Nicolas F. Schlecht

nicolas.schlecht [at] (Email) 

Associate Professor
Albert Einstein College of Medicine
Department Epidemiology & Population Health
Department of Medicine, Division of Oncology
1300 Morris Park Avenue
Bronx, New York, 10461

Phone: (718) 430-2307
Fax: (718) 430-3052

Dr. Schlecht is an Associate Professor in the Departments of Epidemiology & Population Health and Medicine (Oncology) at Albert Einstein College of Medicine in New York. Dr. Schlecht’s research focuses on the molecular epidemiology of cancer and its precursors in the upper aero-digestive tract and cervix.

Head and neck cancers (including the oral cavity, pharynx and larynx) are among the 10 most common malignancies of both men and women worldwide, with 5-year survival rates of only 50%. While early studies have shown tobacco smoking, alcohol drinking and their joint effects to be the most important risk factors for head and neck cancer, recent evidence suggests that as much as half of oropharyngeal cancers harbor HPV. Surprisingly, despite being more advanced at diagnosis, HPV-positive cancers are associated with better response to therapy and longer survival. Dr. Schlecht’s current research focuses on RNA expression and DNA methylation markers in head and neck cancers and oral lesions in individuals who have been exposed to risk factors for cancer including tobacco smoking, HPV and HIV.

Cervical cancer is one of the most common neoplastic diseases affecting women, with a combined worldwide incidence of almost half a million new cases annually, which is second only to breast cancer. Epidemiological evidence shows that infection with certain types of sexually-transmitted HPV plays a causal role in cervical cancer. Furthermore, precursor lesions of the cervix detected by cytology persist longer and are more likely to progress in women with oncogenic HPV infections and high viral load, and that in women with normal cervical cytology, the risk of developing cervical lesions are 2 to 4-fold greater for women who have persistent oncogenic HPV infection. Dr. Schlecht’s current research focuses on genetic and epigenetic precursors to cervical neoplasia, and on the effect of HPV vaccination on the natural history of cervical, anal and oral HPV in adults and adolescents.

Research Interests

  • Molecular Epidemiology
  • Cancer
  • HPV Infection
  • HIV

Selected Ongoing Projects

Cervical, anal, and oral HPV among inner city adolescents (Role: Principal Investigator (PI) with A. Diaz and R. Burk; Funding agency: NIAID)

The life-course approach to study the etiology of head and neck cancer: HeNCe life study (Role: Co-PI with B. Nicolau; Funding agency: CIHR)

Oral HPV and lesions in an HIV positive population (Role: PI; Funding agency: NIDCR)

Natural history of oro-pharyngeal cancer precursors: a Multi-Center Oral Squamous Atypical Lesions (MuCOSAL) study (Role: International-PI with B. Nicolau and M-C. Rousseau; Funding agency: CIHR)


Velly AM, Franco EL, Schlecht N, Pintos J, Kowalski LP, Oliveira BV, Curado MP. Relationship between dental factors and risk of upper aero-digestive tract cancer. Oral Oncol. 1998; 34(4):284-91.

Franco E, Villa L, Rohan T, Ferenczy A, Petzel-Erler M, Matlashewski G, and the Ludwig-McGill Study Group (Schlecht N – collaborating author for the Ludwig-McGill Study Group). Design and methods of the longitudonal study of the natural history of human papillomavirus infection and cervical neoplasia in Brazil. Pan Am J Pub Health. 1999; 6(4):223-33.

Schlecht NF, Franco EL, Pintos J. The effect of smoking cessation on the risk of cancers of the upper aero-digestive tract in Brazil. Epidemiology. 1999; 10(4):412-8.

Schlecht NF, Franco EL, Pintos J, Negassa A, Kowalski LP, Oliveira BV, Curado MP. Interaction between tobacco and alcohol consumption on the risk of cancers of the upper aero-digestive tract in Brazil. Am J Epidemiol. 1999; 150(11):1129-37.

Franco EL, Schlecht NF. Letter to the editor: More evidence of increased risks of cancer among alcohol drinkers. Am J Epidemiol. 1999; 150(11):1141.

