Article Topic: Cancer Prevention

Siteman Cancer Center Prevention Expert Named Guggenheim Fellow

With the prestigious award, Yin Cao, ScD, MPH, will write a book examining why cancers are increasingly occurring earlier in life — and how this shift can be better understood, communicated and prevented.

Yin Cao, ScD, MPH, has been named a 2026 Fellow of the John Simon Guggenheim Memorial Foundation, one of the nation’s most prestigious honors recognizing exceptional scholarship and creativity.

Selected from nearly 5,000 applicants as part of the foundation’s 101st class of fellows, Cao is recognized for her leadership in integrating data science, cancer etiology and population health. She is a molecular epidemiologist and an associate professor of surgery and of medicine in the Public Health Sciences Division at WashU Medicine and a research member of Siteman Cancer Center, based at Barnes-Jewish Hospital and WashU Medicine.

This year’s class of 223 distinguished honorees work across 55 disciplines, each awardee selected based on past career achievements and exceptional promise. Cao is one of only two fellows recognized in data science.

“Our new class of Guggenheim Fellows is representative of the world’s best thinkers, innovators and creators in art, science and scholarship,” said Edward Hirsch, award-winning poet and president of the Guggenheim Foundation. “As the foundation enters its second century and looks to the future, I feel confident that this new class of 223 individuals will do bold and inspiring work, undaunted by the challenges ahead. We are honored to support their visionary contributions.”  

Cao leads a research program focused on one of the most urgent questions in modern health: why cancers are rising among younger adults. Anchored in a multidimensional lens spanning exposures, tissues, life stages and populations, her group integrates epidemiologic and biological insights, empowered by data science, to uncover life course risk factors that contribute to cancer risk and tumor progression in younger generations

In recent work, Cao has highlighted the need to transform how cancer risk factors are discovered for prevention. In a perspective in Cell, she and colleagues proposed new interdisciplinary frameworks to accelerate the discovery of cancer causes in the era of rising early-onset cancers. These frameworks for integrating population research, mechanistic biology and data science to understand how exposures accumulate over time, interact across biological systems and shape disease risk long before diagnosis.

“I am deeply honored to receive this Guggenheim Fellowship,” Cao said. “It provides the rare space to think more deeply and creatively about what is needed for the community and to tell a bigger, more connected story — one that brings together science, patients and the public. Our goal is not only to understand why cancer is rising, but to change its trajectory, so fewer young people develop cancer and more are diagnosed earlier and live longer, healthier lives. We cannot achieve this alone, and progress will depend on working together across disciplines and communities.”

Building on years of work she has led to uncover the causes of early-onset colorectal cancer and advance earlier diagnosis in younger populations, Cao now leads a $25 million international initiative through Cancer Grand Challenges, a global team science initiative co-founded by Cancer Research UK and the National Cancer Institute (NCI), part of the National Institutes of Health (NIH). With support from the Guggenheim Fellowship, her work will bring this urgent scientific question into a broader public conversation — providing clear, evidence-based understanding to patients, families and communities, helping to strengthen public trust and highlighting prevention as an increasingly important priority for younger generations.

For Your Health – Make Health Gains with Whole Grains

Moving toward a diet with more whole foods and fewer processed and fast foods is a great goal for everyone — and can have many health benefits. Adding more whole grains to our weekly menus can help us do just that.

If someone asked us to name five ways to improve our health and lower the risk of illness, “eat a healthy diet” would probably land on most of our lists. And it certainly belongs there. Research has shown that healthy eating could prevent over 80,000 cancer cases each year in the U.S. and help even more people prevent heart disease and diabetes.

While most of us have ways we could make our weekly menus healthier, eating more whole grains is one area where there can be a lot of room for improvement. As many as 90% of us aren’t getting the amounts recommended for our health and wellness.

