Marilyn L. Kwan, PhD

People

Kaiser Permanente Division of Research
2000 Broadway
Oakland, CA 94612

(510) 891-3521 (phone)
marilyn.l.kwan@kp.org
Kaiser Permanente Researcher Profiles

Marilyn L. Kwan, PhD, is a Research Scientist III (equivalent to Professor academic rank) at the Division of Research, Kaiser Permanente Northern California. She graduated from University of California, Berkeley, with her PhD in Epidemiology in May 2004 and completed a one-year postdoctoral fellowship in September 2005, also at UC Berkeley. Dr. Kwan joined the Division of Research in July 2005, where her current research focus is breast and bladder cancer prognosis and survival. Specifically, her interests include lifestyle and molecular factors and their associations with cancer recurrence, survival, and quality of life. She also studies the long-term health effects of cancer treatment specifically lymphedema, fractures, and cardiovascular disease, in breast cancer survivors. Dr. Kwan’s research has been funded by the National Cancer Institute, American Cancer Society, and California Breast Cancer Research Program.

Current Position(s):

Research Scientist III, Division of Research, Kaiser Permanente Northern California

Section Affiliations:

Cancer

Primary Research Interests:

Cancer Epidemiology
Secondary Lymphedema After Breast Cancer
Quality of Cancer Care
Childhood Leukemia
Nutrition
Obesity

Related Website(s):

Studies

Predictors of CVD among Breast Cancer Survivors in an Integrated Health System

This study will comprehensively examine clinical and behavioral predictors of cardiovascular disease (CVD) outcomes among breast cancer survivors, and will maximize unique patient and data resources available at Kaiser Permanente Northern California (KPNC). We will compare CVD events in the Pathways Study, a cohort of female KPNC members age ≥21 years diagnosed with invasive breast cancer (n=4,453, R01CA105274) with CVD events in a new age, race/ethnicity, history of comorbidity, and length of KPNC membership matched cohort of healthy KPNC female members (n=22,265). Results from this study will have important implications for identifying breast cancer subgroups at high risk of CVD and identifying potential targets for intervention, such as medication adherence and control of CVD risk factors.
Investigator: Kwan, Marilyn
Funder: National Cancer Institute

Impact of Low IL-10 Levels at Birth and Leukemia Risk

The objectives of this retrospective cohort study of an established case-control study of childhood leukemia are to understand the relationships among immune status at birth, infectious exposures during childhood, and leukemogenesis, and to use this understanding to decrease the incidence of childhood acute lymphoblastic leukemia (ALL). The aims are to: 1) Assess whether a low interleukin-10 level at birth is associated with an increased incidence of early infections characterized by severe clinical symptoms from medical records and self-report; and 2) Determine whether decreased interleukin-10 can contribute to increased ALL in the setting of immune system activation.
Investigator: Kwan, Marilyn
Funder: National Cancer Institute

Risk of Pediatric and Adolescent Cancer Associated with Medical Imaging

The aims of this multiple PI grant are to: 1) Evaluate patterns of medical imaging (utilization and radiation dose) and estimate cumulative exposure to ionizing radiation from medical imaging in a) children (0-18 years old) and b) pregnant women, from 1996-2016; 2) Determine the risk of childhood leukemia among children and adolescents following exposure to all medical imaging examinations that deliver ionizing radiation from 1996-2016 and followed through 2017. We will also examine effects due to exposure from CT exams alone; 3) Determine the risk of childhood cancers among children and adolescents following fetal, in utero (maternal pregnancy) exposure to medical imaging from 1996-2016 followed through 2017; 4) In the subset of the population with complete information during in utero and child or adolescent exposure to medical imaging, assess the cumulative impact of these exposures on childhood cancers.
Investigator: Kwan, Marilyn
Funder: National Cancer Institute

Diet and Lifestyle in a Prospective Study of Bladder Cancer Survivors

This study involves a new prospective cohort of more than 1,800 non-muscle invasive bladder cancer cases to investigate the role of cruciferous vegetable intake, along with associated individual genetic profiles, on reducing recurrence and progression of disease and improving the efficacy of current treatment modalities.
Investigator: Kwan, Marilyn
Funder: National Cancer Institute

Lifestyle and Molecular Factors of Bone Health in Breast Cancer Survivors

This project will investigate the impact of modifiable lifestyle factors, germline genetic variations, and serum biomarkers, on adverse skeletal outcomes among aromatase inhibitor users, as well as develop a prediction model for risk of fractures for postmenopausal breast cancer patients taking aromatase inhibitors.
Investigator: Kwan, Marilyn
Funder: National Cancer Institute

