Bernard Fuemmeler standing and leaning on the railing of a glass divider
Bernard Fuemmeler, Ph.D., associate director of population science at VCU Massey Cancer and the Gordon D. Ginder, M.D., Chair in Cancer Research professor in the Department of Health Behavior and Policy in the School of Medicine. (Tom Kojcsich, University Marketing)

How the country’s largest twin registry is supporting cancer research at VCU

A study led by VCU’s Bernard Fuemmeler, Ph.D., is using the Mid-Atlantic Twin Registry to discover heritability for common cancers.

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The nation’s largest twin registry, based at Virginia Commonwealth University, plays a role in research across many disciplines and topics including the heredity of alcohol and drug abuse, psychiatric outcomes of bullying victimizationdepression in women behavioral problems in children, and the long-term biological consequences of sexual assault.    

Now, researchers at VCU are delving into the registry to learn more about cancer’s heritability. Certain types of rare cancers have a strong genetic contribution, but the genetic involvement in more common cancers could reflect the role of both genes and environment. But how much is heritable and how much is environmental? This is what VCU’s Bernard Fuemmeler, Ph.D., and his team at Massey Cancer Center are studying.

Fuemmeler is associate director of population science at VCU Massey Cancer and the Gordon D. Ginder, M.D., Chair in Cancer Research professor in the Department of Health Behavior and Policy in the School of Medicine. He studies social and genetic factors such as obesity and tobacco use. He says the Mid-Atlantic Twin Registry is incomparable to other registries in the United States.

“This registry is unique and powerful, there are no similar size twin registries across the U.S.,” he said, adding that the size of the registry allows researchers to study individuals of varying ages and demographic backgrounds, which is vital for his research that seeks to benefit the general population.

His study aims to discover the heritability for common cancers such as breast and lung cancer, the influence of environmental factors on cancer genes, as well as the risk/protective factors associated with cancer. To aid with his research, Fuemmeler will use the Mid-Atlantic Twin Registry and its access to thousands of identical and fraternal twins.

Linking this data to state cancer registries in Virginia and North Carolina, he hopes he and his team can unveil these genetic versus environmental factors that contribute to certain types of cancer. Fuemmeler and his colleagues are finalizing the data in preparation for these studies.

With more than 50,000 participants, the Mid-Atlantic Twin Registry is the largest twin registry in the U.S. and one of the largest in the world. Twins and other multiples who participate offer researchers the opportunity to study “nature versus nurture.”

“As a natural experiment, [Mid-Atlantic Twin Registry] twins enable us to study the interplay of both nature and nurture, transforming the way we understand complex genetic and environmental influences on mental and physical health,” said Judy L. Silberg, Ph.D., scientific director of the twin registry.

VCU’s Kenneth Kendler, M.D., began collaborating with the twin registry (then known at the Virginia Twin Registry) in 1985 with funding from the National Institutes of Health to study twins. He has since become one of the most-cited researchers in the world, with his most influential papers about the genetics of psychiatric disorders, in large part because of the ability to study twins.

“The [twin registry] was a critical resource that was central to the development of my own research career as well as that of the Virginia Institute for Psychiatric and Behavioral Genetics,” Kendler said.

By using the registry and twin studies in general, Kendler discovered that genetic and environmental factors can contribute to major depression, the genetic risk factors for anxiety and mood disorders and that most genetic risk factors for drug abuse were shared among twins and higher other multiples. His work laid the foundation for twin research nationally and internationally.

In addition to pairing twins with researchers, the registry also supports projects by carrying out data collection, project coordination, institutional review board submissions, and providing grant applications support. The registry has an extensive database of twins and other multiples of all ages, races and ethnicities, and zygosity types: identical or fraternal. The diversity of the registry’s database is critical for researchers seeking to reflect the diversity of the world so that their findings are more accurate.

The registry also provides a ready population for researchers who are not studying genetics but need a database of a large number of people who have already indicated their willingness to participate in research.

“VCU's Mid-Atlantic Twin Registry has allowed our researchers to develop better prevention, diagnostic and treatment plans because of the unique perspective of studying twins,” said P. Srirama Rao, Ph.D., vice president for research and innovation. “Through research in cancer and other acute and chronic diseases, to how environmental influences affect development and disease progression, the [twin registry] is indispensable to not only VCU's research community but national as well, and will have a global impact on health outcomes.”

To learn more about the Mid-Atlantic Twin Registry for use in research at VCU and elsewhere, contact the registry at or visit