Maciag PC, Schlecht NF, Souza PS, Franco EL, Villa LL, Petzl-Erler ML. Major histocompatibility complex class II polymorphisms and risk of cervical cancer and human papillomavirus infection in Brazilian women. Cancer Epidemiol Biomarkers Prev. 2000; 9(11):1183-91.

Schlecht NF, Franco EL. Letter to the editor: Interaction between tobacco and alcohol consumption on the risk of cancers of the upper aero-digestive tract in Brazil. Am J Epidemiol. 2000; 152(2):193-4.

Carvalho AL, Pintos J, Schlecht NF, Oliveira BV, Fava AS, Curado MP, Kowalski LP, Franco EL. Incidence of second primary tumours in a cohort of head and neck cancer patients in Brazil. In: Varma AK, Roodenburg JLN (eds.) Oral Oncol, ICOC Press, The Hague. 2001; VII:72-4.

Carvalho AL, Schlecht NF, Pintos J, Oliveira BV, Fava AS, Curado MP, Kowalski LP, Franco EL. Factors influencing patient and professional delay in oral cancer diagnosis. In: Varma AK, Roodenburg JLN (eds.) Oral Oncol, ICOC Press, The Hague. 2001; VII:31-4.

Schlecht NF, Pintos J, Kowalski LP, Franco EL. The effect of alcohol type and ethanol content on the risks of upper aero-digestive tract cancers in Brazil. Cancer Causes Control. 2001; 12(7):579-87.

Healey SM, Aronson KJ, Mao Y, Schlecht NF, Mery LS, Ferenczy A, Franco EL. Oncogenic human papillomavirus infection and cervical lesions in aboriginal women in Nunavut, Canada. Sex Transm Dis. 2001; 28(12):694-700.

Schlecht NF, Franco EL, Rohan T, Kjaer SK, Schiffman MH, Moscicki AB, Duffy SW (for the MARSH International Collaborative Group). Repeatability of sexual history in longitudinal studies on HPV infection and cervical neoplasia: determinants of reporting error at follow-up interviews. J Epidemiol Biostat. 2001; 6(5):393-407.

Schlecht NF, Kulaga S, Robitaille J, Ferreira S, Santos M, Miyamura RA, Duarte-Franco E, Rohan TE, Ferenczy A, Villa LL, Franco EL. Persistent human papillomavirus infection as a predictor of cervical neoplasia. JAMA. 2001; 286(24):3106-14.

Carvalho AL, Pintos J, Schlecht NF, Oliveira BV, Fava AS, Curado MP, Kowalski LP, Franco EL. Predictive factors for diagnosis of an advanced stage upper aerodigestive tract cancer. Arch Otolaryngol Head Neck Surg. 2002;128(3):313-8.

Maciag PC, Schlecht NF, Souza PSA, Franco EL, Rohan TE, Villa LL. Polymorphisms of the human leukocyte antigen DRB1 and DQB1 genes and the natural history of human papillomavirus infection. J Infect Dis. 2002; 186(2):164-72.

Nishimoto IN, Pintos J, Schlecht NF, Torloni H, Carvalho A, Kowalski LP, Franco EL. Assessment of control selection bias in a hospital-based case-control study of upper aero-digestive tract cancers. J Cancer Epidemiol Prev. 2002;7(3):131-41.

Schlecht NF, Trevisan A, Duarte-Franco E, Rohan TE, Ferenczy A, Villa LL, Franco EL. Viral load as predictor of risk of cervical intraepithelial neoplasia. Int J Cancer. 2003; 103(4):519-24.

Carvalho AL, Kowalski LP, Pintos J, Franco EL, Schlecht NF, Oliveira BV, Fava AS, Curado MP. Age and alcohol consumption influence prognosis of head and neck cancer patients. In: Varma AK, Reade P (eds.) Oral Oncol, ICOC Press, The Hague. 2003; IX:101-3.

Schlecht NF. Commentary: Persistence of the same HPV type over 2 years increases the risk of developing high-grade cervical lesions by 800-fold. Evidence-Based Obstet Gynecol. 2003; 5:90-91.

