title: Integration of molecular pathology, epidemiology and social science for global precision medicine.
abstract: The precision medicine concept and the unique disease principle imply that each patient has unique pathogenic processes resulting from heterogeneous cellular genetic and epigenetic alterations and interactions between cells (including immune cells) and exposures, including dietary, environmental, microbial and lifestyle factors. As a core method field in population health science and medicine, epidemiology is a growing scientific discipline that can analyze disease risk factors and develop statistical methodologies to maximize utilization of big data on populations and disease pathology. The evolving transdisciplinary field of molecular pathological epidemiology (MPE) can advance biomedical and health research by linking exposures to molecular pathologic signatures, enhancing causal inference and identifying potential biomarkers for clinical impact. The MPE approach can be applied to any diseases, although it has been most commonly used in neoplastic diseases (including breast, lung and colorectal cancers) because of availability of various molecular diagnostic tests. However, use of state-of-the-art genomic, epigenomic and other omic technologies and expensive drugs in modern healthcare systems increases racial, ethnic and socioeconomic disparities. To address this, we propose to integrate molecular pathology, epidemiology and social science. Social epidemiology integrates the latter two fields. The integrative social MPE model can embrace sociology, economics and precision medicine, address global health disparities and inequalities, and elucidate biological effects of social environments, behaviors and networks. We foresee advancements of molecular medicine, including molecular diagnostics, biomedical imaging and targeted therapeutics, which should benefit individuals in a global population, by means of an interdisciplinary approach of integrative MPE and social health science.
authors.affiliation: a Yale Institute for Network Science , New Haven , CT , USA.|b Department of Sociology , Yale University , New Haven , CT , USA.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Nishi
authors.affiliation: c Department of Pathology , Brigham and Women's Hospital and Harvard Medical School , Boston , MA , USA.|d Department of Immunology and Infectious Diseases , Harvard T.H. Chan School of Public Health , Boston , MA , USA.
authors.forename: Danny A
authors.initials: DA
authors.lastname: Milner
authors.affiliation: e Department of Epidemiology , Harvard T.H. Chan School of Public Health , Boston , MA , USA.|f Department of Nutrition , Harvard T.H. Chan School of Public Health , Boston , MA , USA.|g Channing Division of Network Medicine, Department of Medicine , Brigham and Women's Hospital and Harvard Medical School , Boston , MA , USA.
authors.forename: Edward L
authors.initials: EL
authors.lastname: Giovannucci
authors.affiliation: e Department of Epidemiology , Harvard T.H. Chan School of Public Health , Boston , MA , USA.|f Department of Nutrition , Harvard T.H. Chan School of Public Health , Boston , MA , USA.|h Department of Biostatistics , Harvard T.H. Chan School of Public Health , Boston , MA , USA.|i Department of Medical Oncology , Dana-Farber Cancer Institute , Boston , MA , USA.
authors.forename: Reiko
authors.initials: R
authors.lastname: Nishihara
authors.affiliation: i Department of Medical Oncology , Dana-Farber Cancer Institute , Boston , MA , USA.|j Department of Social and Behavioral Sciences , Harvard T.H. Chan School of Public Health , Boston , MA , USA.
authors.forename: Andy S
authors.initials: AS
authors.lastname: Tan
authors.affiliation: j Department of Social and Behavioral Sciences , Harvard T.H. Chan School of Public Health , Boston , MA , USA.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kawachi
authors.affiliation: c Department of Pathology , Brigham and Women's Hospital and Harvard Medical School , Boston , MA , USA.|e Department of Epidemiology , Harvard T.H. Chan School of Public Health , Boston , MA , USA.|i Department of Medical Oncology , Dana-Farber Cancer Institute , Boston , MA , USA.
authors.forename: Shuji
authors.initials: S
authors.lastname: Ogino
mesh_terms: D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics / Q000473:pathology; D003695:Delivery of Health Care; D057890:Epigenomics; D023281:Genomics; D006801:Humans; D057089:Pathology, Molecular; D057285:Precision Medicine
keywords: clinical outcome; disparity; epigenetics; interdisciplinary; molecular pathologic epidemiology; network analysis; personalized medicine; social medicine