Wheat, oats, rice, corn and barley are examples of grains. They offer the most benefit when they are whole grains — that is, when they include the three key parts of the natural grain kernel: bran, germ and endosperm. Bran and germ are rich in fiber, vitamins, minerals and other healthy compounds. When the bran and germ are removed during processing, they become refined grains.

The new Dietary Guidelines for Americans — along with those of other organizations —recommend focusing on eating whole grains over less-healthy refined grains. Whole-wheat bread and brown rice are classic whole-grain foods, compared to their refined versions, white bread and white rice.

Most adults should aim for 2-4 servings of whole grains a day, with one serving equaling a half cup of cooked oatmeal, a cup of dry breakfast cereal or a slice of bread.

One simple way to choose more whole grains is to look for foods that are labelled “100% whole grain,” “100% whole wheat,” “100% whole-grain oats” or something very similar. You can also look for “whole grain” listed as a first ingredient, which means whole grains are the primary ingredient in the food.

Try these options for working more whole grains into your day. See which ones might be a good place to start, then build from there — and add your own creativity to fit them into your favorite foods.

Snacks

  • Whole-grain pretzels, whole-grain pita chips and whole-grain crackers
  • Whole-grain granola with Greek yogurt
  • Air- or pan-popped popcorn

Breakfast

  • Oatmeal or whole-grain oat dry cereal
  • 100% whole-wheat toast
  • Whole-wheat or whole-grain buckwheat pancakes

Lunch

  • Whole-wheat spaghetti or whole-wheat pasta salad
  • Sandwich with 100% whole-wheat bread
  • Rice bowl with brown rice

Dinner

  • Soup or stew with added barley or brown rice
  • Burrito with whole-wheat tortilla and brown rice
  • Whole-grain veggie burger with whole-wheat bun

When eating out, ask about whole-grain options — for bread, buns, tortillas, fillings or side dishes. They may not always be listed on menus, or if they are, may not be highlighted. But they’re becoming more common options at many restaurants and can be an easy way to sneak more whole grains into our days.

It’s also good to choose whole-grain foods that are lower in added sugar, sodium and unhealthy fats. Some whole-grain breakfast cereals, for example, can still have a lot of added sugar and sodium. Choosing healthier options overall provides an even bigger nutrition boost.

Moving toward a diet with more whole foods and fewer processed and fast foods is a great goal for everyone — and can have many health benefits.

Adding more whole grains to our weekly menus can help us do just that. It can take a little extra time and effort to make the switch. But it’s 100% worth it.

For Your Health: A fresh look at healthy goals in the New Year

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Heading into a new year, it feels like a great time to mix things up. So, after several years interviewing leaders in health and medicine to get their insight for this column, I thought it seemed only fair to turn the tables and have a colleague interview me.

The result was a great discussion that touched on issues big and small — and that may provide a peek behind the curtain of medical research and how I incorporate health recommendations into my own life.

Much of your work focuses on helping people improve their health and prevent diseases like cancer. What drew you to this?

When I was a medical student and we’d visit cancer patients, it seemed like lung cancer was everywhere, and no one really talked about tackling smoking as a way to prevent it. People were talking about how to prevent heart disease and high blood pressure, but not cancer. It looked like there was real potential to go after cancer prevention in a creative and impactful way.

If someone asked you for the top three behaviors they should follow to lower cancer risk, what would you recommend?

The top one is: Don’t smoke. Or, if you smoke, quit. Next would be to avoid weight gain. That may be surprising to hear, but extra weight increases the risk of many different cancers. Regular physical activity helps with controlling weight, as does my third top behavior: eating a healthy diet. Try to focus on fruits, vegetables and whole grains — and limit fast and processed foods.

What’s something you do that’s pretty simple but can have a large payoff for health?

One easy thing has been building short walks into my daily life. A regular 15- to 20-minute walk to work or school or a nearby store can have amazing health benefits. I’m not perfect with it, but I’ve tried to make it a routine to walk instead of drive when it’s safe and pretty easy to do. I like to get longer walks in when I can, but it’s great to have this basic amount of activity built into my day.

