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Dr. John's research focus has been on the epidemiology of breast, prostate, and ovarian cancer, particularly in Hispanic and African-American populations. Since joining NCCC, Dr. John has established several large population-based resources to study the etiology, as well as outcomes, of these cancers, with emphasis on the role of lifestyle factors that are potentially modifiable, genetic susceptibility, the combined effects of environmental and genetic factors, and racial/ethnic differences in risk factors that contribute to racial/ethnic disparities in these cancers. Breast Cancer: Dr. John has conducted a series of population-based case-control studies of breast cancer, the San Francisco Bay Area Breast Cancer Study, in nearly 5,000 Hispanic, African-American and non-Hispanic white women. Extensive interview data were collected on a wide range of hormonal and lifestyle factors, as well as blood samples for studies of genetic susceptibility factors and gene-environment interactions. Major areas of interest concern the role of physical activity, body size and weight gain; heterocyclic amines associated with cooking methods; vitamin D from sun exposure, diet and supplements, a topic that has gained major prominence in recent years; and early-life exposures. Collaborative molecular studies have focused on the role of genetic admixture, polymorphisms in the vitamin D receptor (VDR) gene, obesity-related and fat-metabolizing genes, and gene-environment interactions. The Hispanic component of this resource is one of the largest case-control studies of breast cancer conducted in Hispanic women living in the U.S. Dr. John is interested in gaining a better understanding of changes in lifestyle factors that follow migration to the U.S. and subsequent acculturation and their impact on the occurrence of breast cancer in subsequent generations. Efforts are underway to study survival in relation to lifestyle and other factors among the over 2,200 breast cancer cases included in this study. Prostate Cancer: A second major focus of Dr. John's work has been the etiology of prostate cancer which remains largely unknown. Most recently, she has conducted a population-based case-control study of advanced prostate cancer in conjunction with a similar study conducted in Southern California by Dr. Sue Ingles at the University of Southern California. This two-center study, the California Collaborative Study of Advanced Prostate Cancer, serves as a rich resource to elucidate the etiology of advanced prostate cancer in African-American, Hispanic and non-Hispanic white men. Current investigations focus on the role of vitamin D, physical activity, body size, diet, heterocyclic amines and genetic susceptibility factors. Dr. John is also participating in several multi-center collaborations to identify new genes related to prostate cancer. Cancer Family Registries: In collaboration with researchers at Stanford University, Dr. John has been involved in the establishment of two family registries to study the genetic epidemiology of breast and ovarian cancer. She is Principal Investigator of the Northern California site of the Breast Cancer Family Registry, an international consortium established by the National Cancer Institute in 1995 for interdisciplinary and translational studies of the genetic epidemiology of breast cancer. The six collaborating family registries in the U.S., Canada and Australia have enrolled over 13,000 breast cancer families, with over 3,000 families from the San Francisco Bay area. Dr. John is involved in numerous international collaborations that use these resources, including studies of BRCA1 and BRCA2 mutations in minority populations, modifying effects of lifestyle factors in BRCA1 and BRCA2 mutation carriers, other susceptibility genes such as ATM, CHK2 and IGF, and the genetics of mammographic density, a major risk factor for breast cancer. Selected Research Projects: Selected Research Publications: John EM, Koo J, Schwartz GG. Sun exposure and prostate cancer risk: Evidence for a protective effect of early life exposure. Cancer Epidemiol Biomarkers Prev 2007;16:1283-1286. John EM, Schwartz GG, Koo J, Wang W, Ingles SA. Sun exposure, polymorphisms in the vitamin D receptor gene and breast cancer risk. Am J Epidemiol 2007;166(12):1409-19. Epub 2007 Oct 12. John EM, Miron A, Gong G, Phipps AI, Felberg I, Li FP, West DW, Whittemore AS. Prevalence of pathogenic BRCA1 mutation carriers in five US racial/ethnic groups. JAMA 2007;298(24):2869-76. Fejerman L, John EM, Huntsman S, Beckman K, Choudhry S, Perez-Stable E, González Burchard E, Ziv E. Genetic ancestry and risk of breast cancer among US Latinas. Cancer Res 2008;68(23)9723-8. Kurian AW, Gong GD, John EM, Miron A, Felberg A, Phipps AI, West DW, Whittemore AS. Performance of prediction models for BRCA mutation carriage in three racial/ethnic groups: Findings from the Northern California Breast Cancer Family Registry. Cancer Epidemiol Biomarkers Prev 2009;18(4):1084-91.
Professional Memberships, Professional Activities, and Awards: 1988 - present Member, Society for Epidemiologic Research (SER) Web site Links:
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