Lawrence H. Kushi, ScD

People

Kaiser Permanente Division of Research
2000 Broadway
Oakland, CA 94612

(510) 891-3837 (phone)
larry.kushi@kp.org
Kaiser Permanente Researcher Profiles

Lawrence H. Kushi, ScD, is Director of Scientific Policy at the Kaiser Permanente Northern California Division of Research. Prior to joining the Division of Research, Dr. Kushi was at Columbia University, where he held the Ella McCollum Vahlteich Chair in Human Nutrition in the Department of Health and Behavior Studies, Teachers College; and he was a member of the Herbert Irving Comprehensive Cancer Center at Columbia-Presbyterian Medical Center. Dr. Kushi is internationally recognized for his expertise in nutritional epidemiology, and his research interests focus on the role of diet and nutrition in the etiology of coronary artery disease and breast and other cancers. He serves on a grant review committee for the American Cancer Society and has served on various American Cancer Society committees to develop guidelines for the dietary prevention and management of cancer. Dr. Kushi has also served on review committees for the Epidemiology and Disease Control Study Section of the National Institutes of Health, and the Integration Panel of the Breast Cancer Research Program of the US Army Medical Research and Materiel Command. He was formerly the chair of the Food and Nutrition Section of the American Public Health Association; on the executive committee of the American Society of Preventive Oncology; and has worked at the Fred Hutchinson Cancer Research Center and the University of Minnesota School of Public Health. Dr. Kushi graduated from Amherst College and the Harvard School of Public Health.

Current Position(s):

Research Scientist III, Division of Research, Kaiser Permanente Northern California
Director of Scientific Policy, Division of Research, Kaiser Permanente, Northern California
Adjunct Professor of Nutrition, Teachers College, Columbia University, New York, NY

Section Affiliations:

Cancer

Primary Research Interests:

Nutritional epidemiology
Diet and nutrition in the etiology of coronary artery disease
Diet and nutrition in the etiology and prognosis of breast and other cancers

Related Website(s):

Studies

Obesity, Chemotherapy Dosing, and Breast Cancer Outcomes

Body size is associated with survival in women with breast cancer in complicated ways. Chemotherapy to treat breast cancer is typically dosed based on body size, often as a function of body surface area. Previously, there was concern that obese patients may receive doses of chemotherapy that may be too toxic given their higher body surface area, resulting in dose capping. This has resulted in the suggestion that obese women were receiving less-than-optimal doses for cancer treatment. Indeed, in 2012, the American Society of Clinical Oncology recommended that doses of chemotherapy not be capped. This project, enabled by availability of detailed infusion data, examines the impact of body size on chemotherapy dosing and subsequent outcomes. The project builds upon pilot work conducted in the Pathways Study cohort of 4,505 women with breast cancer, expands to other women with electronic data only, and includes over 4,000 women with breast cancer at Kaiser Permanente Washington. This project is led by Dr. Elizabeth Kantor at Memorial Sloan Kettering Cancer Center.
Investigator: Kushi, Lawrence
Funder: National Cancer Institute

End-of-Life Care for Adolescents and Young Adults with Cancer: An Evaluation of Care and Development of Patient-Centered Quality Measures

This project examines aspects of end-of-life care for people diagnosed with adolescent and young adult cancers (ages 15 to 39 years). Current measures of end-of-life care quality were designed for older adults; a coherent set of measures to characterize high-quality end-of-life care for adolescent and young adult cancer patients does not exist. This study seeks to answer the questions: What is the quality of end-of-life care for adolescents and young adults with cancer, and what is a patient-centered definition of high-quality end-of-life care for adolescents and young adults facing terminal illness? The aims of this project are to examine the quality of end-of-life care in adolescent and young adult cancer patients, identify sources of variation in end-of-life care, and develop a set of indicators of end-of-life care quality suitable for adolescent and young adult cancers. Data from about 1,800 patients diagnosed from 2000 to 2015 with adolescent and young adult cancers in Kaiser Permanente Northern California and Kaiser Permanente Southern California will be included in data-only aspects, with in-depth interviews of patients, family members, and providers from these Kaiser Permanente regions and the Dana-Farber Cancer Institute to better identify factors that may improve end-of-life care quality. This project is led by Dr. Jennifer Mack at the Dana Farber Cancer Institute.
Investigator: Kushi, Lawrence
Funder: National Cancer Institute

Clinical Pregnancy Outcomes in Adolescent and Young Adult Female Cancer Survivors

