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You have reached the web site of

Clement Adebayo Adebamowo

BM, ChB, Hons (Jos), FWACS, FACS, ScD (Harvard)

You are welcome!

I am a Professor of Surgery with sub-specialization in Clinical Oncology, Epidemiology and Bioethics. I practice general surgery and clinical oncology at the University College Hospital, Ibadan - http://www.uchibadan.org/; lecture surgery and bioethics at the College of Medicine, University of Ibadan http://www.comui.edu.ng/ and nutrition epidemiology at the University of Ibadan - http://www.ui.edu.ng/. In addition, I direct the West African Center for Bioethics - http://www.westafricanbioethics.net

From October 2007, I became the Director of the Institute for Advanced Medical Research and Training at the University of Ibadan. This institute which was established in 1978 and designed to promote multidsciplinary research serve as an "Office for Research" for the University of Ibadan, College of Medicine. We are therefore looking forward to the establishment of multiple research programs across all social, physical and medical sciences related to health care with partners from all parts of the world.

I conduct research in a wide range of issues, including medical education, clinical oncology, general surgery, bioethics and epidemiology - including genetic, molecular, nutrition and environmental health epidemiology. You can find some of my publications on PubMed while others are in Libraries and Databases that specialise in African medical publications.

This site showcases some of the interesting clinical and research activities that I am involved in. I hope that you will find something of interest here. Hit the "contact us" button to send me an e-mail if you have comments, questions or complaints!

Current activities

REDUCING CHILDHOOD LEAD EXPOSURE STUDY - RECLES (pronounced reckless) http://adebamowo.googlepages.com/home

We have just published our analysis of the lead levels of paint sold in Nigeria and this showed that 96% of these paints contained high levels of lead. We are proposing a global ban on the use of lead in domestic paint since there are alternatives that are safer. Our group conducts multidisciplinary translational research of childhood lead exposure in South Western Nigeria. Clck on the RECLES button on the side panel for more information ...

WEST AFRICAN CENTER FOR BIOETHICS - http://www.westafricanbioethics.net/

The West African Bioethics Training program is an program funded by the U.S. National Institutes of Health through the Fogarty International Center to provide training and support for the development of international research bioethics in West Africa. The WAB supported MSc, MPhil/PhD Bioethics degree program at the University of Ibadan has admitted its first set of students. Go to WAB for more information ...

NATIONAL HEALTH RESEARCH ETHICS COMMITTEE - http://www.nhrec.net/

In August 2006, I was appointed Chairman of the National Health Research Ethics Committee of Nigeria. This committee, which is modelled after the United States OHRP and British COREC among others, has developed the Nigerian Code for Health Research Ethics and is currently registering health research ethics committees in Nigeria in order to ensure compliance with modern standards in international research ethics. The Code can be downloaded from the NHREC website at http://www.nhrec.net

The NHREC held its last reguar meeting on August 2007. During the meeting amendments to the National Code for Health Research Ethics that more clearly specify protections for research participants, the role of community advisory groups were considered and approved. Various seminars and workshops would be held for members of health research ethics committees and biomedical researchers in the country in order to increase awareness and utilization of the Code. Go to the http://www.nhrec.net site for recent information and an update of the activities of the committee

INTERNATIONAL HAPLOTYPE MAPPING PROJECT - http://www.hapmap.org/

I was the Nigerian principal investigator for this project that is contributing to new ways of studying gene-disease associations. We recruited participants from a community in Ibadan and the samples were sent to Coriell Institute in the U.S. (http://ccr.coriell.org/) where the cells were immortalized and samples sent to genomic analysis centers. This study generated a lot of scientific data (http://www.hapmap.org/downloads/nature02168.pdf; http://www.hapmap.org/downloads/presentations/Nature_HapMap_phaseI.pdf) and raised ethical issues (http://www.hapmap.org/downloads/HapMapEthics.pdf) that are still resonating till today. The community where the Nigerian component of the study was conducted continues to take an active interest in the project and its uses http://www.westafricanbioethics.net/aba-alamu/. The community advisory committee meets regualrly and receives quarterly updates from the Coriell Institute about how the samples are being used.

