From Ethiopia to America, from publications to policy, Jemal focuses on population-wide public health


Ahmedin Jemal grew up in the 1960s and 70s in the small town of Butajira, Ethiopia, about 80 miles south of Addis Ababa. The town had no running water, no electricity. Drinking water – for the family and their cattle – came from streams, where the family also washed their clothes.

Ahmedin and his ten siblings spent their time pitching in on the family farm, with chores such as plowing (traditionally, with oxen), herding cattle, and doing whatever work was needed to support the family.

Neither his father, a farmer and a merchant, nor his mother had any formal education. Both were illiterate. Yet they encouraged their children, above all, to invest in their studies.

“My father would say, ‘The only thing I can give you is education.’ My Mom, especially when I was in high school, didn’t want me to do anything but study,” Jemal said. (Although he played for the school soccer team!)

His parent’s commitment paid off. Seven of Jemal’s ten siblings have a Bachelor of Science degree. Several went on to earn doctoral degrees.

And Ahmedin? Ahmedin Jemal holds two doctoral degrees. Colleagues describe him as “brilliant,” “extraordinary,” and “delightful.” He is a globally respected cancer researcher, a prolific author, and one who leads the creation of perhaps the most highly cited suite of cancer-related publications around the world, the American Cancer Society’s Cancer Facts & Figures, and the companion statistics articles published in CA: A Cancer Journal for Clinicians.

Unorthodox beginnings

Today, Jemal leads an interdisciplinary team of about 36 cancer surveillance, health services, tobacco control, and disparities researchers. In 2022 alone, they published 83 articles, nearly half of which were in highly impactful journals (those with an impact score greater than 10). He is “dominant in the field of epidemiology,” according to Dr. Otis Brawley, Bloomberg Distinguished Professor of Oncology and Epidemiology at Johns Hopkins University and former chief medical officer at the American Cancer Society.

Yet it wasn’t a straight path to where Jemal sits today.

“Since an early age, guided by my older brother –an expert in soil science – I wanted to be a medical doctor,” Jemal said. ”But, more than anything, I just didn’t want to be a farmer!” He was accepted to Addis Ababa University School of Medicine and completed his first year there. But because of a university paperwork snafu at the beginning of his second year, Jemal made the decision to transfer to the veterinary faculty – a decision he regretted for the first three years of his veterinary school.

Jemal earned his first doctoral degree – a Doctor of Veterinary Medicine – from Addis Ababa University School of Veterinary Medicine in 1986. Once he graduated, Jemal was assigned as a district veterinary officer in the western part of the country and, after a year of service, reassigned to the western region veterinary diagnostic laboratory – to be an investigator.

His main research was to assess the impact of tsetse fly control on the health and productivity of cattle in the western part of Ethiopia. The tsetse fly is a vector of trypanosomiases, a major cattle health problem in the western and southern parts of the country and several other sub-Saharan African countries.

While he had one doctoral degree in veterinary medicine, Jemal was interested in studying beyond that. In 1991, he moved to the United States for graduate studies at the School of Veterinary Medicine at Louisiana State University in Baton Rouge, where he earned a master’s degree and then another doctoral degree in veterinary medical science with a focus on epidemiology.

At this point, Jemal was at a crossroads. With two new degrees and half a world away from home, he faced big decisions for his future. He considered a few prestigious post-doctoral opportunities, one at the National Cancer Institute’s (NCI) Division of Cancer Epidemiology and Genetics (DCEG).

At that point, “I didn’t know much about cancer,” Jemal said. “But Dr. Susan Devesa of DCEG took a chance on me, for which I am very grateful.”

This position took Jemal into the cancer field for the first time but it was not entirely new territory or as big of a shift as it might seem. “I was thrilled to make the change [from veterinary medicine],” he said. “It was an easy transition. I had the basic background in epidemiology, anatomy, physiology, and other related subjects to learn the new field.”