Most of us can improve the way we eat. Do you have something you’ve been trying to work on recently?

One thing I started doing was switching to alcohol-free, or NA, beer. I’m Australian, and we’re known for liking beer. And the NAs are really good now — with a lot of options in stores and at bars and restaurants. So, I was like, “Let’s give it a go and switch.” It also felt important to do because we’ve tried to bring more attention to the message that zero alcohol is the best choice when it comes to cancer risk and overall health.

Health recommendations can change over time, whether it’s what to eat or drink or when we should get screening tests. Why this is?

This can feel frustrating, for sure. But we can also see such changes and say, “It’s really good news. We know a lot more now than we used to.” Looking at breast cancer screening, mammogram technology today is much better than what we used to have. The richness of the image is better. And we have more studies that have gone on for longer periods of time. So, we have more evidence on the positive impact of mammograms on women’s health. With this, we can revisit and refine recommendations for when women should start screening and how often they should have it. This also applies to many other health recommendations. They can be refined over time as we learn more.

Wrapping things up, do you have any specific health goals for the coming year?

I’d like to lose a few more pounds and get back into the normal weight range. As a nation, the weight issue stands out. It’s a driver of so many chronic conditions — not just cancer, diabetes and heart disease, but also mobility and memory problems. And we haven’t done a great job with policies and approaches that make it easier for people to be physically active and choose healthier foods. That’s a bigger goal for policymakers and health professionals like me. But on a more personal level, I’ll try to keep up with the steps that can help me get to a healthier weight in 2026.

That’s great. Thank you.

Thank you — and happy New Year!

Genetic study suggests ways to catch blood cancer earlier

New understanding of how mutations interact could pave way for early detection, prevention strategies

As we age, our cells replicate, and the DNA in these cells can acquire mistakes — or mutations — every time the sequence is copied. Most newly acquired mutations are harmless, but some can tip the balance toward cancer development later in life.

Now, a new study led by researchers at Washington University School of Medicine in St. Louis shows that such newly acquired mutations interact with our inherited mutations — those passed down by our parents — in important ways that influence a person’s lifetime cancer risk. Understanding such interactions could guide development of new methods for early detection and prevention of cancer.

The research, published in Nature Genetics, focused specifically on the risk of blood cancers such as acute myeloid leukemia (AML), although interactions between inherited and acquired mutations likely have roles in other types of cancer.

Inherited mutations are carried in the egg and sperm and are therefore present in every cell starting at birth, whereas acquired mutations accumulate gradually with age in different cells. Led by Kelly Bolton, MD, PhD, an assistant professor of medicine in the Division of Oncology at WashU Medicine and the study’s senior author, the research team set out to understand how interactions between these two types of mutations influence a person’s risk of developing blood cancer.

In particular, they focused on a blood condition called clonal hematopoiesis that is known to increase a person’s risk of developing blood cancer. Clonal hematopoiesis is caused by a mutation in blood stem cells — cells that give rise to all the different cell types in the blood — that gives those cells a slight survival advantage over the normal stem cells. Such stem cell clones multiply more and are at risk of transforming to blood cancer.

“Most people with clonal hematopoiesis never develop blood cancer,” said Bolton, who treats patients at Siteman Cancer Center, based at Barnes-Jewish Hospital and WashU Medicine. “To a certain extent, it’s a normal aging process. However, we think that many if not all individuals who develop blood cancer pass through a phase of clonal hematopoiesis at some point. We are still in the early stages of trying to figure out which individuals with clonal hematopoiesis will go on to develop blood cancer and which will not.”

