Issues of the Environment: MI-CARES team conducting extensive study on cancer-causing chemicals
- A new study from researchers at the University of Michigan’s School of Public Health and Rogel Cancer Centerwill describe and quantify the impact of known and suspected environmental exposures on cancer risk. The program, called MI-CARES, or Michigan Cancer and Research on the Environment Study, is funded through a $13 million grant from the National Cancer Institute.
- MI-CARES will enroll at least 100,000 people from diverse racial and ethnic backgrounds who live in environmental hotspots throughout Michigan. The program will target the Detroit metropolitan area, Flint, Grand Rapids, Kalamazoo, Lansing and Saginaw, but enrollment will be open to all Michiganders ages 25-44. Participants will be followed over time through surveys as well as blood and saliva samples to track environmental exposures and cancer biomarkers. Women who are pregnant or may become pregnant are greatly encouraged to participate as data on this population is sorely lacking.
- Michiganders have a long history of tragic environmental exposures, from contaminated animal feed with polybrominated biphenyls in the 1970s, to lead and toxin contamination in Flint’s water supply. Michigan has the highest knownPFAS levels of any state due to industrial contamination of lakes and rivers from the 1940s to 2000s.
- Justin Colacino, Associate Professor of Environmental Health Sciences at the University of Michigan School of Public Health, is one of the chief investigators for the MI-CARES study. The study is important not just for tracking exposure to a single chemical or exposure event, but it can examine how toxins create an interactive burden over time.
David Fair: This is 89 one WEMU with another edition of Issues of the Environment. I'm David Fair, and today we're going to explore the prevalence of environmental exposure on public health, particularly its causal effects on cancer risk in Michigan residents. The University of Michigan School of Public Health has partnered with the Rogel Cancer Center in the U of M Health System for a new study on the matter. It's called the Michigan Cancer and Research on the Environment Study or MI-CARES. Our guest this morning is Justin Colacino, and he is an associate professor of environmental health sciences at the U of M School of Public Health and is serving as one of the chief investigators on the MI-CARES study. Thank you so much for the time today, Justin.
Justin Colacino: Thank you so much for having me.
David Fair: As I understand it, this study at its end is going to better describe and quantify the impacts of known and suspected environmental exposures on cancer risk. What about the design and structure of the study helped secure a $13 million grant from the National Cancer Institute?
Justin Colacino: Yes. So, this is a great question. So, there's a lot of things that we know about what causes cancer, but there's still a lot that we don't know. And that's really what motivates this study. So, a lot of people know that genetics play a major role in how we get cancer. But what I think a lot of people don't know is that for the big cancers that affect the state of Michigan--things like breast cancer, prostate cancer, colon cancer, liver cancer--actually, the majority of the risk derives from the environment. And so, the specific environmental risk factors for these cancers, we don't really have that good of an idea. So, Michigan ends up being a really good place to run a study like this. We all know that Michigan is a beautiful state with a lot of great natural resources, but I don't think that any Michigander would be surprised to know that, you know, we also have some significant pollution problems dating back to the PBB contamination in the 1970s, through lead contamination in the water, to our neighbors in Flint and Benton Harbor, to air pollution in Detroit and Kalamazoo, to even our dioxane plume in our own backyard, and PFAS and our water. We know that Michigan has a lot of environmental exposures, but we don't really know the risk of those on developing diseases, like cancer. And we especially don't know the cumulative risk or what happens when we're exposed to multiple of these chemicals at the same time. And so, I think what sets our study apart is that we're going to be focusing on these exposures where communities have been disproportionately exposed. This idea of environmental injustice, where communities that are--communities of color or communities with lower socioeconomic status--have been, you know, placed or redlined into these areas where they are disproportionately exposed to toxic exposures. These communities have traditionally been excluded from this type of research. And I think we're trying to really make a big push here. And this is actually a big push across. The National Cancer Institute is trying to include these communities to try to really understand what the cancer risk or to those the risk of the environmental exposures is that might be the most vulnerable.
David Fair: So, as you mentioned, we know going in based on how we've structured our communities, that lower income residents and people of color are most definitely more adversely impacted by exposure because that's where we've chosen to locate our industrial and manufacturing bases. So, when you mentioned the areas that will be focused on as part of the study, where exactly are those areas?
Justin Colacino: So, we're recruiting people from all over the state of Michigan, because we know that all across the state of Michigan, there are specific environmental health concerns, whether it might be pesticide exposure and the agricultural communities, these PFAS exposures that we're all burdened with, or air pollution. But the areas where we're specifically wanting to target are what we call environmental injustice hotspots. And so, these tend to be some of the more industrial or urbanized parts of our communities of the Detroit metro area, Saginaw, Flint, Lansing, Kalamazoo, Grand Rapids. These are the areas where we're specifically wanting to target because we know that they are the most disproportionate levels and environmental exposures there. And we think that that's where we might see the biggest link between environmental risk and cancer.
