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National Cancer Institute U.S. National Institutes of Health www.cancer.gov
About DCEG

Eric A. Engels, M.D., M.P.H.

Senior Investigator

Location: 6120 Executive Boulevard, EPS Room 7076
Phone: 301-496-8115
Fax: 301-402-0817
E-mail: engelse@exchange.nih.gov

 Eric A. Engels, M.D., M.P.H.

Biography

Dr. Engels earned a B.A. in mathematics from the University of Virginia in 1987 and an M.D. from Harvard Medical School in 1991. From 1991 to 1994, he trained in internal medicine at Brigham and Women's Hospital. Subsequently, Dr. Engels received clinical training in infectious diseases and an M.P.H. at Tufts University School of Medicine. He joined the NCI Viral Epidemiology Branch in 1998 as a senior staff fellow, became an investigator in 2000, and was tenured in 2007. Dr. Engels holds an adjunct faculty appointment in the Department of Medicine at the Johns Hopkins Hospital. He received the 2006 Mentor of Merit award from the National Cancer Institute.

Research Interests

Immunosuppression, infection, and inflammation in cancer

A major focus of investigation concerns the epidemiology of cancer in immunosuppressed individuals. My research on HIV-related cancers utilizes data from our HIV/AIDS Cancer Match (HACM) Study. This study links HIV/AIDS and cancer registry data from 13 U.S. regions to identify cancers arising in 639,000 people registered with HIV/AIDS. The HACM Study allows my colleagues and me to address important research questions and examine patterns of cancer incidence that have direct public health relevance. We used this resource to characterize trends in cancer risk among people with AIDS over the entire course of the AIDS epidemic (1980-2002). Our study documented substantial declines in Kaposi sarcoma and non-Hodgkin lymphoma over time, and a steep rise in Hodgkin lymphoma risk. Additional studies are ongoing to characterize in more detail the risk factors and trends for specific malignancies.

My coworkers and I also conduct research on cancer in transplant recipients, another immunosuppressed population. We performed the first epidemiologic study of risk factors for transplant-associated Kaposi sarcoma, using U.S. registry data on all transplants conducted during 1993-2003. Our work has led us to initiate a major collaboration with the Health Resources and Services Administration (HRSA), which oversees the U.S. transplant network. Together with HRSA, we are undertaking a computerized match of U.S. transplant, end-stage renal disease, and cancer registries. This Transplant Cancer Match Study will obtain population-based cancer data on approximately half of the U.S. transplant and ESRD populations.

My observation of a remarkably high risk for lung cancer among HIV-infected people caused me to question the common assumption that frequent tobacco use entirely explains the elevation. I have now conducted several retrospective cohort studies of lung cancer among HIV-infected persons, including one using our HACM data. Utilizing various statistical methods to adjust for the effects of tobacco, each study has demonstrated that lung cancer risk is higher in HIV-infected people than predicted from the effects of smoking alone. We are performing additional studies to better understand the role of smoking and other factors in the etiology of lung cancer in this setting.

This work on HIV-related lung cancer has encouraged me to pursue other research projects to clarify the role of inflammation or infection in lung carcinogenesis in the general population. My colleagues and I performed a systematic analysis of polymorphisms in 37 inflammation genes in relation to lung cancer risk in a large U.S. case-control study. Our study identified significant associations of lung cancer risk with variants in interleukin 1A and 1B, key cytokines in initiating inflammation. In other studies, we are presently evaluating chronic Chlamydia pneumoniae infection, pulmonary scarring, and a history of pneumonia or tuberculosis as risk factors for lung cancer.

My interest in non-Hodgkin lymphoma stems from the high risk seen in people with HIV/AIDS, as well as my belief that other infections and immune-related conditions are important. Building on our prior work on the epidemiology of human herpesvirus 8 (HHV8), we described the first case of an HHV8-positive non-Hodgkin lymphoma in Africa. My collaborators and I also conducted a large retrospective cohort study of hepatitis C virus and risk of lymphoproliferative malignancies in U.S. military veterans. This study showed an association with non-Hodgkin lymphoma and, for the first time, an association with the related malignancy, Waldenström macroglobulemia.

Keywords

human immunodeficiency virus (HIV), acquired immunodeficiency syndrome (AIDS), hepatitis C virus, solid organ transplantation, Kaposi sarcoma, non-Hodgkin lymphoma, lung cancer

Selected Publications

Collaborators

DCEG Collaborators

  • James Goedert
  • Ola Landgren
  • Patricia Hartge
  • Ruth Pfeiffer
  • Nilanjan Chatterjee
  • Barry Graubard