A tribute to Dame Valerie Beral

Cancer

© Anne-Katrin Purkiss

Cancer Research UK would like to pay tribute to Dame Valerie Beral, whose research has contributed enormously to the field of women’s health.

Dame Valerie was born in Australia where she studied medicine at the University of Sydney. After a few years of clinical work, she turned her attention to epidemiology and joined the London School of Hygiene and Tropical Medicine, where she headed the epidemiological monitoring unit.

Valerie was an exceptionally talented epidemiologist who dedicated her career to providing reliable answers to some of the biggest questions in women’s health- including the impact of oral contraceptive and HRT use on the risk of female cancers.

She will also be remembered for her warmth and generosity towards junior researchers, and she took a special interest in supporting women in science to fulfil their potential.

Professor Gill Reeves, Director of the University of Oxford Cancer Epidemiology Unit

Paving the way for the discovery of HPV

In 1974, whilst at the London School of Hygiene and Tropical Medicine, Beral published a paper that first suggested that cervical cancer might be linked to an infection.

This paved the way for future research, and human papillomavirus (HPV) 16 was first isolated and characterised in 1983 from a cervical cancer specimen. A plethora of studies identifying HPV in historical cervical cancer biopsies, case control studies of HPV virus presence, as well as exploration of molecular mechanisms of HPV-linked carcinogenesis, led to the development of a vaccine in the 1990s.

Unravelling the mystery of Kaposi’s sarcoma

In 1988, Beral was offered the position of Director of our Cancer Epidemiology Unit in Oxford. But before moving to Oxford, she spent 12 months as a visiting scientist with the Centres for Disease Control and Prevention in Atlanta, Georgia, in the United States. She was interested in Kaposi’s sarcoma (KS), a cancer that causes patches of abnormal tissue to grow, and its link with AIDS. So she worked with a team to analyse 8 years’ worth of information about more than 90,000 people with AIDS.

After returning to the UK, in 1990 she published the results of her US research which built a compelling case for KS being caused by a sexually transmitted infection in people with AIDS – but not by HIV.

Once again her research laid the foundation for others to follow, and after the publication of this work, scientists began experiments to track down the infectious agent that Beral’s research alluded to. In 1994, a team of researchers in New York discovered a virus called human herpesvirus 8 (HHV-8), which was found to cause KS.

Unpicking the risks of the pill

In the early 1990s a lack of academic consensus relating to the oral contraceptive pill and breast cancer led Beral to investigate. She helped set up the Collaborative Group on Hormonal Factors in Breast Cancer which formed worldwide collaborations and painstakingly reanalysed epidemiological studies from around the globe.

In 1996 the group published their first paper, concluding that while the use of the contraceptive pill does slightly elevate breast cancer risk, this is only temporary.

The group later went on to demonstrate that the oral contraceptive pill significantly reduces the long-term risk of ovarian and endometrial cancers. These findings have brought reassurance to millions around the world, giving women the freedom to make fully informed decisions about their contraception.

The million women who helped millions more

Beral then turned her attention to hormone replacement therapy (HRT). This led her to establish, perhaps most notably in her illustrious career, the Million Women Study. The largest study of its kind in the world, it includes 1 in 4 of all UK women born between 1935 and 1950.

From this study, they found that HRT, even if only used for a short time, increases risk of both breast and ovarian cancer. They also found a link between a specific form of HRT, called tibolone, and endometrial cancer. This has helped to support informed conversations about the risks and benefits of HRT.

The Million Women Study has also provided many other valuable insights, such as the role of risk factors (such as alcohol intake and smoking) in cancer. The impacts of this incredible project will be felt for many years to come.

A celebrated scientist

Beral’s achievements and commitment to research did not go unrecognised. Among many other prestigious awards, in the 2010 New Year’s Honours list she was named Dame Commander of the Order of the British Empire (DBE) for services to science.

She was also awarded Companion of the Order of Australia in the 2010 Queen’s Birthday Honours list for ‘eminent service to medicine and women’s health through significant advances in cancer research and epidemiology, through seminal contributions to public health policy and as a mentor to young scientists.’

Beral’s ground-breaking research has had huge impacts in the field of women’s health, but also contributed notably to many other fields of research, stretching far beyond cancer.

Dame Valerie was an outstanding researcher and world class epidemiologist. Her seminal findings benefited human health and particularly women’s health in important ways. She was also an incredible communicator and became a regular on Woman’s Hour and the Today Programme talking about her work, which, among other things, had a tremendous impact on awareness on issues around the Pill and HRT.

Iain Foulkes, Cancer Research UK’s executive director of research & innovation

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