Christopher P. Crum, MD

2020 Maude Abbott Lecture

Christopher Paul Crum was born in Newport News, Virginia and completed his medical school education and pathology residency at the University of Virginia. At Columbia Presbyterian Hospital in New York, he trained in colposcopy and cervical pathology with Ralph Richart. In 1984 he published the first detailed description of HPV 16-associated precursors in the cervix with Lutz Gissmann from Harald zur Hausen’s laboratory. Crum then joined Saul Silverstein’s laboratory at Columbia and received a Physician Scientist Award from the NIAID in 1985. He returned to the University of Virginia in 1987 and was recruited in 1990 by Ramzi Cotran to direct Women’s and Perinatal Pathology at Brigham and Women’s Hospital in Boston. Dr. Crum held that position for 28 years until 2018. During his tenure as Director, he and his colleagues contributed both seminal research and textbooks in obstetrical and gynecologic disease.

With Frank McKeon, who cloned TP63, Crum and colleagues mapped p63 expression in the female genital tract in 1999. In 2011, Crum, McKeon, Wa Xian, and Michael Herfs discovered a cell type in the cervical squamocolumnar junction (SCJ) and proposed these cells as the origin of cervical cancer. This discovery was the impetus for an ongoing clinical trial to determine if prophylactic SCJ ablation will lower the risk of cervical cancer.

In 2005, Crum hypothesized that the distal fallopian tube is an origin of extrauterine high grade serous cancer (HGSC) and created a dissection protocol focusing on the fimbria (SEE-FIM) that has been adopted in academic institutions and pathology practices in the USA and many parts of the world. The fimbria has thus emerged as a primary site of origin for HGSC in the form of both early serous cancers (STICs) and early serous precursors (ESPs). The current practice of opportunistic salpingectomy has been a consequence of this new appreciation of the fallopian tube as a source of HGSC. Recently, Crum’s group showed that ESPs often share identical TP53 mutations with concurrent HGSCs, and hypothesized that precancerous cells could escape the tubes and eventually undergo malignant transformation in the peritoneal cavity. This discovery suggests that HGSCs could develop from both STICs and inconspicuous “wandering precursors”. Moreover, it could help to explain the seemingly spontaneous emergence of many HGSCs in the peritoneal cavity, with obvious challenges for the prevention of this lethal malignancy.

Dr. Crum recently received the 2019 Innovation Award from the Society of Gynecologic Oncology for his contributions to research in gynecologic cancer. In this year’s Maude Abbott Lecture he will trace the time-line of ovarian cancer research, highlighting the impact of pathology on the quest for effective ovarian cancer prevention. Integral to the quest has been the search for truths that quietly await recognition in a tissue section under a light microscope. During this search the pathologist must continually question his or her assumptions and test emerging hypotheses, while striving for meaningful discovery.

Dr. Crum and his wife Tucker reside in Brookline Massachusetts, have two daughters Emily Day (Brookline) and Amanda Gibson (Mobile) and four grandchildren, Beckett and Piper Day, and Spencer and Stella Gibson.