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Summary
- Sylvester Comprehensive Cancer Center’s Dr. Shria Kumar studies ways to prevent gastrointestinal cancers by treating H. pylori.
- Dr. Kumar’s research is filling a data gap for gastric cancers in the United States.
- Dr. Kumar advocates for H. pylori screening as a way to identify gastric cancers early.
The best way to reduce cancer burden is to prevent cancer, says Shria Kumar, M.D., a member of the Cancer Control Program at Sylvester Comprehensive Cancer Center, part of the University of Miami Miller School of Medicine.
Dr. Kumar, an assistant professor and director of endoscopic research in the Division of Digestive Health and Liver Diseases at the Miller School, studies ways to prevent gastrointestinal cancers by treating Helicobacter pylori (H. pylori), a bacteria that can cause stomach cancer, and by studying which groups face the highest risk of colon cancer before age 50.
She discusses her work in the following interview, which has been edited for length and clarity.
What is your research focus at Sylvester?
I study effective ways that we can eradicate H. pylori in appropriate populations so that we might reduce their gastric cancer risk. I’m also exploring risk factors and nuanced or risk-stratified screening approaches for people who are at risk for early-onset colon cancer.
What was your journey to focusing on gastrointestinal cancers?
In my training, I quickly realized that I was seeing a lot of late-stage gastric cancer diagnoses, especially in people who were from historically disadvantaged groups.
I realized there wasn’t a lot of literature on gastric cancer prevention in the U.S. There was a lot of data from outside the U.S. and we were extrapolating. Given that gastric cancer has such a strong environmental component—the strain of H. pylori that you have, whether you get it, and when you might get it is environmentally related—it was important to have U.S.-based data.
I then did my advanced fellowship at MD Anderson Cancer Center and we saw a lot of young people with early-onset colon cancer. Early theories hypothesized that it was related to obesity, smoking and lifestyle, but that wasn’t congruent with what I was seeing. As I dove into the literature, I realized that we actually don’t know enough about the risk factors. It’s not simply an extension of colon cancer in those over 50.
It’s an impactful area. We have prevention tools for colon cancer. If you undergo colonoscopy, we find and remove polyps and that prevents the progression of them to cancer. The burden of cancer diagnoses in people who are young is unique and substantial.
February is National Cancer Prevention Month. What should people know about reducing GI cancer risk through screening?
H. pylori screening as a means to prevent gastric cancer is not presently recommended, but there are certain groups that warrant testing.
The best way that people can identify whether they’re in these groups is to speak with their doctor and/or gastroenterologist and share their family history. Where you were born, where your parents were born, if you’ve lived abroad…These are all relevant factors, and whether anyone in your family has had gastric cancer or even H. pylori.
From a public health standpoint, the fact that gastric cancer is less common overall means it’s important is to find out who it impacts the most. That way, you can target screening to the people who benefit the most.
Dr. Shria Kumar
For colonoscopy, our present guidelines suggest that for average-risk people, screening should start at age 45. But make sure your doctor is aware of your history and ask your family members if they’ve had a lot of large polyps or colon cancer. These risk factors might alter your screening strategies.
Please tell us about your work to address GI cancer incidence.
H. pylori and gastric cancer disproportionately impact some in the U.S. From a public health standpoint, the fact that gastric cancer is less common overall means it’s important is to find out who it impacts the most. That way, you can target screening to the people who benefit the most.
Over the last few years, we’ve been going out into the community and testing people for H. pylori. South Florida’s demographics, particularly the influx of people who have been born outside of the U.S. or people who are Hispanic, result in a high burden of H. pylori and gastric cancer.
We offer free testing, treatment and retesting for H. pylori. It’s not a one-day process. You have to get tested, take a two-week treatment and undergo retesting.
While it’s pretty unequivocal that getting rid of H. pylori reduces your gastric cancer risk, it’s less clear how we actually implement that within our country and health care system. Because this is a few-week process that involves medications, you can imagine that people might not start their medication or might not be able to complete it, or H. pylori might not get eradicated. At each step, you want to minimize attrition.
What do you enjoy outside of work?
I enjoy being outdoors—taking walks, playing tennis—but I also love reading and traveling. I want to constantly explore new places and immerse myself in different cultures.
Tags: cancer research, cancer screening, Division of Digestive Health and Liver Diseases, Dr. Shria Kumar, gastric cancer, H. pylori infection, Sylvester Comprehensive Cancer Center
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