Studying genomic data of more than 730,000 people, including from blood samples, the researchers found that clonal hematopoiesis was more common among those with inherited mutations in certain genes already known to increase the risk of cancer. They also found that such inherited mutations had an impact on patterns of newly acquired mutations that cause clonal hematopoiesis. If stem cell clones go on to acquire just a handful more harmful mutations, the clonal hematopoiesis can transform into a blood cancer, such as AML, in which the cells stop doing their jobs and multiply until they crowd out healthy cells.

With the goal of finding ways to detect and eliminate pre-cancerous cells in people at high risk of blood cancer, Bolton and her colleagues found that among individuals with clonal hematopoiesis, those who had inherited mutations that predispose to clonal hematopoiesis had a higher risk of developing blood cancer than those without inherited mutations.

“Our study is a first look at the inherited genetic background that is providing the soil, so to speak, and we’re seeing what undesirable seeds that are acquired later in life are more or less likely to grow from that soil,” Bolton said. “The goal is to stamp out the weeds early, before they can take root and become full-blown cancer.”

Though clonal hematopoiesis is part of normal aging, certain factors such as smoking or prior exposure to radiation or chemotherapy can speed up the process and increase the risk of it transforming into cancer. Still, some people progress to cancer without major environmental risk factors, and the new study suggests that the interaction of their inherited genome with newly acquired mutations plays an important role in this cancer progression.

The study’s first author Jie Liu, a graduate student in Bolton’s lab, noted: “It’s exciting to see how combining large-scale genomic data can reveal how inherited and acquired mutations work together to influence cancer risk. These insights move us closer to identifying high-risk individuals before cancer develops. Our work shows that it’s not just the mutations you’re born with or those you acquire later in life, it’s the interaction between them, and we can now measure that.”

Earlier intervention

Bolton said being able to detect and measure both inherited cancer risk and clonal hematopoiesis would likely be a powerful way to identify individuals who would benefit most from early prevention strategies, such as targeted therapies for the most damaging mutations. At present, clonal hematopoiesis is difficult to identify without specialized blood tests that are not given as part of routine care. Even though such individuals already have clones taking up a greater proportion of their blood stem cells, they can still show normal blood cell counts as part of blood tests typically given at an annual well visit, for example.

In theory, if scientists know what gene mutations to look for, they could develop new blood tests to identify such individuals before any evidence of a problem could be detected with routine blood screening tests. The new study singles out many genes of interest that could be key in the future development of such a blood test.

“Because leukemia is so hard to treat, we hope to find ways to intervene early — when it’s still pre-cancerous — so we can stop clonal hematopoiesis from transforming into leukemia,” Bolton said. “We would want to start with preventive clinical trials for people who have certain inherited mutations and who already have evidence of clonal hematopoiesis, such as one or two clones expanding in their blood.”

Researchers at Siteman are now conducting clinical trials investigating whether specific drugs called IDH1 and IDH2 inhibitors can stop the expansion of certain types of blood stem cell clones before they become cancer. For now, such trials only include people who could be identified as having clonal hematopoiesis because they already had progressed to having abnormal blood cell counts, placing them on the cusp of full-blown leukemia.

“We are hopeful about the prospects of these preventive treatments, but we would like to have tools to identify these individuals even earlier, before their blood cell counts become abnormal,” Bolton said. “There are a lot of targeted therapies that are being developed right now and new approaches researchers are looking at for this purpose.”

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Liu J, Tran D, Xue L, Wiley BJ, Vlasschaert C, Watson CJ, MacGregor HAJ, Zong X, Chan ICC, Das I, Uddin MM, Niroula A, Griffin G, Ebert BL, Mack T, Pershad Y, Sharber B, Berger M, Sehir A, Ptashkin R, Levine RL, Papaemmanuil E, Joseph V, Gao T, Kemel Y, Mandelker D, Stopsack KH, Pharoah PDP, Mukherjee S, Ding L, Cao Y, Walter MJ, Blundell JR, Chatterjee N, Offit K, Godley LA, Link DC, Stadler ZK, Bick AG, Natarajan P, Bolton KL. Germline genetic variation impacts clonal hematopoiesis landscape and progression to malignancy. Nature Genetics. July 15, 2025. DOI: 10.1038/s41588-025-02250-x.

