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  • We envision a world free from cancer.

    Our research scientists and their teams collaborate with colleagues around the world to conduct cutting-edge research using large data-sets to:
    • understand the causes of cancer
    • find ways to prevent it or detect it early
    • improve outcomes for cancer survivors 
  • Our mission began more than 40 years ago.

    Established in 1974 as the Northern California Cancer Program, the organization later became known as the Northern California Cancer Center. The name was changed again in 2010 when it became the Cancer Prevention Institute of California (CPIC), which reflects the organization's broader scope and demonstrates its large scale impact of preventing cancer before it starts.
  • We are an independent research institute and a valued partner to many.

    Through its collaborative approach, CPIC also serves as an asset to the nation’s leading cancer fighting organizations, including the National Cancer Institute, and to scientists worldwide, educators, patients, and clinicians, and is affiliated with the Stanford Cancer Institute.
  • We work hard to understand who gets cancer and why.

    Our scientists are frequent contributors to major scientific journals, and often present their findings at important cancer-related conferences. CPIC research has been covered by numerous local, national and international media outlets, such as The New York Times and The Washington Post.
  • Every case of cancer counts…and is counted.

    CPIC operates the Greater Bay Area Cancer Registry as part of the National Cancer Institute's Surveillance, Epidemiology and End Results program and the California Cancer Registry. As required by law, the registry gathers data from hospitals and doctors on all cancers diagnosed and treated in nine Bay Area counties. This information is used to produce cancer statistics and as a platform for research to understand cancer occurrences and survival. Our registry regularly earns Gold Standard Certification by the North American Association of Central Cancer Registries.
  • Our educational efforts reach people of all ethnicities and backgrounds.

    Our Community Education team provides important information to cancer survivors, health professionals and others through conferences and publications on many cancer-related topics including employment, patient advocacy, care giving, specific cancers, and treatments.

  • Breast cancer rates decline when hormone therapy is stopped.

    CPIC was first to report on the alarmingly high and increasing rates of breast cancer in the Bay Area and Marin County in the 1990s. In subsequent studies, CPIC found that when women stopped taking hormone replacement therapy, breast cancer rates declined immediately and dramatically. This showed that hormone therapy was a major contributor to the high rates previously reported and identified one clear path to breast cancer prevention.
  • Our work to associate tanning beds and melanoma prompted legislation.

    CPIC described increased occurrence of melanoma in young women in California, particularly in high socioeconomic areas, implicating use of tanning beds as one cause. This finding led to passage of the first statewide legislation to ban minors from using tanning beds, which should ultimately reduce occurrences of deadly melanoma in young persons.
  • Physical activity lowers your risk of Breast Cancer

    CPIC found that risk of breast cancer was lower for women engaging in more physical activity, such as walking and biking, doing household chores and yard work, and being active on the job. This shows a simple and practical way women can help prevent breast cancer from occurring.
  • Second-hand smoke increases the risk of lung and breast cancer.

    CPIC studies have shown that women exposed to second-hand tobacco smoke have a higher risk of lung cancer even if they don't smoke, and that exposure to household smoke increases their risk of breast cancer over and above the risk they incur from smoking themselves. These findings have been important in leading to anti-smoking legislation.
  • Vitamin D may reduce the risk of prostate cancer.

    CPIC assessed whether sun exposure, which is the main source of vitamin D, is related to prostate cancer risk. Using the difference in skin color measured on the forehead and upper underarm as an indicator of sun exposure, the study found that prostate cancer risk was reduced by 50% in men with a high sun exposure index, with an even higher reduction in risk noted in men with certain alterations in the vitamin D receptor gene.
  • Survival outcomes differ among Asian women of different ethnic backgrounds.

    CPIC was the first to show that breast cancer survival is not uniform across women of different Asian ethnicities, irrespective of how advanced the cancer was when diagnosed. In California, Korean, South Asian and Vietnamese women had the poorest survival after breast cancer, pointing to the need in these communities for better screening and/or breast cancer treatment.
  • Melanoma is on the rise throughout California.

    CPIC demonstrated that the rates of both early and more advanced melanomas were rising in all populations in California. This disturbing finding signals a true and alarming epidemic of this deadly cancer, and it has been cited over 245 times in the medical literature since 2009 because it identifies a major public health problem.
  • Survival disparities occur across many cancer types.

    CPIC showed that survival after follicular lymphoma, a common form of this cancer, is lower in poorer communities than in more affluent communities. This demonstrates population disparities in cancer treatment and shows a need in poorer communities for more access to skilled lymphoma care, including access to new successful drug treatments.
  • Our nail salon studies have widespread positive impact.

    CPIC found that California nail salons had higher than expected levels of carcinogens and other banned substances in the air, identifying the need for better standards and the importance of clarifying whether such exposures lead to cancer and other undesirable health outcomes.
  • Tailored approaches to healthcare are needed to address cultural differences.

    CPIC used two approaches to learn how best to help Vietnamese communities in California receive lifesaving colorectal cancer screening: one approach involved lay health workers directly educating the community on the importance of screening, and the other involved advertising about colorectal cancer screening. CPIC found that the use of lay health workers worked best to improve the screening rate, proving that organized community involvement improves colorectal screening practices among Vietnamese-Americans in California.
  • Lung cancer afflicts nonsmoking women more than men.