Impact at the population level

When Jemal completed his post-doctoral work, he seriously considered two positions as next steps: one with the American Cancer Society. Dr. Michael Thun, former vice president, epidemiology and surveillance research (retired from ACS in 2012), was more than pleased to hire Jemal for the team. He had a job offer within a few days of his interview.

“When I came to ACS in 1989, there were only three doctoral-level people in the department,” Thun said. “The Society had just moved to Atlanta and the entire epidemiology team had resigned because they wanted to stay in New York. The surveillance process had been very informal – pretty much working it out on the back of an envelope.”

In the decade before Jemal joined ACS, Thun and others had rebuilt the team and begun to develop a more systematic process for data. They changed the name of the team from cancer “statistics” to “surveillance research.” They began powerful collaborations which remain today, such as the Annual Report to the Nation on the Status of Cancer.

“At the time, public health schools in America were not teaching surveillance research as a priority discipline,” Thun said. “The emphasis was on analytic epidemiology – about individuals. In surveillance research you have information on populations, but not at the individual level. Ahmedin recognized the incredible value of surveillance research.”

Jemal said he began understanding the importance of surveillance research to inform cancer prevention and control and public policies during his post-doctoral training at NCI.

Other organizations were beginning to emphasize surveillance research as well, Thun said. The NCI started its Surveillance, Epidemiology, and End Results (SEER) Program and state cancer registries were coming into being. Yet there was one key difference between this work and what Jemal knew was possible.

“There was much more emphasis on collecting the data accurately,” Thun said. “What Ahmedin realized was the power to analyze [data] to influence policy. … His ability to analyze data just took it to a whole new level very quickly.”

For Jemal, this wasn’t his childhood ambition of becoming a medical doctor, but it was a “blessing in disguise,” he said. “It is about public health, right?  As a medical doctor in Ethiopia, I could have been seeing patients in my office. As a surveillance researcher now, I have opportunities to contribute to improving the lives of patients and their families at a population level – at a much larger scale.”

Access for all

That focus on populations – not individuals – soon proved it could have a profound impact on real people. In the early 2000s, Jemal and colleagues began publishing research on cancer disparities that gained significant attention.

Jemal is most proud of his research during this time that helped shape the American Cancer Society’s efforts to support access to health care. The research he worked on with lead author Dr. Elizabeth Ward (former VP for ACS intramural research) found that uninsured colorectal cancer patients with stage 1 disease had worse survival rates than privately insured patients with stage 2 disease. “That finding was very striking!” Jemal said.

In 2007, ACS devoted its entire advertising budget to the issue of improving access to health care, with this research as the foundation. A New York Times editorial at the time discussed this campaign, underscoring what Jemal and team’s research had shown: “When it comes to dealing with cancer, any delay in detection or treatment, as is common among the uninsured or poorly insured, can be fatal.”

After the Affordable Care Act became law in 2010, Jemal and team published studies on its lifesaving impact.

“We showed the benefits of the Affordable Care Act in improving access to care, receipt of care, and survival,” he said. “In Medicaid expansion states, for example, we reported that low-income persons had their uninsurance rates decreased, they had better access to care, they were more likely to receive treatment, and to survive their cancer. These findings were used in the amicus brief [to the US Supreme Court] to defend the Affordable Care Act.”

“That is one accomplishment that I am really proud of,” Jemal said. “The impact is huge; it has improved the lives of millions of people.”

Lisa Lacasse, president of the American Cancer Society Cancer Action Network (ACS CAN), ACS’s partner advocacy organization, called the research from Jemal and his colleagues “seminal.” “It “underscores the critical importance of access to affordable health care and directly adds to a large body of evidence that proves a correlation to improved cancer outcomes,” she said. “These findings by Dr. Jemal and team have strengthened and continue to defend the [Affordable Care Act], landmark legislation that has completely changed the health care landscape for cancer patients, survivors, and their families.”

Brawley has also worked with Jemal on game-changing research over the years. He first met Jemal when Ahmedin was a post-doc at the NCI – several decades ago.