Post-diagnosis fertility is a critical issue for adolescent and young adult cancer survivors (diagnosed at age 15 to 39 years), with little information on the impact of cancer diagnosis and treatment on pregnancy outcomes. This study focuses on five leading cancer types among female adolescent and young adult cancer survivors: breast, melanoma, thyroid, and Hodgkins and non-Hodgkins lymphomas. We will analyze North Carolina state-wide cancer registry data linked to claims and offspring birth records from 2003 to 2012, as well as data from Kaiser Permanente Northern California (KPNC) and Kaiser Permanente Southern California (KPSC) for 2000 to 2016. Study aims include assessment of adverse pregnancy outcome risk among 7,200 female adult and young adult cancer survivors at KPNC and KPSC, with 1,300 births, matched five-to-one to 36,000 women without a prior cancer diagnosis on age and enrollment year. Adverse pregnancy outcome risk will also be assessed among 8,000 female adult and young adult cancer survivors in North Carolina, matched five-to-one on maternal age, state, and delivery year. Additionally, the impact of fertility preservation counseling and use on risk of adverse pregnancy and birth outcomes will be evaluated.
Investigator: Kushi, Lawrence
Funder: National Cancer Institute

Infrastructure for Pathways, a Prospective Study of Breast Cancer Survivorship

This grant provides core infrastructure support for the Pathways Study (Kushi, PI), a prospective cohort study of breast cancer survivorship and prognosis. Since 2006, the study enrolled 4,505 women diagnosed with invasive breast cancer in KPNC. Activities (Ambrosone, Christine, Roswell Park Cancer Institute, Co-PI) include ongoing follow-up of participants, active and passive ascertainment of outcomes, collection of tumor specimens, linkage to KPNC electronic records, enhancement of area-level data from contextual databases through virtual neighborhood audits, provision of genotypic data from genome-wide assays, and establishment of a community and participant advisory board. These activities enhance the Pathways Study to make it an unparalleled, outstanding resource for studies of breast cancer prognosis.
Investigator: Kushi, Lawrence
Funder: National Cancer Institute

Highlighted Publications

American Cancer Society guidelines on nutrition and physical activity for cancer prevention; Reducing the risk of cancer with healthy food choices and physical activity

Author(s): Kushi LH; Doyle C; McCullough M; Rock CL; Demark-Wahnefried W; Bandera EV; Gapstur S; Patel AV; Andrews K; Gansler T; The American Cancer Society 2010 Nutrition and Physical Activity Guidelines Advisory Committee

CA Cancer J Clin. 2012 Jan-Feb;62(1):30-67.

Current Position(s):

Section Affiliations:

Primary Research Interests:

Related Website(s):

Studies

Obesity, Chemotherapy Dosing, and Breast Cancer Outcomes

End-of-Life Care for Adolescents and Young Adults with Cancer: An Evaluation of Care and Development of Patient-Centered Quality Measures

Clinical Pregnancy Outcomes in Adolescent and Young Adult Female Cancer Survivors

Infrastructure for Pathways, a Prospective Study of Breast Cancer Survivorship

Highlighted Publications

American Cancer Society guidelines on nutrition and physical activity for cancer prevention; Reducing the risk of cancer with healthy food choices and physical activity

Lifestyle factors and survival in women with breast cancer

Publications

Conflicts of Interest in Nutrition Research

Comparing Reported Dietary Supplement Intakes between Two 24-Hour Recall Methods: The Automated Self-Administered 24-Hour Dietary Assessment Tool and the Interview-Administered Automated Multiple Pass Method

Personal and clinical social support and adherence to adjuvant endocrine therapy among hormone receptor-positive breast cancer patients in an integrated health care system

Reparameterization of PAM50 expression identifies novel breast tumor dimensions and leads to discovery of a genomewide significant breast cancer locus at 12q15

Understanding racial/ethnic differences in breast cancer-related physical well-being: the role of patient-provider interactions

Associations Between Maternal Obesity and Pregnancy Hyperglycemia and Timing of Pubertal Onset in Adolescent Girls: A Population-Based Study

Development, Validation, and Dissemination of a Breast Cancer Recurrence Detection and Timing Informatics Algorithm

Cardiovascular disease incidence in adolescent and young adult cancer survivors: a retrospective cohort study

Girls' Sleep Trajectories Across the Pubertal Transition: Emerging Racial/Ethnic Differences

Research Strategies for Nutritional and Physical Activity Epidemiology and Cancer Prevention

Changes in bone mineral density in women with breast cancer receiving aromatase inhibitor therapy

Childhood Socioeconomic Position and Pubertal Onset in a Cohort of Multiethnic Girls: Implications for Breast Cancer

Genetic Ancestry Is not Associated with Breast Cancer Recurrence or Survival in U.S. Latina Women Enrolled in the Kaiser Permanente Pathways Study

Monitoring Lung Cancer Screening Utilization and Outcomes in Four Cancer Research Network Sites

Age at Pubertal Onset in Girls and Tobacco Smoke Exposure during Pre- and Post-natal Susceptibility Windows

Primary care visit use after positive fecal immunochemical test for colorectal cancer screening

Vitamin D and Breast Cancer Survival-In Reply

Impact of body mass index on ovarian cancer survival varies by stage

Invited Commentary: The Contribution to the Field of Nutritional Epidemiology of the Landmark 1985 Publication by Willett et al

Phenol concentrations during childhood and subsequent measures of adiposity among young girls

