Skin Cancer Risks and Risk Prediction in Patients with Actinic Keratosis - PROJECT SUMMARY Research: Actinic keratoses (AKs) are pre-cancerous skin lesions that arise in the setting of chronic sun exposure and affect tens of millions of people in the United States each year. AKs have a risk of transformation to cutaneous squamous cell carcinoma. The majority of AK clinical care and research focuses on the individual AK and its risk of malignant transformation. However, there is evidence that the presence of AKs may be associated with increased risk of squamous cell carcinoma and other types of skin cancer (melanoma and basal cell carcinoma) for the patient as a whole. Though they are not typically used this way, AKs may be an important clinical biomarker of skin cancer risk, including melanoma, squamous cell carcinoma, and basal cell carcinoma. Unfortunately, there are no specific recommendations for clinicians to follow for skin cancer surveillance or early detection in patients with AKs. This project will address key knowledge gaps: to examine the absolute risks of skin cancer in patients with AKs, which are unknown (Aim 1); to understand the care currently being provided to patients with AKs, which is uncharacterized (Aim 2); and to develop a skin cancer risk prediction model for patients with AKs, which has not previously been done (Aim 3). The overarching goal is to provide evidence to guide clinical care and form the foundation for future recommendations on skin cancer surveillance and early detection in patients with AKs, a large and high-risk group. Candidate: Dr. Mackenzie Wehner, MD MPhil is an Assistant Professor of Health Services Research and of Dermatology at MD Anderson Cancer Center. She completed her undergraduate degree at Yale University, medical school at Stanford University, a Master's in Epidemiology at the University of Cambridge, and residency and post- doctoral research fellowship at the University of Pennsylvania. Her career goal is to become an independent, R01-funded physician scientist in patient-oriented skin cancer research and through her research to decrease the burden of skin cancer in the United States. Environment: During this award period Dr. Wehner will devote at least 75% of her time to research and 20% to clinical care of patients at high risk of skin cancer, including those with AKs. Her primary mentor, Dr. Sharon Giordano, and co-mentor, Dr. David Margolis, are proven mentors and experts in patient-oriented research in cancer. The exceptional training environment in cancer research at MD Anderson will offer Dr. Wehner an outstanding opportunity to launch her career as an independent physician-scientist. Career Development: Dr. Wehner will have support from an experienced and diverse advisory committee and will focus her training on developing skills and experience in 1) health services research and large administrative datasets, 2) risk prediction modeling and tools development, and 3) incorporating genetic data in epidemiologic analyses. Completion of the proposed research and career development plan will serve as a platform upon which Dr. Wehner can successfully transition to independence and pursue an impactful career focused on patient-oriented skin cancer research.