Schlecht NF, Platt RW, Duarte-Franco E, Rohan TE, Ferenczy A, Villa LL, Franco EL. Human papillomavirus infection as a predictor of the rate of progression and regression of cervical intraepithelial neoplasia. J Natl Cancer Inst. 2003; 95(17):1336-43.

Schlecht NF, Platt RW, Negassa A, Duarte-Franco E, Rohan TE, Ferenczy A, Villa LL, Franco EL. Modeling the time dependence of the association between human papillomavirus infection and cervical cancer precursor lesions. Am J Epidemiol. 2003; 158:878-86.

Franco EL, Schlecht NF, Saslow D. The epidemiology of cervical cancer. Cancer J. 2003; 9(5):348-59.

Pinto AP, Schlecht NF, Pintos J, Kaiano J, Franco EL, Crum CP, Villa LL. Prognostic significance of lymph node variables and human papillomavirus DNA in invasive vulvar carcinoma. Gynecol Oncol. 2004; 92(3):856-65.

Strickler HD, Palefsky JM, Fazzari M, Anastos K, Minkoff H, Massad LS, Hall C, Bacon M, Levine AM, Watts DH, Silverberg M, Xue X, Schlecht NF, Melnick S, Burk R. Natural history and possible reactivation of human papillomavirus in human immunodeficiency virus-positive women. J Natl Cancer Inst. 2005; 97(8):577-86.

Schlecht NF, Burk R, Palefsky JM, Minkoff H, Xue X, Massad LS, Bacon M, Levine AM, Anastos K, Gange SJ, Watts DH, Da Costa MM, Chen Z, Bang, JY, Fazzari M, Hall C, Strickler HD. Variants of HPV16 and 18 and their natural history in HIV-positive women. J Gen Virol. 2005; 86(10): 2709-2720.

Belbin TJ, Schlecht NF, Smith RV, Prystowsky MB, Childs G. Deciphering the Molecular Signatures of Head and Neck Cancer. Pharmaceutical Discovery. 2005: 22-31.

Schlecht NF. Prognostic value of human papillomavirus in the survival of head and neck cancer patients: an overview of the evidence. Oncol Rep. 2005; 14(5):1239-46.

Schlecht NF, Schwartzman K, Bourbeau J. Dyspnea as clinical indicator in patients with chronic obstructive pulmonary disease. Chronic Respir Dis. 2005; 2(4):183-91.

Adrien LR, Schlecht NF, Kawachi N, Smith RV, Brandwein-Gensler M, Massimi A, Chen S, Prystowsky MB, Childs G, Belbin TJ. Classification of DNA methylation patterns in tumor cell genomes using a CpG Island microarray. Cytogenet Genome Res. 2006; 114(1):16-23.

Smith R, Schlecht NF, Childs G, Prystowsky M, Belbin T. A pilot study of mucosal genetic differences in early smokers and nonsmokers. Laryngoscope. 2006; 116(8):1375-9.

Madan R, Brandwein-Gensler M, Schlecht NF, Elias K, Gorboritsky E, Belbin TJ, Mahmood R, Breining D, Qian H, Childs G, Locker J, Smith R, Haigentz M Jr, Gunn-Moore F, Prystowsky MB. Cytoplasmic ezrin has prognostic significance for head and neck squamous cell carcinoma. Head Neck. 2006; 28(11):1018-27.

Schlecht NF, Trevisan A, Baggio ML, Galan L, Duarte-Franco E, Greenberg MD, Rohan TE, Ferenczy A, Villa LL, Franco EL. Lack of agreement between cervicography and cytology and the effect of human papillomavirus infection and viral load. J Low Genit Tract Dis. 2006; 10(4):229-37.

Belbin TJ, Bergman A, Brandwein-Gensler M, Chen Q, Childs G, Garg M, Haigentz M, Hogue-Angeletti R, Moadel R, Negassa A, Owen R, Prystowsky MB, Schiff B, Schlecht NF, Shifteh K, Smith RV, Zheng X. Head and neck cancer: reduce and integrate for optimal outcome. Cytogenet Genome Res. 2007; 118(2-4):92-109.

