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Northern California Cancer Center

The Northern California Cancer Center (NCCC), located in Fremont, California, is a center for epidemiological research examining the incidence of cancer among general and specific groups of people at the local, statewide, and national level [see cancer research], and for the dissemination of cancer screening information. Epidemiology studies the distribution and causes of disease among defined groups of people. Applied to the study of cancer, it is an important tool in understanding who gets cancer, why they get cancer, and why some populations are more affected by cancer than others. Unlike laboratory cancer research, which looks at cancers at the cellular, molecular or genetic level, or clinical research, which addresses cancer treatments, epidemiological studies, such as those done at NCCC, focus on the patterns of cancer within various communities—that is, a particular set of people within a defined geographic region over a defined time period.

These findings lead to advances concerning the causes of cancers and predictors of survival after cancer among the populations studied. When these factors are better understood, methods of abating cancer, and of helping to reduce mortality after diagnosis, can be identified. Research findings can support public health interventions that lead to early detection of cancers through improved screening guidelines, and to reducing cancer risk through behavior modifications such as changes in diet, exercise, or smoking cessation, the identification of occupational or environmental hazards that can be reduced or eliminated, or such studies may raise awareness about genetic factors that elevate cancer risk among certain groups. NCCC studies help scientists and public health agencies understand when ethnic, racial, or other demographic-based variables result in health disparities wherein one group has a higher incidence of cancer compared to others groups of people. For example, NCCC research has demonstrated the higher incidence of colorectal cancer among certain Asian populations. The organization was also instrumental in identifying and understanding factors leading to the markedly higher incidence of breast cancer among women in Marin County, California.

NCCC Scientists

NCCC typically has between twelve and fifteen doctoral level scientists working under the direction of a Chief Scientific Officer. Most of the organization’s scientists have degrees in epidemiology, demography, biostatistics, or public health. To support their research, they compete individually and collectively for major government awards, and for private sector research awards as these become available. The scientist designated as the study’s principal investigator assembles a team of experts, such as demographers or biostatisticians, who will conduct the investigation and when a grant or contract is awarded based on peer review, other study staff, such as field staff, are hired. When the study is completed, the results are disseminated, primarily by being published in peer-reviewed [see Peer Review] scientific journals, such as The Journal of the American Medical Association. NCCC scientists also hold faculty appointments at Stanford University’s School of Medicine.

Recent NCCC Original Research and NCCC Supported Research:

Cancer (General)
• California Teachers Study: Cohort Study of California Teachers
• Patterns of Care Study
• Characterization of Occupational Information in California Cancer Registry for Mesothelioma Cases
• Accuracy of racial classification of Vietnamese patients in a population-based cancer registry
• Age, period, cohort, and immigration effects on cancer incidence
• Assessing the feasibility of collecting body height, weight and obesity in a cancer registry
• Association of social and built environment with cancer outcomes
• Cancer incidence trends in Asian subgroups
• Enhancing Cancer Information Service for Latino Cancer Patients
• Evaluating comorbidity data sources for cancer surveillance
• Improving air pollution exposure estimates in the analysis of mortality in the California Teachers Study cohort
• Improving functional status and quality of life of cancer survivors through regular physical activity
• Increasing diversity in cancer control research
• Increasing fruit and vegetable consumption among callers to the CIS
• Latino cancer patient focus groups
• Pilot survey of cancer patients and survivors
• Quality and utility of cancer registry data on race, ethnicity, birthplace, and language
• Social and Built Environment and Race/Ethnic Variations in Cancer Outcomes
• Trends of Cancer Incidence Among Asian and Hispanic Sub-Populations by Age, Period, and Immigration Cohort
• Tailored communications to increase fruit and vegetable consumption