“We get to work with a lot of brilliant people; few are able to translate their brilliance to impact,” Brawley said. “[Jemal’s] contributions are vast. He doesn’t just define the problems in the population, he goes beyond that and demonstrates the solution. Beyond brilliance, he is a nice guy who has built an amazing team of researchers.”

Publications with impact

Disparities and access to care are only a small piece of the significant number of publications Jemal and his team publish. Jemal has published nearly 500 articles in peer-reviewed journals throughout his career, with a Hirsch index of 141, in addition to book chapters, editorials, and lists of Cancer Facts & Figures publications.

“There was always a concern – he was so productive and so influential, that he would be hired away,” Thun said. “NCI was always hoping to hire him back.” IARC [the International Agency for Research on Cancer also wanted to hire him.

Jemal’s impact on ACS and its publications has been substantial. Since joining in 2001, he took on progressively more responsibilities, eventually becoming senior vice president for surveillance and health equity science, where he is today. Jemal also serves as an adjunct professor in the Department of Epidemiology at Emory University.

“He kept getting more and more responsibilities and yet his good nature never changed,” Thun said. “He recruited and trained an extremely loyal group of people (like Becky [Rebecca] Seigel) who have become highly recognized researchers on their own.”

Cancer Facts & Figures has grown substantially under Jemal’s leadership. First published more than 70 years ago as a stand-alone document, today, Cancer Facts & Figures is a globally recognized suite of publications, each accompanied by a companion article in CA: A Cancer Journal. CA has the highest impact factor in scientific literature – thanks in large part to the number of references each year to these highly cited companion articles. Jemal is regularly noted as one of the most highly cited researchers in the field because of this popular publication.

Jemal has made significant contributions to Cancer Facts & Figures, Thun said, systemizing things.  Under Jemal’s leadership, the team has added Facts & Figures on colorectal cancer, cancer treatment and survivorship, and global cancer.

Looking ahead

Today, Jemal stays busy not only with his work but also parenting two older children, along with his wife of 22 years, Hawa Adem – a stay-at-home mom also from Ethiopia. In his free time, he enjoys catching a Premier League soccer game on TV or walking down the street to visit with his brother (and families) – a pharmacist at the VA – who lives in the same Atlanta, Georgia, neighborhood.

Jemal may be geographically far from his African roots, but they’re not far from him. He travels back to Ethiopia regularly to visit his mother and several siblings who still live in Butajira and Addis Ababa. He also advises graduate students at the School of Public Health and oncology residents at the School of Medicine as part of capacity building for research collaborations with Addis Ababa University.

Like his parents, Jemal instilled the value of education into his children. His daughter is in her first year at Washington University School of Medicine at St. Louis. His son – a college sophomore majoring in biomedical engineering – is eager to be close behind her.

“I am very proud of them,” Jemal said.

Jemal is also proud of the progress against cancer during his career – how his team has contributed and what is possible tomorrow. He cites findings by Siegel and team on increasing colorectal cancer incidence in young adults that informed the American Cancer Society’s and the US Preventive Service Task Force’s guideline and recommendation to lower the age for initiation of colorectal screening from age 50 years to 45 years.

Jemal also notes a recent study by Dr. Samuel Asare and team, which showed a Massachusetts law ending the sale of menthol-flavored tobacco led to a significant drop in overall cigarette sales. “The US Food and Drug Administration cited the paper nine times when they put forth a new rule to ban menthol US-wide,” he said.

The American Cancer Society provides a unique opportunity for researchers to translate their findings into actions because it has an intramural research program, a cancer control (or patient support) program, and an advocacy arm (ACS CAN), Jemal said.  “We work closely with colleagues from other departments to identify research gaps for evidence-based decision-making. We strive for research to action.”

“We have incredibly talented young investigators, who are passionate about their research, the American Cancer Society’s mission, and who think big. Don’t go to the puck, go where it is going,” he said. “That is what our team tries to do to rise to the next level.”

It is clear he is succeeding.