Teixeira MS, Camacho-Vanegas O, Fernandez Y, Narla G, DiFeo A, Lee B, Kalir T, Friedman SL, Schlecht NF, Genden EM, Urken M, Brandwein-Gensler M, Martignetti JA. KLF6 allelic loss is associated with tumor recurrence and poor survival in head and neck squamous cell carcinoma. Int J Cancer. 2007; 121(9):1976-83.

Schlecht NF, Burk RD, Adrien L, Dunne A, Kawachi N, Sarta C, Chen Q, Brandwein-Gensler M, Prystowsky MB, Childs G, Smith RV, Belbin TJ. Gene expression profiles in HPV infected head and neck cancer. J Pathol. 2007; 213(3):283-93.

Pinto AP, Schlecht NF, Woo TY, Crum CP, Cibas ES. Biomarker (ProExC, p16(INK4A) and MiB-1) distinction of high grade squamous intraepithelial lesions from its mimics. Modern Pathology. 2008; 21(9):1067-74.

Lawson W, Schlecht NF, Brandwein-Gensler M. The role of the human papillomavirus in the pathogenesis of schneiderian inverted papillomas: an analytic overview of the evidence. Head Neck Pathology. 2008; 2:49-59.

Belbin TJ, Schlecht NF, Adrien LR, Kawachi N, Brandwein-Gensler M, Bergman A, Smith RV, Childs G, Prystowsky MB. Site-specific molecular signatures predict aggressive disease in head and neck squamous cell carcinoma. Head Neck Pathology. 2008; 2:243-56.

Einstein, MH, Leanza S, Chiu LG, Schlecht NF, Goldberg GL, Steinberg BM, Burk RD. Genetic variants in TAP are associated with high-grade cervical neoplasia. Clin Can Res. 2009; 15(3):1019-23.

Childs G, Fazzari M, Kung G, Kawachi N, Brandwein-Gensler M, McLemore M, Chen Q, Burk RD, Smith RV, Prystowsky MB, Belbin TJ, Schlecht NF. Low level expression of microRNA’s let-7d and miR-205 are prognostic markers of head and neck squamous cell carcinoma. Am J Pathol. 2009; 174(3):736-45.

Prystowsky MB, Adomako A, Smith RV, Kawachi N, McKimpson W, Atadja P, Chen Q, Schlecht NF, Parish JL, Childs G, Belbin T. The histone deacetylase inhibitor LBH589 inhibits expression of mitotic genes causing G2/M arrest and cell death in head and neck squamous cell carcinoma cell lines. J Pathol. 2009; 218(4):467-77.

Somma J, Schlecht NF, Fink D, Khader SN, Smith RV, Cajigas A. Thyroid FNA: Follicular lesions and the gray zone. Acta Cytol. 2010; 54(2):123-31

Brandwein-Gensler M, Smith RV, Wang B, Penner C, Theilken A, Broughel D, Schiff B, Owen RP, Smith J, Sarta C, Hebert T, Nason R, Ramer M, DeLacure M, Hirsch D, Myssiorek D, Heller K, Prystowsky M, Schlecht NF, Negassa A. Validation of the histologic risk model in a new cohort of patients with head and neck squamous cell carcinoma. Am J Surg Pathol. 2010; 34(5):676-88.

Schlecht NF, Brandwein-Gensler M, Nuova GJ, Li M, Dunne A, Kawachi N, Smith RV, Burk RD, Prystowsky MB. A comparison of clinically utilized human papillomavirus detection methods in head and neck cancer. Mod Pathol. 2011; 24(10):1295-305.

Lleras R, Adrien LR, Smith RV, Brown B, Jivraj N, Keller C, Sarta C, Schlecht NF, Haris TM, Childs G, Prystowsky MB, Belbin TJ. Hypermethylation of a cluster of krüppel-type zinc finger protein genes on chromosome 19q13 in oropharyngeal squamous cell carcinoma. Am J Pathol. 2011; 178(5):1965-74.