Breast Cancer
• The Hygiene Hypothesis and Breast cancer Risk
• Culture and Ethnic Variations in Breast Cancer Treatment
• Center for Nutrient Gene Interaction and Cancer Prevention
• The Impact of the Built Environment on the Risk of Breast Cancer
• The IGF (Insulin-like Growth Factor) Pathway and Breast Cancer Risk in African Americans
• Genetics of Breast Cancer in Blacks
• Admixture and Breast Cancer Risk Among Latinas
• The Role of the ATM Gene in Familial Breast Cancer
• Genetic Studies of Mammographic Density
• Epstein-Barr virus and breast cancer
• Body Size and breast Cancer Risk in a Multiethnic Population
• Young Breast cancer Survivors: Ten Years Later
• Exercise for Bone Health: Young Breast cancer Survivors
• Birth Characteristics and Breast Cancer in Young Women
• Breast cancer Risk Profile of Vietnamese Nail Salon Workers
• Prognosis in BRCA1 Associated Breast Cancer

Colorectal Cancer
• Colorectal Screening in Vietnamese: A Controlled Trial
• Ethnic/Racial Minorities in the Colon CFR (Cooperative Family Registry)

Hodgkin Lymphoma
• Age and Hodgkin lymphoma survival
• Aspirin use, genetic variation in aspirin-related genes and Hodgkin lymphoma risk
• Body size, physical activity and Hodgkin lymphoma
• Changing epidemiology of HIV lymphomas
• Epidemiology of EBV-defined Hodgkin lymphoma
• Epstein-Barr virus in Hodgkin lymphoma in women
• Epstein-Barr virus-associated Hodgkin lymphoma: Epidemiologic characteristics in international data
• Preparing the Stanford Hodgkin lymphoma patient cohort for novel epidemiologic and clinical studies
• Reliability of EBV detection in Hodgkin lymphoma
• Reproductive factors in Hodgkin lymphoma in women
• Socioeconomic disparities in survival after Hodgkin lymphoma
• Survival with Hodgkin lymphoma in a multiethnic population: The prognostic value of Epstein-Barr Virus
• Utility of SEER data in the descriptive epidemiology of HIV-associated cancers
• Validity of self-reported family history of lymphomas

Leukemia
• Acute myeloid leukemia
• Assessment of patients’ experience of cancer care (APECC)
• Exposure Insights Using GIS in a Case-Control Study
• Childhood Leukemia and Environmental Exposures

Melanoma
• Association of Medicaid status with late-stage cancer and validation of Medicaid status from the medical record
• Defining Populations At Risk of Melanoma in California – Influence of Race, Socioeconomic Status, and Ultraviolet Light Exposure
• Replication of results regarding completeness of melanoma surveillance

Thyroid
• The Bay Area Thyroid Cancer Study
• Nutrition and Thyroid Cancer Risk in the California Teachers Study Cohort

History

The organization was founded in response to President Richard M. Nixon’s avowed “war on cancer.” By signing The National Cancer Act of 1971, Nixon strengthened the National Cancer Institute, marshalling resources to “plan and develop an expanded, intensified, and coordinated cancer research program encompassing the programs of the National Cancer Institute, related programs of the other research institutes, and other Federal and non-Federal programs.”

In 1974, the deans of the schools of medicine at Stanford University and the University of California, San Francisco joined with the California Division of the American Cancer Society to form the Northern California Cancer Program to support regional clinical trials. The organization identifies its founders as: Clayton Rich, M.D., Stanford University; Julius Krevans, M.D., the University of California, San Francisco; Robert Murphy, American Cancer Society; B. J. Feigenbaum, Esq., Steinhart & Falconer; and Saul Rosenberg, M.D., Stanford University. Dr. Saul Rosenberg, a Stanford oncologist, was the NCCC’s first Director, serving from 1974 to 1976 and again from 1983 to 1985. In 1983, NCCC took over the Surveillance Epidemiology and End Results (SEER) cancer registry activities in northern California. To reflect its new orientation to population science, the organization changed its name to the Northern California Cancer Center in 1986 and began its work in cancer epidemiology and prevention. Today, the NCCC partners with independent scientists, academic institutions, and health organizations in the U.S. and around the world to examine the path of cancer through distinct populations.