Comparison of recruitment and retention among demographic subgroups in a large diverse population study of diet

Patterns and reasons for switching classes of hormonal therapy among women with early-stage breast cancer

Body mass index, PAM50 subtype, recurrence and survival among patients with nonmetastatic breast cancer

Adiposity, post-diagnosis weight change, and risk of cardiovascular events among early-stage breast cancer survivors

Peripubertal dietary flavonol and lignan intake and age at menarche in a longitudinal cohort of girls

Impact of social and built environment factors on body size among breast cancer survivors; the Pathways Study

BMI, Lifestyle Factors and Taxane-Induced Neuropathy in Breast Cancer Patients; The Pathways Study

Bone remodeling and regulating biomarkers in women at the time of breast cancer diagnosis

Associations of urinary phthalate and phenol biomarkers with menarche in a multiethnic cohort of young girls

Association of Serum Level of Vitamin D at Diagnosis With Breast Cancer Survival; A Case-Cohort Analysis in the Pathways Study

The Cancer Research Network; a platform for epidemiologic and health services research on cancer prevention, care, and outcomes in large, stable populations

Effect of Angiotensin System Inhibitors on Survival in Patients Receiving Chemotherapy for Advanced Non-Small-Cell Lung Cancer

Racial/Ethnic Disparities in Ovarian Cancer Treatment and Survival

Exercise and Prognosis on the Basis of Clinicopathologic and Molecular Features in Early Stage Breast Cancer; The LACE and Pathways Studies

Outpatient Use of Low Molecular Weight Heparin Monotherapy for First-Line Treatment of Venous Thromboembolism in Advanced Cancer

Race/ethnicity, genetic ancestry, and breast cancer-related lymphedema in the Pathways Study

Impact of Chemotherapy Dosing on Ovarian Cancer Survival According to Body Mass Index

Residential proximity to traffic and female pubertal development

Recent Trends in Cardiovascular Mortality in the United States and Public Health Goals

A prospective cohort study of early discontinuation of adjuvant chemotherapy in women with breast cancer; the breast cancer quality of care study (BQUAL)

Associations Between Maternal Pregravid Obesity and Gestational Diabetes and the Timing of Pubarche in Daughters

Exercise and Risk of Cardiovascular Events in Women With Nonmetastatic Breast Cancer

Association Between Complementary and Alternative Medicine Use and Breast Cancer Chemotherapy Initiation; The Breast Cancer Quality of Care (BQUAL) Study

Breast cancer multigene testing trends and impact on chemotherapy use

Neighborhood deprivation, race/ethnicity, and urinary metal concentrations among young girls in California.

Thyroid Hormones and Timing of Pubertal Onset in a Longitudinal Cohort of Females, Northern California, 2006-11

Environmental phenols and pubertal development in girls

Training in the Conduct of Population-Based Multi-Site and Multi-Disciplinary Studies; the Cancer Research Network's Scholars Program

Representativeness of breast cancer cases in an integrated health care delivery system

Genotyping Informatics and Quality Control for 100,000 Subjects in the Genetic Epidemiology Research on Adult Health and Aging (GERA) Cohort

Automated Assay of Telomere Length Measurement and Informatics for 100,000 Subjects in the Genetic Epidemiology Research on Adult Health and Aging (GERA) Cohort

Characterizing Race/Ethnicity and Genetic Ancestry for 100,000 Subjects in the Genetic Epidemiology Research on Adult Health and Aging (GERA) Cohort

Thyroid Antagonists (Perchlorate, Thiocyanate, and Nitrate) and Childhood Growth in a Longitudinal Study of U.S. Girls

Use of Bevacizumab in Community Settings; Toxicity Profile and Risk of Hospitalization in Patients With Advanced Non-Small-Cell Lung Cancer

The Impact of DNA Input Amount and DNA source on the Performance of Whole-Exome Sequencing in Cancer Epidemiology

Brominated Flame Retardants and Other Persistent Organohalogenated Compounds in Relation to Timing of Puberty in a Longitudinal Study of Girls

Association of high obesity with PAM50 breast cancer intrinsic subtypes and gene expression

Leveraging biospecimen resources for discovery or validation of markers for early cancer detection

Reply to E Archer and SN Blair

Imputation of the Rare HOXB13 G84E Mutation and Cancer Risk in a Large Population-Based Cohort

Younger pubertal age is associated with allergy and other atopic conditions in girls

Non-initiation and early discontinuation of adjuvant trastuzumab in women with localized HER2-positive breast cancer

Neighborhood Influences on Girls' Obesity Risk Across the Transition to Adolescence

Bone health history in breast cancer patients on aromatase inhibitors

A multi-level model of postmenopausal breast cancer incidence

Local food environments are associated with girls' energy, sugar-sweetened beverage and snack-food intakes

Preliminary Development and Evaluation of an Algorithm to Identify Breast Cancer Chemotherapy Toxicities Using Electronic Medical Records and Administrative Data