Steven R. Cummings, MD, FACP is Professor of Medicine and of Epidemiology, Associate Chair of Medicine for Clinical Research and Director of the UCSF Coordinating Center. Dr. Cummings leads several large multicenter studies of osteoporosis and breast cancer and has trained and mentored dozens of young researchers interested in women's health and clinical research. He is an international expert on osteoporosis and prevention of breast cancer. 415-597-9363; scummings@psg.ucsf.edu

Predicting and Preventing Osteoporosis and Breast Cancer

Osteoporosis and breast cancer are two of the most common preventable problems in postmenopausal women. Dr. Cummings is interested in developing models to predict risk of these diseases and ways to prevent them.

• The Study of Osteoporotic Fractures (SOF). Dr. Cummings designed and leads the Study of Osteoporotic Fractures, a 15-year study of nearly 10,000 women from four communities in the United States. SOF discovered that measurement of bone density in the hip is the best test for diagnosing osteoporosis and predicting hip fractures. This study also showed that the higher a woman's natural estrogen (estradiol) level, the greater her risk of breast cancer, but the lower her risk of fracture.
  
• The Fracture Intervention Trial (FIT). Dr. Cummings designed and led this randomized trial of the effect of alendronate (Fosamax) on risk for fractures in 6,400 women. The FIT trial proved that alendronate reduces the risk of hip and other types of fractures in women who have osteoporosis. It showed that alendronate is beneficial in women with osteoporosis but has little or no benefit for women with normal or only slightly low bone density.
• The Multiple Outcomes of Raloxifene Evaluation (MORE). Dr. Cummings is the leader of this international multicenter trial which found that Raloxifene (Evista) reduces the risk of spine fractures about 50% in women with osteoporosis and reduces the risk of breast cancer by about 70%. Since raloxifene also causes blood clots, Dr. Cummings is currently working on tests, such as measurement of serum estrogen or testosterone, that may help identify which women will benefit most from the treatment.
• The Male Osteoporosis Study (Mr. OS). Dr. Cummings is a leader of this study of 6,000 older men designed to determine the risks and causes of osteoporosis and fractures in men. By comparing the findings to its sister study, SOF, we hope to find out why women are more prone to fractures than men.
• The Clinical Research Program. Dr. Cummings developed and leads this UCSF Department of Medicine program that helps fellows and junior faculty develop careers in clinical research. The program also aims to help all UCSF faculty perform clinical research more efficiently and effectively and to raise the visibility and reputation of research involving people.

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