Cancer systems epidemiology: Overcoming misconceptions and integrating systems approaches into cancer research

Abstract

• While traditional epidemiological approaches have helped generate important insights about cancer prevention and treatment, they have important limitations and alone cannot bridge the gaps that continue to exist in cancer research and knowledge. • One shortcoming is the failure to fully account for and characterize the complexity of various systems (e.g., biological, behavioral, social, environmental, and economic) that can lead to cancer and are affected by cancer. • Systems approaches can help researchers, clinicians, and other decision makers better understand complex systems and address these systems at many levels, ranging from the cellular to the societal scale. • Systems mapping can shed light on otherwise hidden mental models, and dynamic modeling can enable virtual experimentation—the systematic exploration of counterfactual scenarios not observable in the real world. • We present and discuss 14 common misconceptions that will need to be overcome in order for systems epidemiology to realize its potential role in cancer prevention and control. • Examples of systems approaches applied to cancer-related research topics are given to illustrate the utility of systems approaches to transform cancer epidemiology to cancer systems epidemiology.