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Figuring Out Who Will Get Liver Cancer

September 9, 2013

Liver cancer incidence is increasing in the general population, and elevated rates have been found in people living with HIV/AIDS. Lesley Park (MPH 2010), a PhD candidate in the Department of Chronic Disease Epidemiology and a fellow at the Center for Interdisciplinary Research on AIDS at Yale, studies liver cancer in the HIV/AIDS population.

Her previous work identified a biomarker (specifically FIB-4) for liver cancer. She is now using longitudinal studies to refine the risk model. With that new information, she hopes to provide recommendations to clinicians and patients on how to prevent the disease. Using statistical methods to quantify risk prediction and prevention, she teases out which factors are most clearly implicated: anti-retroviral therapy, hepatitis B and C, alcohol consumption, or other factors related to HIV. Patients with HIV sometimes suffer liver toxicity from the very medicines that keep them alive. Furthermore, some HIV-positive patients are co-infected with hepatitis B or C and some may have a high rate of alcohol consumption, she says. “By better treating and understanding how these issues interact, we may be able to prevent liver cancer and reduce the burden of cancers in the aging HIV-infected population.”

Lesley has been working in HIV research for about eight years, first as a statistical programmer at the Harvard School of Public Health, and now at Yale.

My early career used my math, logic, and computing skills to organize and clean data and contribute to the design of a long-term study on HIV-infected subjects who have participated in antiretroviral therapy clinical trials. Now, in pursuing my doctorate, I’m focused more on designing and executing my own studies on cancer in people living with HIV/AIDS. With my dissertation, I’m in charge of the study, from inception to analysis to publication.”

Lesley uses data from the Veterans Aging Cohort Study (VACS). VACS is an observational study that includes HIV-positive and HIV-negative groups matched for age, race, and clinical site. The data go back to 1996, which makes this a unique source for information on diseases with long latency, such as cancer. This year she received a perfect score in a grant application to the National Institutes of Health (NIH) and was awarded funding from the National Cancer Institute (NCI) for her remaining years of dissertation research at Yale.

Her advisers are Robert Dubrow and Amy Justice, and she finds them “incredible. I have a standing weekly meeting, which really allows me to stay focused (especially during my dissertation writing years) and obtain regular feedback on my analyses and writing.”

Born and raised in Fairfax, Virginia, just outside Washington, D.C., Lesley attended the University of Virginia, where she majored in both French and mathematics. After graduation, she moved to France for a year and taught elementary school English. “Since I was only allowed to work twelve hours a week by French immigration law, I had an amazing year of volunteering in a small French town and exploring France and Europe,” she says.

When it came time to go back to school, she opted for a Masters in Public Health and then a doctorate. She chose Yale because “the intimate program size and accessibility of faculty are incomparable to other major research universities. In addition, only at a campus like Yale can you truly have an interdisciplinary approach to training, with access to all of the departments: medicine to MCDB to epidemiology to management to history of science/history of medicine.”

In addition to her academic commitments, she keeps busy with Yale activities and Pilates.

Lesley represents her department in the Graduate Student Assembly (GSA) and was a professional ethics training facilitator for new graduate students. In addition, she is a Graduate Affiliate of Jonathan Edwards College and serves on the Dean’s Advisory Committee on Regulations and Discipline. “As a way to cope with the stress of my doctoral studies (especially the killer year before qualifying exams), I regularly practiced Pilates. It became such an important outlet from research, coursework, and teaching, that I decided to become a certified Pilates instructor!” She now teaches mat classes at Aldrich Pilates.