University of Nebraska Medical Center

Summer Epidemiology Research in a Mediterranean Island

UNMC College of Public Health Faculty, Dr. Evi Farazi, and two Master of Public Health (MPH)-Epidemiology students, Ellana Haakenstad and Emma Schultz, spent part of this past summer setting up research projects at the Bank of Cyprus Oncology Center, the largest oncology treatment center in Cyprus, a small island in the Eastern Mediterranean. The students received an award from the Cancer Epidemiology Education in Special Populations program at UNMC, headed by Dr. Amr Soliman, for their summer work which was executed.

Both projects were based on previous findings from Dr. Farazi’s and collaborators’ research in Cyprus. What sparked the interest in the lung cancer project was the finding that lung cancer incidence rates in Cyprus were lower compared to other Euro-Mediterranean countries despite Cyprus being among the countries with the highest smoking rates in Europe. Therefore, the group designed a case control study based on a questionnaire with sections on demographics, lifestyle factors, occupational exposures, workplace and residence history, and family cancer history. By comparing lung cancer patients and healthy controls, they aimed to investigate whether adherence to the Mediterranean diet and low exposure to air pollution are inversely associated with lung cancer. Ellana was able to pilot test the questionnaire on a few patients while she was in Cyprus. Being partly of Greek origin, she was able to practice her Greek through her research as well.

The thyroid cancer project also was based on previous findings from Dr. Farazi’s and collaborators’ research that showed a more than double increase in thyroid cancer incidence in Cyprus within a decade. In Emma’s project, they hoped to address the reasons for this increased incidence by looking in more detail at the types of thyroid cancers diagnosed in Cyprus. The idea is that a true increase due to risk factors would be reflected with more severe forms of thyroid cancer. Therefore, the team set out to investigate the size, histological stage and metastasis characteristics of the thyroid cancers diagnosed in Cyprus. Emma went through 1526 medical records from 1998 to 2014 to extract this information.

It was a great experience for the faculty and students. Dr. Farazi is originally from Cyprus and therefore had the opportunity to contribute to public health issues in her community through this work. The students got to experience a new culture, a different health care system, and organization of a cancer center in a different country. It was a great practical and educational experience for them as emerging public health professionals.

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