Erica Warner, ScD, MPH
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Dr. Erica Warner is an Assistant Investigator in the CTEU and an Assistant Professor at HMS where she conducts epidemiological research on cancer. Her research studies how lifestyle, behavioral, and genetic factors affect cancer screening and early detection, intermediate markers of cancer risk, cancer risk and survival, with an interest in molecular subtypes and racial/ethnic and socioeconomic health disparities. Dr. Warner is a member of Dana-Farber Harvard Cancer Center (DF/HCC) Executive Committee, Deputy Associate Director for Membership at DF/HCC and Director of Epidemiology for the MGH Cancer Center’s Early Detection and Diagnostics Clinic.
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Projects
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Impact of Cancer on Cognitive Trajectories in Older Adults
In this prospective study funded through a NCI R01, we will: 1) Determine the impact of cancer and cancer treatment on trajectories of cognitive functioning; 2) Determine the impact of cancer and cancer treatment on clonal hematopoiesis of indeterminant significance (CHIP), and Alzheimer’s Disease and related ADRD biomarkers (Aβ, p–tau, NfL, and GFAP) and investigate potential mediating effects with respect to cognitive functioning.
Lung Cancer Risk Prediction in Firefighters Using Deep Learning
We will use an innovative new deep learning model (“Sybil”), which can estimate an individual’s risk of lung cancer in the next six years through examination of a single low dose computed tomography (LDCT) scan, to identify firefighters at increased risk of lung cancer and determine specific exposures associated with risk. This study will be conducted within the Fire Health Study, established in 2021 to investigate the lung health and lung cancer risk of firefighters.
Implementing Blood-Based Early Detection of CRC in Clinical Practice: A Pilot and Feasibility Study
Our overall objective is to determine the acceptability and feasibility of blood-based CRC testing in multiple populations to inform the merit of and strategies for future clinical implementation. Our central hypothesis is that a blood test may be more accessible and acceptable to hard-to-reach populations than existing screening approaches, and that it may identify and motivate individuals in need of accelerated colonoscopy. Our rationale is a blood test addresses barriers to screening such as long waits or unwillingness to handle and/or mail a stool sample that may have hindered participation through traditional modalities. We will leverage an early access program through which up to 468 MGH patients will be eligible to receive Freenome’s blood-based CRC-specific test over a six-month period.
Community Collaboration to Advance Racial/Ethnic Equity in CRC Screening (CARES)
We will establish three SU2C Equity Zones (Greater Boston, Los Angeles, Tribal Nations in South Dakota) focused on four overarching goals. Our first goal will be to establish and implement comprehensive stool-based screening programs striving to increase CRC screening participation in all three Zones. Our second goal will be to ensure patient receipt of a follow-up colonoscopy as recommended after an abnormal stool-based screening test result. Our third goal is to build a collection of blood and stool specimens safely stored for future research to ensure that low income and racial/ ethnic minority populations are represented in the development of new CRC screening tests in the future. Our fourth goal is to promote the careers of a new generation of Black, Latino and American Indian doctors and researchers.
Let’s Do Better: Community & Patient Centered Approaches to Biospecimen Research
It is imperative to identify barriers and facilitators to participation, and to create strategies to diversify participation. Previous studies have identified barriers and facilitators of participation in biospecimen research but translating these findings into effective interventions remains an area of high need. This mixed methods collaborative effort between Massachusetts General Hospital (MGH) and Providence sites of the CRC Health Equity Dream Team has three primary aims: 1) Use qualitative methods to identify patient and community member information needs and culturally appropriate approaches to biorepository recruitment in Boston, Los Angeles, and the South Dakota Tribal Nations; 2) Develop tailored biorepository recruitment strategies incorporating findings from qualitative analyses; 4) Develop a pilot implementation trial to test strategies and materials developed.
Lung Cancer Diagnostic Delays in Women
The incidence of lung cancer in women continues to rise, and since 2018 has become higher in young women than in young men, irrespective of tobacco use. The full extent of ways in which lung cancer is unique in women continues to be explored, but initial data shows that women face greater delays from symptom(s) onset to diagnosis of lung cancer compared to men. The proposed experimental, mixed-methods study will evaluate such differences in diagnostic time points among newly diagnosed (within 3 months of diagnosis) men and women (<50 and ≥50 years) with lung cancer. An administered survey will also explore diagnostic timelines, perceptions of factors contributing to diagnostic timeliness, and symptom management throughout the journey to lung cancer diagnosis. Subsequent semi-structured interviews will expand on the quantitative data collected via the survey to gain a comprehensive understanding of contributing clinical barriers to diagnostic delays, including how experiences may differ by sex and age, but also race/ethnicity, educational level, and family history of lung cancer.
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Key Publications
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Lipsyc-Sharf M, Ballman KV, Campbell JD, Muss HB, Perez EA, Shulman LN, Carey LA, Partridge AH, Warner ET. Age, Body Mass Index, Tumor Subtype, and Racial and Ethnic Disparities in Breast Cancer Survival. JAMA Netw Open. 2023 Oct 2;6(10):e2339584. doi: 10.1001/jamanetworkopen.2023.39584. Erratum in: JAMA Netw Open. 2023 Nov 1;6(11):e2348174. doi: 10.1001/jamanetworkopen.2023.48174. PMID: 37878313; PMCID: PMC10600583.
Warner ET, Revette A, Restrepo E, Lathan CS. Women's Information Needs and Educational Preferences Regarding Lung Cancer Screening. J Womens Health (Larchmt). 2024 Mar;33(3):318-327. DOI: 10.1089/jwh.2023.0429. Epub 2023 Dec 8. PMID: 38061051; PMCID: PMC10924114.
Ko NY, Fikre TG, Buck AK, Restrepo E, Warner ET. Breast cancer survivorship experiences among Black women. Cancer. 2023 Sep;129(S19):3087-3101. doi: 10.1002/cncr.34634. PMID: 37691522.
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