Current Research and Scholarly Interests
As an oncologist and epidemiologist, I aim to understand cancer burden and improve treatment quality at the population level. I have a strong focus on genetic risk assessment and precision oncology. My research employs methods from the population sciences, in collaboration the Surveillance, Epidemiology and End Results (SEER) Program. I lead epidemiologic studies of cancer risk factors, clinical trials of novel approaches to cancer risk reduction, and decision analyses of strategies to optimize cancer outcomes.
I led a large population-based study, "Genetic testing, treatment use, and mortality after diagnosis of breast and ovarian cancer: the Georgia-California GeneLINK Initiative" (R01 CA225697), of genetic testing results linked to SEER registry data, with the aim of understanding the epidemiology, treatment and survival implications of cancer susceptibility gene mutations at the population level. I am now leading a second study, "Personalizing Genetic Test Results Management and Outcomes after Diagnosis of Cancer: the Georgia-California SEER GeneLINK Study" (R01 CA283207) that focuses on all cancer types and the use and outcomes of targeted therapies.
Together with colleagues at the University of Michigan, Emory University and University of Southern California, I co-led the GIFT study, a randomized clinical trial of approaches to cascade genetic testing of relatives, which is funded by the National Cancer Institute's Cancer Moonshot (U01 CA254822) through the Inherited Cancer Syndrome Collaborative. This will soon be followed by the GIFT2 study. Currently, I co-lead the PROACT study, a multi-site, randomized clinical trial of cascade genetic testing strategies in cancer genetics clinics, with colleagues at Stanford and the University of Michigan.
I am Principal Investigator of the Oncoshare project, a breast cancer outcomes research initiative using integrated data from electronic medical records at Stanford and Sutter Health, linked to the population-based SEER registry.
Other notable work includes spatial molecular imaging analysis of breast tumors from the diverse Northern California Breast Cancer Family Registry; development of a decision support tool to help women with BRCA1/2 mutations manage their cancer risks; and research on the clinical impact of next-generation sequencing for hereditary cancer risk assessment.