This work was supported by the National Institutes of Health (NIH), grant numbers R01HL148050, R01HL168894, DP5 OD029586, R01AG088657 and R01AG083736; the MDS Foundation; the Children’s Discovery Institute; a Prostate Cancer Foundation Challenge Award; the Edward P. Evans Foundation; the SciLifeLab & Wallenberg Data Driven Life Science Program, grant number KAW 2020.0239; the Swedish Cancer Foundation, grant numbers 22.0577JIA and 22.2362Pj; the Swedish Research Council, grant number 2023-03131; a Burroughs Wellcome Fund Career Award for Medical Scientists; a Pew Charitable Trusts and Alexander and Margaret Steward Trush Pew-Stewart Scholar for Cancer Research Award; and a Hevolution/AFAR New Investigator Award in Aging Biology and Geroscience Research. The study was conducted using the U.K. Biobank Resource and data provided by patients and collected by the National Health Service. It was also conducted using data from the All of Us Research Program of the National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

For Your Health: Staying cool and sun-safe this summer

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Food sizzling on the grill is one of the classic sounds of summer — right up there with kids splashing in sprinklers and the crack of a bat at the ballpark.

That sizzling can also be a good stand-in for how we might feel outside on a sweltering day.

With a little planning, though, we can make our time in the sun feel cooler and more comfortable — and much better for our skin.

“Any amount of tan, and certainly sunburn, represents damage to the DNA of our skin cells,” said Dr. Aubriana McEvoy, a dermatologist at WashU Medicine in St. Louis. “And the more sun people get over their lives, the more of a chance there is for damaged cells to turn into skin cancer, which can affect our quality of life and, in some cases, the length of our lives.”

Too much sun can also lead to wrinkles, coarse skin and discoloration, making our skin look older than it is, she added.

Some simple steps can go a long way toward lowering the risk of skin cancer while keeping our skin looking healthier as well. And everyone can benefit, from those with fair skin to those with darker skin.

Sunscreen is a great place to start. Choose one with Sun Protection Factor (SPF) 30 or higher and be sure to use a generous amount, about an ounce for an adult at the pool — reapplying every couple hours. There are a lot of sunscreen options these days, so try out a number of them to find one you and your family like.

“My favorite sunscreen is the one you will wear,” McEvoy said.

Clothes are another way to stay sun-safe. Long-sleeved shirts, pants and wide-brimmed hats do a great job covering skin and don’t need to be reapplied like sunscreen. And there are many inexpensive, lightweight options that are specifically made to protect from the sun and that have their own rating, called Ultraviolet Protection Factor (UPF). As with sunscreens, the higher the UPF number, the greater the protection.

The combination of clothes and shade from trees or sun shelters can be particularly important for kids. Sunscreen is not recommended for children under 6 months old. And older kids can be so active that it can be hard to keep them well-covered in sunscreen, McEvoy added.

Shade and lightweight, loose-fitting clothes can also help with staying cool and feeling good on a hot day summer day. And it’s hard to overstate the importance of drinking enough water. It can be easy to get behind on our hydration, especially on a fun-filled outing with family and friends. Try to keep a bottle close by filled with plain water or low-sugar sports drink mix. Make it as easy as possible for you and your family to stay hydrated.

For many of us, summer is the best time of year, in no small part because we get to spend so much time enjoying long days and warm weather outside. And that’s an important part of life, McEvoy feels. Also important, of course, is doing so safely and healthfully.

When asked for one of her favorite tricks for staying cool and sun-safe in summer heat, she replied:

“If I’m at the playground or park with my kids, I’ll wear a sun-protective shirt and just wet it down. That keeps me way cooler and protects me from the sun.”