Current Activities
Most of the organization’s research activities derive from federal government grants and contracts to study some aspect of cancer, either site specific cancers (such as breast cancer or prostate cancer) or cancers in specific populations (low-income women of color, Vietnamese people, or nail salon workers, for example). The NCCC also operates the Greater Bay Area Cancer Registry, which follows a state mandate to compile statistical information on the occurrence of all new cancers in nine California counties: Monterey, San Benito, Santa Clara, Santa Cruz, Alameda, Contra Costa, Marin, San Francisco, and San Mateo. This registry is part of the California Cancer Registry, which is operated through regional registries. The combined data from the registries is used to monitor cancer in California and is summarized in the Annual Cancer Incidence and Mortality Report. The NCCC was instrumental in the creation of the Family Registry for Breast Cancer for which over 900 minority families have supplied demographic data. NCCC also houses the statewide Cancer Detection Program call center, Every Woman Counts, and the National Cancer Institute’s Cancer Information Service for California.

NCCC Community Education and Outreach regularly present current awareness and survival information in various public forums throughout California. The Every Woman Counts Program directs low-income women to free or low-cost cancer screening in their area.

In 2007, the NCCC formally entered into an agreement with Stanford University to supply epidemiological research and community outreach to the Stanford Cancer Center.

Major Collaborations

Stanford Cancer Center
The NCCC recently formed a partnership with the Stanford Cancer Center at Stanford University Medical Center that played a role in the center’s recent designation as a NCI Cancer Center [see NCI-designated Cancer Center]. The NCCC contributes epidemiology, prevention and outreach programs to the partnership.

California Teachers Study
In conducting the California Teachers Study, the NCCC collaborates with the University of Southern California, the University of California at Irvine and the California Cancer Registry. NCCC scientists are investigating the influence of obesity, diet, alcohol, and other environmental exposures such as tobacco smoke, pesticides, and air pollution on cancer risk among California teachers and school administrators. The scientists at other institutions are looking at factors such as physical activity, hormone replacement therapy, and heredity.

Breast Cancer Family Registry
The NCCC also collaborates in the Breast Cancer Family Registry, an international consortium established in 1995 by the National Cancer Institute. To date, over 15,000 breast cancer families from the US, Canada and Australia have been enrolled, including over 3,000 from the San Francisco Bay Area, most of who are from racial/ethnic minority populations.

Cancer Care Outcomes Research Surveillance Consortium
Through its collaboration in the Cancer Care Outcomes Research and Surveillance Consortium (CanCORS), the NCCC works with Harvard Medical School, the California Cancer Registry, the Cancer Surveillance Program of Sacramento, and the Northern California Kaiser Permanente Division of Research to identify patterns of cancer care and survival for patients with colorectal and lung cancer. Other institutions involved in this project include: VA Hospitals, the University of Alabama at Birmingham, the University of California at Los Angeles, the Dana-Farber Cancer Institute, the University of Iowa, the University of North Carolina, and a network of HMOs. CanCORS is primarily focused on disparities in cancer care in different US populations and is funded by the National Cancer Institute. This collaboration has collected information for over 20% of the consortium’s patients - over 1,000 patients with colorectal cancer and 1,000 patients with lung cancer.

See also

Northern California Cancer Center Official Website

Annual Cancer Incidence and Mortality in the Greater Bay Area report (1988-2005)

Marin County Breast Cancer Incidence Patterns

California Teachers Study

Ductal Carcinoma Website

Bay Area Breast Cancer Resource Guide Cancer Calendar Website

External links

Surveillance, Epidemiology and End Results (SEER)

California Cancer Registry (CCR)

Stanford Cancer Center

NCI CanCORS page

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