    CPIC was the first to show definitively that among nonsmokers, women were more likely than men to have lung cancer. Until this paper, there were no hard data about the incidence of lung cancer in nonsmokers. This study has been cited extensively as motivation for other research to understand the reasons why.
  • Genetic screening is especially important for African American and Hispanic women.

    CPIC was the first to study the level of BRCA1 mutations (genetic changes responsible for increased risk of breast cancer) in nonwhite women. This work found that young African American and Hispanic women with breast cancer had a particularly high prevalence of BRCA1 mutations, and signaled the importance to these communities and their doctors of screening for this mutation when indicated.

Registry News and Reports

Annual Cancer Incidence and Mortality Report

This annual report presents information on all new cancer cases and deaths occurring in the Greater Bay Area from 1988 to the latest year for which information is available. For more information, please visit our Annual Report webpage.


Recent trends in breast cancer incidence and mortality in Marin County

As part of our regular surveillance of cancer in the nine-county Greater Bay Area region, the Greater Bay Area Cancer Registry has carefully assessed recent trends in breast cancer incidence in the population of Marin County, a population for whom elevated rates had been reported among non-Hispanic whites in the past. Our review of the most complete incidence data (1988-2012) and mortality data (1988-2013) is available here.


Recent findings regarding elevated incidence of melanoma in Marin County

As part of our regular surveillance of cancer in the nine-county Greater Bay Area region of Callifornia, we have identified some recent changes in invasive melanoma incidence in the non-Hispanic white population of Marin County with implications for melanoma screening and prevention activities. Melanoma is now the second most commonly diagnosed cancer after prostate cancer for men in Marin County. Melanoma incidence in Marin County is 43% higher than the rest of the San Francisco Bay Area. Death rates from melanoma in Marin County are 18% higher than the California state average. CPIC and Marin County Health and Human Services issued a press release about the findings on July 23, 2014.

Please see the full report, Melanoma Incidence in Marin County, California, 1988 - 2011, for details of the findings, recommendations and next steps. 

Detailed studies regarding breast cancer in Marin County

The Greater Bay Area Cancer Registry closely monitors breast cancer rates in Marin County and the rest of the San Francisco Bay Area, where elevated rates have raised public concern in the past. Breast cancer incidence rates in Marin County increased dramatically in the last half of the 1990’s, peaked in 1999, and leveled off at a high rate between 1999 and 2003.
Breast cancer incidence then declined sharply for the years 2003 and 2004 both in the Bay Area and nationally.  Since 2004, incidence rates seem to have leveled off.  It is thought that these patterns track largely to prescription trends for menopausal hormone therapies, used by women for menopausal symptoms.

In July 2002, large numbers of women stopped taking hormone therapy after the announcement by the Women's Health Initiative that estrogen/progestin hormone therapy increases the risk of developing breast cancer and heart disease.  Reassuringly, breast cancer mortality rates have been declining consistently in Marin county, the Bay Area, California, and nationally.   We are continuing our collaboration with the Marin County Health Department and their long-term Marin Women's Study to better characterize patterns in hormone therapy use and breast cancer occurrence for Marin County.   

Our most recent review of breast cancer incidence and mortality for Marin has been summarized in the Recent trends in breast cancer incidence and mortality in Marin County, California, 1988-2012, An Update from the Greater Bay Area Cancer Registry, September 21, 2015. 

Please see the current Annual Cancer Incidence and Mortality Review for the latest statistics on the rates of in situ and invasive breast cancer for Marin and other counties in the Bay Area. Scientific articles that may be of interest are listed below.

When possible, links to the full text or abstract are provided; some publications require a subscription or fee to access more than the abstract online.

Ereman R, Prebil LA, Mockus M, Koblick K, Orenstein F, Benz C, Clarke CA. Recent trends in hormone therapy utilization and breast cancer incidence rates in the high incidence population of Marin County, California. BMC Public Health 2010; 10(1):228.

Robbins AS, Clarke CA. A decline in breast-cancer incidence. N Engl J Med 2007 Aug 2;357(5):511-2; author reply 513.

Clarke CA, Glaser SL. Declines in breast cancer after the WHI: apparent impact of hormone therapy. Cancer Causes Control 2007 Oct;18(8):847-52. Epub 2007 Jul 6. 

Robbins AS, Clarke CA. Regional changes in hormone therapy use and breast cancer incidence in California from 2001 to 2004. J Clin Oncol 2007 Aug 10;25(23):3437-9. Epub 2007 Jun 25. 

Clarke CA, Glaser SL, Uratsu CS, Selby JV, Kushi LH, Herrinton LJ. Recent declines in hormone therapy utilization and breast cancer incidence: clinical and population-based evidence. J Clin Oncol 2006 Nov 20;49-50.

Clarke CA, Purdie DM, Glaser SL. Population attributable risk of breast cancer in white women associated with immediately modifiable risk factors. BMC Cancer 2006 Jun 27;6:170. 

Update on breast cancer incidence patterns in Marin County and the San Francisco Bay Area, California. Northern California Cancer Center, September 2004. 

Clarke C, Glaser S, West D, et al. Breast cancer incidence and mortality trends in an affluent population: Marin County, California, USA, 1990-1999. Breast Cancer Res 2002; 4:R13.

Prehn A, Clarke C, Topol B, Glaser S, West D. Increase in breast cancer incidence in middle aged women during the 1990s. Ann Epidemiol 2002; 12:476-81. 

Prehn AW, West DW. Evaluating local differences in breast cancer incidence rates: a census based methodology (United States). Cancer Causes Control 1998; 9:511-7.