David Fair: WEMU's Issues of the environment and our conversation with Justin Colacino continues. Justin is lead researcher on a new research and study project at the U of M called the Michigan Cancer and Research on the Environment Study, or MI-CARES. You mentioned participants. So, the research process is really just getting started, a six-year study, and it's going to require some lofty numbers in terms of participation. So, as I understand it, the grant says you have to have 10,000 voluntary participants within two years and then seek to get up to 100,000 program enrollees. What is required of those who choose to participate?
Justin Colacino: Yes. So, this is a lofty goal, and this is really a huge effort that we're hoping to partner with all of the folks in Michigan for people that are interested in participating. So, one of one of the things that's unique about our study is that we're recruiting individuals who are a little bit younger than the traditional cancer study. So, we're looking for individuals who are aged 25 to 44 in the state of Michigan, and some of them are recruiting up to 100,000 people or more, as you said. For folks that are interested in participating in the study, they can go to our website, which is micares dot health, and you can see a little bit more information about what's entailed. But in general, what's required for study participation is we have some questions that we ask. And these are things about like where do you work? Where do you live? You know, what's your home like? What personal care products do you use? What do you eat? How do you exercise? Some things that we know are, like, general risk factors. We'll ask folks about, you know, their health status and their family's health status. And then, we will ask them to provide us with some blood spots or just like a finger prick with, like, a few spots of blood and then some saliva samples. And within those bio specimens, that blood and saliva, we can look for levels of chemicals. And then, we can also look for markers that we think might predict whether someone gets cancer or not down the line. And so, this is really a big goal of our study is to combine this questionnaire data to really try to with with these bio specimen data to really try to figure out, you know, what are people exposed to in Michigan within these different environmental injustice hotspots. Can we identify some classic exposures that we know have been really a problem in the state of Michigan, but also try to identify some new exposures and then look for some health biomarkers that might reflect the health effects of those exposures. Ideally, what we'd like to do with these data is potentially develop new tests to identify individuals who are at increased risk of cancer down the line. And then, what our long term goal is is to take these data and use them to translate into health policy to work with the state of Michigan government or the United States Environmental Protection Agency to develop new regulation to protect those who are at most risk of environmental exposures in our state.
David Fair: Once again, this is 89 one WEMU, and we're talking with Justin Colacino on this week's edition of Issues of the Environment about a study out of the U of M is helping lead to better understand environmental impacts on cancer cases and cancer risk in Michigan. Now, I mentioned that the National Cancer Institute's $13 million grant for the study runs for a period of six years. Obviously, cancer can take a lot longer than that to develop. So, as you take note of markers throughout this six-year period, should we then consider this a first phase in what will have to be a much longer study of the up to 100,000 participants to see how or if those cancers develop?
Justin Colacino: Yeah, so this is a great question. So, like you said, what we do know about cancers is that they take a long time to develop--sometimes years, sometimes decades. We think that some of these formative exposures that might be leading to cancer could actually happen earlier in life. And so, we're taking it sort of like a two-pronged approach to get at this. So, we will be, as we're recruiting individuals, we'll be following them forward through time. This is called a cohort study. So, we recruit folks. We capture some measures now. And then, we'll follow folks forward through time. We want to compare, you know, the environmental risk factors between individuals who do and don't develop cancer in our study. And, like you said, this can take a long time. So, we've been fortunate to get support through the Rogel Cancer Center here at the University of Michigan to continue to follow these people throughout time, even after the six-year study expires. One other unique thing about the state of Michigan is that many folks who were born in Michigan have what are called neonatal blood spots. And so, these blood spots are available, and they've been bio-banked by the state. And we can actually go back and see what folks were exposed to very early in life and see how those early life exposures might predict developing cancer later in life. And so, this is something that a lot of us are very interested in is that the exposures that might happen when we're, you know, babies or children, those might have disproportionate impact on our disease status later in life. And this is something that we're also hoping to be able to get information in as part of our study.
David Fair: Well, obviously, there is a long and hard road ahead on a research study project of this magnitude. As you launch, what are you and the rest of the team most excited about in its potential?
Justin Colacino: I think we're most excited about engaging with our community partners on this study. We've already established a lot of really amazing collaborations with community partners across the state and just being able to go out to the community and talk to community members, learn about what they're concerned about and their health effects and what they've been seen on the ground there is so important. It's just been so gratifying to learn and learn from our community partners. As we go around the state, you can see that the environmental exposures that impact different communities in our state are very different. I think that's what we're most excited about learning here is being able to really dig in on these individual communities, work with them, and partner with them to really try to understand what health effects might be driven by the exposures in those communities.
David Fair: Well, I think we're all really interested to find out exactly what it is you learn and how we can apply that to better public health outcomes throughout the state. Justin, thank you so much for the time today.
Justin Colacino: Thank you so much. I appreciate it.
David Fair: That is Justin Colacino. He's an associate professor of environmental health sciences at the U of M School of Public Health and is serving as one of the chief investigators for the MI-CARES study. Now, for more information on the study and to learn how you can participate or enroll, should you desire, visit our web page at WEMU dot org. Issues of the Environment is produced in partnership with the Office of the Washtenaw County Water Resources Commissioner, and we bring it to you every Wednesday. I'm David Fair, and this is your community NPR station, 89 one WEMU FM Ypsilanti.
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