FRAMEWORK PROGRAMS FOR GLOBAL HEALTH - http://www.globalhealthframework.net

The First Network Meeting of this program held in April 2007. The focus of the meeting was "The problem of Cancer in Africa". There were multidisciplinary presentations from Civil Engineering, Nursing, Environmental Health, Architecture, the Mass Media, Psychology, Sociology, Bioethics, Nutrition, Surgery, Medicine, Radiotherapy, Radiology, etc. The proceedings of this meeting will be published as a supplement in the African Journal of Medicine and Medical Sciences shortly.

The program will shortly advertise opportunities for student's research experience at the University College Hospital Surgery Research Laboratories.

This is a program funded by the United States National Institutes of Health Forgarty International Center to support the development of multidisciplinary and multi-institutional programs around the subject of global health in institutions around the world. Though our initial focus is Nigeria, we anticipate a gradual roll out to other West African countries. Our program focuses on

a. Utilizing research to inform policy in health care (RIP initiative). We will create a database of health related research, societies and infrastructure in Nigeria and produce position papers on the studies carried out in Nigeria or on health care problems relevant to Nigeria for use by policy implementers at both Federal and State levels in the country.

b. Develop multidisciplinary and multiinstitutional approach to the problems of cancer prevention including tobacco control, nutritional intervention, use of vaccines and behavioral modification

c. Develop multidisciplinary and multiinstitutional approach to health problems associated with the built environment

d. Encourage multiple innovative intervention to stem the tide of traumatic injuries and death at a population level.

We will target under and postgraduate students as well as researchers and policy makers for effective delivery of our program plans. Visit the West African Framework Program for Global Health website to learn more about this.

SOCIETY OF ONCOLOGY AND CANCER RESEARCH OF NIGERIA (SOCRON)http://www.socron.net/

Whenever cancer care professionals in Nigeria meet, 2 issues dominate the discussion, one is the increasing incidence of cancer in Nigeria and the other is the inadequate opportunities for training and research. I initiated the Society of Oncology and Cancer Research of Nigeria because of the latter concern. My hope is that this society will provide a forum for developing the practice of oncology in Nigeria, provide opportunities to share knowledge and to teach, encourage young clinicians to develop an abiding interest in oncology and provide opportunites to present papers and learn from other peoples' research. The establishment is evolving slowly in order for us to put solid foundation that will last in place and I commend the patience of colleagues who share this vision. An immediate offshoot of this initiative is the development of an online journal - Cancer in Africa - which will soon start accepting papers after we have ensured that such papers will be indexed and the journal will publish at least 12 new articles every year. Modest though these aims are, they are not easy to achieve and we are working assiduously towards their realization.

The Meeting of the Society of Oncology and Cancer Research of Nigeria has been scheduled for July 21st to 25th 2007. The program will feature joint symposium with the American Society of Clinical Oncology, Nursing Oncology Training Workshop, opportunities for poster and oral presentations, a students section, etc. Please visit the society's web page for more information

CANCER IN NIGERIA

As an oncologist, cancer is the main focus of my clinical, teaching and research activities. The commonest cancers in Ngeria are, among females, breast and cervical cancers, and among males, liver and prostate cancers. For more go to the Cancer page (see the side panel)

BREAST CANCER CLINICAL TRIALS IN NIGERIA

An important way of generating new knowledge about cancer treatment is the clinical trials mechanism (http://www.cancer.gov/clinicaltrials/learning/page3). Clinical trials benefit patients and institutions in many ways including:

Providing patients access to cutting edge treatment that is often not yet widely available
Close and detailed follow-up
Subsidizing treatment of patients
Contribution to new knowledge that will benefit future generation
Working with leading experts in the field and increasing local skills and expertise

At the Oncology Division of the Department of Surgery, University College Hospital, Ibadan, patients can enroll in any of the following clinical trials:

a. A multinational study of the benefit of oophorectomy (removal of the ovaries) at different phases of the menstrual cycle in addition to Tamoxifen for the treatment of patients with advanced breast cancer. This study is led by Dr. Richard Love of Ohio State State University, U.S. (http://www.ibcrf.org/index.html) abd is currently accruing patients

b. An International Breast Cancer Study Group (http://www.ibcsg.org/) clinical trial of the value of metronomic chemotherapy in the treatment of breast cancer patients whose tumors are hormone receptor negative (IBCSG Trial 22-00). The chemotherapy is used as an anti-angionesis agent in these patients for whom there is currently little evidence based gold standard treatment. Patient accrual into this study will start shortly so contact us if you are a clinician interested in referring patients or you are a Nigerian patient interested in participating in the trial.

