very proud of the WHI,” Anderson said. “It’s been an incredible career opportunity as well as a wonderful contributor to what we know about women’s health.”
In 2002, Anderson co-led the WHI study that revealed combined hormone-replacement therapy (CHT) — which was almost universally being prescribed to menopausal women at the time — significantly raised a woman’s risk for cardiovascular disease, stroke and breast cancer.
The landmark finding triggered a sharp decline in the use of CHT — and saved thousands of lives. A recent Fred Hutch study extrapolated that the study has resulted in 126,000 fewer breast cancer cases, 76,000 fewer cases of cardiovascular disease and 80,000 fewer cases of potentially deadly blood clots — with a cost savings of more than $37 billion.
Still, the finding was not universally embraced.
“I certainly wasn’t prepared for the backlash,” said Anderson. “I think I got 1,500 emails that summer ... I have heard from women who are grateful. But the women who didn’t get breast cancer because of this study don’t call us and say, ‘Thank you.’ They don’t know that they didn’t get breast cancer because of us.”
Anderson scoffs at the notion that prevention is a thankless job, though.
“It’s not thankless, but it’s not appreciated at the individual level so much,” she said. “That’s why we have to do a better job of communicating the impact. You can see the same thing right now with the measles outbreak. We’re so far away from the measles that most of us have forgotten how terribly sick you can become. That’s the thing of prevention — if you never get the disease, then the interventions that were taken to protect you don’t seem as important.”
Over the years, Anderson’s prevention and public health research has had a profound effect in many areas of women’s health.
“When I found biostatistics in grad school, it was clear to me how that could play a valuable role in people's lives. It inspired me.”
In 2010, she and colleagues made important strides in the realm of using biomarkers for earlier detection of ovarian cancer. Her participation in Fred Hutch’s MsFLASH studies (Menopause Strategies: Finding Lasting Answers for Symptoms and Health) has led to the identification of an inexpensive antidepressant as a safe and effective alternative to hormone replacement therapy. She was involved in one of the largest studies yet to show that long-term exposure to air pollution impacts women’s likelihood of having and dying from cardiovascular disease. She was also instrumental in research that showed women who use short-term, estrogen-only hormone replacement therapy after hysterectomy are less likely to develop breast cancer than women who have never used this therapy.
However, eking out definitive answers about how genetics, lifestyle and environmental factors impact our health is only part of her contributions to the Hutch. This dedicated scientist also acts as a mentor to junior faculty members and has helped to establish the WHI as a model for collaborative and translational research.
And she recognizes there is much more to do — and learn — when it comes to keeping all those moms, dads, aunts, uncles, grandparents and grandkids sitting around those kitchen tables laughing and talking for decades to come.
Public health is a long game and Anderson is a committed player.
Her current priorities for the division include finding better ways to tackle the obesity epidemic and its many negative health consequences; developing new ways to test and implement prevention strategies; researching — and reversing — the many health disparities that exist in this country and beyond; and containing the ever-burgeoning costs of cancer care, particularly among cancer survivors.
She’s also excited about melding new technologies — think smartphones, apps and wearables— with traditional data collection and research methods.
“That will be the next generation of large studies,” she said. “Good old-fashioned research design with new technologies married to it. That’s what we’d like to do.”
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