Mary Beth Terry Models Leadership in Cancer Prevention and Community-Building

Mary Beth Terry knows that promoting cancer prevention at the population level works best when you include not just researchers and health care providers in the conversation but also community members. As proof, she points to how women who took diethylstilbestrol (DES), a synthetic estrogen, between 1940 and 1971 to prevent miscarriage were the first to question whether cancers in their daughters, exposed to DES in utero, were related to taking the drug. “I think as researchers we often forget how many scientific discoveries have actually come from patients themselves or from the communities that are most affected,” she says.

A professor of epidemiology at Columbia Mailman School whose breast cancer prevention research is internationally known, Terry also helps direct cancer population studies and community outreach and engagement at the Herbert Irving Comprehensive Cancer Center. In those roles, for which she was recently recognized with Dean Linda P. Fried's Excellence in Leadership Award, she thinks constantly about how to help local populations with cancer health care disparities. “We're one of the few cancer centers in New York City, especially, that has a very large public health program that focuses on community level carcinogens including environmental chemical exposures,” Terry says.

“Mary Beth Terry demonstrates an unwavering commitment to building a more inclusive and diverse public health workforce, building health equity in our community, and building community engagement in public health and medical research,’” says Dean Fried.

Connecting Communities

Recently, the National Cancer Institute awarded Columbia University and Weill Cornell Medicine a $9.8 million, five-year grant to help combat cancer disparities fueled by persistent poverty. Terry is part of a multi-principal investigator team leading the project, which will launch a specialized research center and spearhead projects in communities of persistent poverty in New York City, including a cancer education and social justice curriculum, a tobacco cessation study, and support for early-career researchers.

This new award builds off multi-institutional partnerships that started two years ago through collaborations with Columbia, Cornell, Hunter, and the Physician Affiliate of Greater New York (PAGNY). This COMMUNITY Center has built partnerships between community groups, faith organizations, schools, and local governments across New York City and in some nearby counties, an area that includes about 12 million people. A partnership might include community members being trained to act as community healthcare workers and Terry and colleagues are working across New York City and countries to increase cancer screening rates. 

For example, in their COMMUNITY center that Terry leads with colleagues, Professor Olajide Williams is working with congregants at Black churches to speak to their peers about colorectal cancer screening and nutrition. “They’re trusted members of the church, so hearing from them about the need for screening can be very effective,” Terry says. Another project in the COMMUNITY Center led by Columbia Mailman investigators Parisa Tehranifar and Nour Makaram, also uses a community health worker approach for improving sleep quality, a strong influence on many chronic diseases, in community members in Washington Heights.

Her commitment to community involvement and healthcare equity is a huge asset according to Anil K. Rustgi, director of the Herbert Irving Comprehensive Cancer Center at NewYork-Presbyterian/Columbia University Irving Medical Center. “I think our cancer center is better because of her vision of having a dialogue with community members and community organizations, and it's amplified further because this city is such a microcosm of the world’s diversity, and so community engagement is perhaps even more critical here.”

The Cancer Center’s work has four pillars: basic science, clinical cancer research, population-based research, and patient care. To support those core areas, Rustgi says, the researchers, doctors, and staff prioritize community outreach and diversity, equity, and inclusion; they also share resources with other healthcare centers to provide technology, pilot grants, administration, and education and training. “I couldn't be more proud of our leaders and our members and staff,” he says. “And I'll say that Mary Beth is very, very prominent in our cancer center. It's like the old E.F. Hutton commercial, ‘When Mary Beth talks, we all listen.’”

Terry’s community-oriented fingerprints can be found in those four pillars as well as the support services. For instance, their team works collaboratively with other cancer centers and shares resources and educational training material and protocols, developed and validated in multiple languages. Recently with her colleague Karen Schmitt at NewYork-Presbyterian, they were funded through the Cancer Moonshot to work with a local federally funded healthcare center on increasing cancer screening rates through the use of their training protocols. She also helps direct a virtual and in-person summer program for high school and undergraduate students underrepresented in science with her colleague Jasmine McDonald. The idea is to introduce them to STEM fields such as cancer research to help diversify those occupations for better cancer care and prevention in the future. “The data have shown that health outcomes are better when the workforce is diverse,” Terry says. “That’s especially true for cancer research. No one person is going to solve these complex problems.”

Listening and Leading

Strong connections with community are crucial to how Terry works. She holds a monthly meeting with a community advisory board made up of people from across the region to keep abreast of their priorities. Those meetings led to her recently creating an educational seminar for the Center’s doctors and nurses on environmental exposures and cancer. It also helped her design a health equity workshop for early-career scientists who do basic cancer science research. And it prompted her to help create a Community science course that is open to anyone and that is designed to demystify how clinical trials work with her colleague Karen Hubbard at City College as well as a long-standing community partner Desiree Walker. She hopes it will help overcome the long shadow of the Tuskegee experiment and help local people of color want to participate more in cancer clinical trials, which are dominated by white patients.

Terry says the old top-down model of doing science and healthcare is slowly giving way to a bottom-up model where community members are intimately involved in helping determine what researchers focus on, from which clinical trials to run to which prevention strategies to try. “It’s a very different way of thinking,” she says. “It’s about making sure that we achieve what we all want, which is to reduce the cancer burden, and this can only happen when cancer discoveries and treatments are developed with the community to ensure that they are community-relevant and community-wanted.”