c. An International Breast Cancer Study Group (http://www.ibcsg.org/) clinical trial of chemotherapy in the treatment of breast cancer patients whose tumors have recurred after initial treatment (IBCSG Trial 27-02, NSABP Protocol B37, BIG Trial 1-02). There is currently no gold standard for the treatment of these patients and studies like this will help us to know what to do for cush patients in future. Patient accrual into this study will start shortly so contact us if you are a clinician interested in referring patients or you are a Nigerian patient interested in participating in the trial.

d. We have just published our analysis of the molecular subtype of breast cancer seen in Ibadan and contrary to the often stated claims, there was no substantial difference in the pattern compared to the results from well conducted studies from other parts of the world. This finding is practice changing in many ways:

a. When the ER/PR status of patients is unknown, it is appropriate to treat as ER positive

b. We need to focus on other issues such as quality of care, early presentation, etc to reduce the poor survival of our breast cancer patients rather than assume that it is due to biology.

NUTRITION EPIDEMIOLOGY

My work in epidemiology include:

a. Dietary intake of milk and teenage acne: Teenage acne is an important source of physical and psychological morbidity as well as occasional mortality in young people. In addition, acne provides a biological model to study dietary intake and its association with glandular tissue such as breast which shares close embryological and evolutionary origin with the sebaceous gland. Our retrospective (http://www.eblue.org/issues/contents?issue_key=TOC@@JOURNALS@YJAAD@0052@0002) and prospective studies (http://dermatology.cdlib.org/124/) showed a positive association between dietary intake of skim milk and teenage acne. The prospective study of association between milk intake and teenage acne in girls is one of the top ten most read articles in Dermatology in 2006 according to Medscape. We believe that this association is either mediated by IGF1 pathways or through bioactive molecules in milk. You can see the interest generated by this study at http://search.live.com/results.aspx?q=adebamowo AND acne&first=11&FORM=PERE.

The milk, hormones and human health symposium that held in Boston in October 2006 was a powerful setting for discussion of issues relating to the association between milk intake and various health and disease states. In bringing together experts from medicine, public health and veterinary sciences, it laid the foundation for future important cross talk among these specialists to further understanding on the health impact of milk intake in humans. The proceedings of the workshop will soon be available online at http://www.hsph.harvard.edu/cancer/workshops/milk/

b. Dietary antioxidants and breast cancer risk: There is a lot of interest in the potential benefit of dietary antioxidants intake and risk of diseases. I have been exploring this in breast cancer patients. Flavonols are a major source of the antioxidant content of fruits and vegetables so we looked at the association between dietary flavonols intakes and risk of breast cancer. Overall, there was no association, but we found a protective effect with intake of beans and legumes (http://www3.interscience.wiley.com/cgi-bin/abstract/109859016/ABSTRACT?CRETRY=1&SRETRY=0). You can read about interest generated by this work here - http://search.live.com/results.aspx?q=adebamowo AND beans&first=11&FORM=PERE

We continue to probe this question and at the upcoming AACR Frontiers in Prevention of Cancer Meeting in Boston, Nov. 2006, we will be presenting the results of our study of dietary antioxidants intake measured using FRAP technique and risk of breast cancer http://www.aacr.org/default.aspx?p=7166

c. Dietary patterns and risk of breast cancer: Most dietary epidemiology studies focus on one or a group of foods or nutrients and evaluate the association between these and risk of breast cancer or other diseases. Well, dietary intake usually consist of complex mixture of foods and nutrients. Therefore, we decided to use factor analysis to identify major dietary patterns and test the association between these patterns and breast cancer risk. Overall, we did not find an association possibly because the effect of the different food items cancel each other out. However, subset analysis showed an interesting inverse association between prudent dietary pattern and breast cancer risk among people who have ever smoked. This latter finding and our finding in the subset analysis of dietary antioxidants intake and breast cancer risk among smokers suggest that this subject requires further study.

Adebamowo.com

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