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Christina Clarke, Ph.D., M.P.H.
Research Scientist, Cancer Prevention Institute of California

Consulting Assistant Professor, Division of Epidemiology, Dept. of Health Research & Policy, Stanford University School of Medicine
Member, Stanford Cancer Institute

2201 Walnut Avenue, Suite 300
Fremont, California 94538-2334
E-mail: tina@CPIC.org
Phone: 510-608-5000
Fax: 510-608-5085

Research Interests:

    • Breast cancer occurrence and risk factors
    • Occurrence and causes of lymphoid malignancies
    • Improving the relevance and utility of cancer surveillance data
    • Patient-centric methods for research and data display

Dr. Clarke got her BS in Biology from Duke University, an MPH in Epidemiology from the Tulane School of Public Health and Tropical Medicine, and her Ph.D. in Epidemiology from the University of California, Berkeley. She has research ongoing in four general areas: 1) breast cancer occurrence and causes, 2) occurrence and causes of lymphoid malignancies 3) cancer surveillance, and 4) patient-centric methods for research and data display.

Breast cancer: This research area involves descriptive work to describe geographic and temporal variations in incidence especially in the Bay Area, and analytic efforts to uncover possible immunologic and infectious causes. Dr. Clarke was among the first to note and report on the unprecedented decline in breast cancer incidence that occurred in mid-2002 after many women stopped taking hormone therapy. Dr. Clarke recently completed two population-based case-control studies to explore environmental factors associated with immune system development (as identified by the “hygiene hypothesis” literature for asthma and allergy development). With colleagues, she is also investigating associations of breast cancer with immune genes, human herpes viruses, and other markers of immune function and infection.

Lymphoid malignancies: this research area emphasizes the causes and outcomes of Hodgkin lymphoma (HL) and the many subtypes of non-Hodgkin lymphoma (NHL). Her dissertation research described patient survival after HL in the general population and with respect to a certain molecular marker (Epstein-Barr virus in HL tumor cells). With Dr. Sally Glaser, she has examined reproductive, infectious, social class and other risk factors for Hodgkin lymphoma in a population-based case control study of women. In addition to descriptive efforts to describe NHL incidence, she has conducted methodological studies to improve the surveillance and study of NHL subtypes, which has been challenged by changing classifications over time and by inability to separate HIV-related from –unrelated forms. She is a co-leader of the Pathology Working Group of the NCI-backed International Interlymph Consortium.

Cancer surveillance: As co-Investigator for the Greater Bay Area Cancer Registry, part of the NCI SEER and California Cancer Registry programs, Dr. Clarke monitors changes in cancer incidence and survival patterns among various population subgroups, particularly those defined by geography, race/ethnicity and socioeconomic status. In particular, she has examined cancer incidence survival patterns jointly by racial/ethnic and socioeconomic characteristics. Recent work with Dr. Susan Swetter at Stanford also emphasizes melanoma incidence, especially how possible underreporting by physicians may have led to underestimates of the burgeoning melanoma epidemic. She is also working on methodologies for cancer surveillance research, an emerging sub discipline of epidemiology concerned with the analysis of cancer registry and other routinely collected health data. An ARRA funded proposal with Dr. Matt Kreuter at Washington University focuses on better means of visually displaying cancer registry data.

Patient-centric epidemiology: Traditional methods for recruitment and data collection as part of population-based research emphasize the preferences and convenience of researchers, when it should be the other way around. With multidisciplinary colleagues in marketing, information technology, communications, and graphic design, we are working on new methodologies for recruitment, data collection, and other aspects of the research "user experience".

Selected Research Projects:


All Research Projects


Selected Research Publications:

Kurian AW, McClure LA, John EM, Horn-Ross PL, Ford JM, Clarke CA. Second primary breast cancer occurrence according to hormone receptor status.  J Natl Cancer Inst. 2009 Aug 5;101(15):1058-65.

Linos E, Swetter SM, Cockburn MG, Colditz GA, Clarke CA. Increasing burden of melanoma in the United States. J Invest Dermatol. 2009 Jul;129(7):1666-74.

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.   

Keegan, THM, Chang ET, John EM, Horn-Ross PL, Wrensch MR, Glaser SL, Clarke CA.  Recent changes in breast cancer incidence and risk factor prevalence in San Francisco Bay Area women: 1988-2004.  Breast Cancer Res. 2007;9(5):R62.

Robbins AS, Clarke CA. Regional Changes in Hormone Therapy Use and Breast Cancer Incidence in California From 2001 to 2004. J Clin Oncol. 2007;25(31):5038-9, author reply 5039-40.

Clarke, CA, Uratsu CS, Selby JV, Kushi LH, Glaser SL, Herrinton LJ. Recent declines in hormone therapy utilization and breast cancer incidence: clinical and population-based evidence (correspondence). J Clin Oncol. 2006;24(33):e49-50.

All Publications (88)


Education:

INSTITUTION AND LOCATION DEGREE YEAR FIELD OF STUDY
Duke University, Durham, North Carolina B.S  1995 Biology
Tulane University, New Orleans, Louisiana M.P.H  1996 Epidemiology
University of California, Berkeley  Ph.D  1999 Epidemiology


Professional Activities and Awards:

1998 John Young Award of Excellence, California Association of Regional Cancer Registries
2002-present Member, Scientific Advisory Panel, Marin County Breast Cancer Research Collaborative
2005-present  Member, Stanford Cancer Center
2005-present  Steering Committee, California Teachers Study
2006-present  Steering Committee, Marin Womens Study


Web site Links:
Stanford website for Dr. Clarke:
http://med.stanford.edu/profiles/cancer/researcher/Christina_Clarke/


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