Maleki S, Schlecht NF, Keller C, Diaz J, Moss J, Prystowsky MB, Macian F, Brandwein-Gensler M. Lymphocytic host response to oral squamous cell carcinoma: an adaptive t-cell response at the tumor interface. Head Neck Pathol. 2011; 5(2):117-22.

Bottalico D, Chen Z, Dunne A, Ostoloza J, McKinney S, Chang Sun C, Schlecht NF,Fatahzadeh M, Herrero R, Schiffman M, Burk RD. The oral cavity contains abundant known and novel human papillomaviruses from the betapapillomavirus and gammapapillomavirus gener. J Infect Dis. 2011; 204(5):787-92.

Schlecht NF, Brandwein-Gensler M, Smith RV, Kawachi N, Broughel D, Lin J, Keller CE, Reynolds PA, Gunn-More FJ, Harris TM, Childs G, Belbin TJ, Prystowsky MB. Cytoplasmic ezrin and moesin correlate with poor survival in head and neck squamous cell carcinoma. Head Neck Pathol. 2012; 6(2):232-43.

Harris TM, Jimenez L, Kawachi N, Fan JB, Chen J, Belbin T, Loudig O, Keller CE, Smith RV, Prystowsky MB, Schlecht NF, Segall JE, Childs G. Low-level expression of miR-375 correlates with poor outcome and metastasis while altering the invasive properties of head and neck squamous cell carcinomas. Am J Pathol. 2012; 180(3):917-28.

Luo J, Chlebowski R, Wactawski-Wende J, Schlecht N, Tinker L, Margolis KL. Diabetes mellitus as a risk factor for lung cancer among post-menopausal women. Diabetes Care. 2012; 35(7):1485-91.

Li Y, Bai S, Carroll W, Dayan D, Dort JC, Heller K, Jour G, Lau H, Penner C, Prystowsky M, Rosenthal E, Schlecht NF, Smith RV, Urken M, Vered M, Wang B, Wenig B, Negassa A, Brandwein-Gensler M. High-risk classification and tumor pattern of invasion predict outcome for patients with low-stage oral squamous cell carcinoma. Head Neck Pathol. 2012; (in press).

Schlecht NF, Burk RD, Nucci A, Shankar V, Peake K, Lorde-Rollins E, Porter R, Lineares LO, Rojas M, Strickler H, Diaz A. Cervical, anal and oral HPV in an adolescent inner-city health clinic providing free vaccinations. PLoS ONE. 2012; 7(5):e37419.

Schlecht NF, Rojas M, Lorde-Rollins E, Nucci-Sack A, Strickler HD, Burk RD, Diaz A. Cervical, anal and oral HPV in an inner-city pre-vaccination adolescent population. J Urban Health. 2013; 90(1):141-6.

Fatahzadeh M, Schlecht NF, Botallico D, McKinney S, Ostoloza J, Dunne A, Burk RD. Oral human papillomavirus detection in older adults with human immunodeficiency virus infection. Oral Surg Oral Med Oral Pathol Oral Radiol. 2013; 115(4):505-14.

Chevarie-Davis M, Ramanakumar AV, Ferenczy A, Villa LL, Franco EL; Ludwig–McGill Cohort Study (Baggio ML, Galan L, Sobrinho JS, Prado JC, Ferreira S, Termini L, Costa MC, Miyamura R, Trevisan A, Thomann P, Candeias J, Sichero L, Rahal P, Ruiz A, Kaiano J, Santos M, Savio P, Maciag P, Rabachini T, Villa L, Rousseau MC, Mahmud S, Schlecht N, Trottier H, Ferenczy A, Rohan T, Chevarie-Davis M, Tota J, Ramanakumar A, Duarte E, Kulaga S, Robitaille J, Platt R, Franco E). Assessment of the performance of algorithms for cervical cancer screening: evidence from the Ludwig-McGill cohort study. Gynecol Oncol. 2013 Mar;128(3):415-9.

Trevisan A, Schlecht NF, Ramana-Kumar AV,Franco EL,Villa LL. HPV16 viral load measurement as a predictor of infection clearance. J Gen Virol. 2013; (in press).