Urinary Diversion Among Bladder Cancer Survivors: Cost, Complications and QOL

This mixed-method, comparative effectiveness study will compare costs, complications, patient- and family-centered outcomes related to urinary diversion. Study participants will include bladder cancer patients undergoing cystectomy and their family caregivers within three Kaiser Permanente regions with a membership base of over six million enrollees.
Investigator: Kwan, Marilyn
Funder: National Cancer Institute

Highlighted Publications

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

Author(s): Kwan ML; Yao S; Lee VS; Roh JM; Zhu Q; Ergas IJ; Liu Q; Zhang Y; Kutner SE; Quesenberry CP; Ambrosone CB; Kushi LH

Breast Cancer Res Treat. 2016 Jul 22.

Current Position(s):

Section Affiliations:

Primary Research Interests:

Related Website(s):

Studies

Predictors of CVD among Breast Cancer Survivors in an Integrated Health System

Impact of Low IL-10 Levels at Birth and Leukemia Risk

Risk of Pediatric and Adolescent Cancer Associated with Medical Imaging

Diet and Lifestyle in a Prospective Study of Bladder Cancer Survivors

Lifestyle and Molecular Factors of Bone Health in Breast Cancer Survivors

Urinary Diversion Among Bladder Cancer Survivors: Cost, Complications and QOL

Highlighted Publications

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

Breastfeeding, PAM50 Tumor Subtype, and Breast Cancer Prognosis and Survival

Bone health history in breast cancer patients on aromatase inhibitors

Obesity and Mortality After Breast Cancer by Race/Ethnicity; The California Breast Cancer Survivorship Consortium

Publications

Perioperative Intravesical Chemotherapy for Patients with Non-Muscle Invasive Bladder Cancer: Understanding the Extent of and Sources of Variation in Guideline-Recommended Use

The deterioration of muscle mass and radiodensity is prognostic of poor survival in stage I-III colorectal cancer: a population-based cohort study (C-SCANS)

Lifestyle and nutritional modifiable factors in the prevention and treatment of bladder cancer

Associations of pre-existing co-morbidities with skeletal muscle mass and radiodensity in patients with non-metastatic colorectal cancer

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

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

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

Use of iDXA spine scans to evaluate total and visceral abdominal fat

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

Association of Systemic Inflammation and Sarcopenia With Survival in Nonmetastatic Colorectal Cancer: Results From the C SCANS Study

Explaining the Obesity Paradox: The Association between Body Composition and Colorectal Cancer Survival (C-SCANS Study)

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

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

Association of Weight Change after Colorectal Cancer Diagnosis and Outcomes in the Kaiser Permanente Northern California Population

Post-diagnosis social networks and breast cancer mortality in the After Breast Cancer Pooling Project

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

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

Metabolic Dysfunction, Obesity, and Survival Among Patients With Early-Stage Colorectal Cancer

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

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

Dual energy X-ray absorptiometry spine scans to determine abdominal fat in postmenopausal women

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

Analysis of Body Mass Index and Mortality in Patients With Colorectal Cancer Using Causal Diagrams

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

The effect of patient and contextual characteristics on racial/ethnic disparity in breast cancer mortality

Tamoxifen and Antidepressant Drug Interaction in a Cohort of 16 887 Breast Cancer Survivors

Who Gets to Decide?

Impact of very low physical activity, BMI, and comorbidities on mortality among breast cancer survivors

Validation of self-reported comorbidity status of breast cancer patients with medical records; the California Breast Cancer Survivorship Consortium (CBCSC)

RE; Body Mass Index, PAM50 Subtype, and Outcomes in Node-Positive Breast Cancer; CALGB 9741

A pooled analysis of post-diagnosis lifestyle factors in association with late estrogen-receptor positive breast cancer prognosis

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

Breastfeeding, PAM50 Tumor Subtype, and Breast Cancer Prognosis and Survival

Intersection of Race/Ethnicity and Socioeconomic Status in Mortality After Breast Cancer

Contribution of the Neighborhood Environment and Obesity to Breast Cancer Survival; The California Breast Cancer Survivorship Consortium

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

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

A hybrid approach to identify subsequent breast cancer using pathology and automated health information data

Statins and breast cancer stage and mortality in the Women's Health Initiative

Diabetes and other comorbidities in breast cancer survival by race/ethnicity; The California Breast Cancer Survivorship Consortium (CBCSC)

Body Mass Index, PAM50 Subtype, and Outcomes in Node-Positive Breast Cancer

Pre- to post-diagnosis weight change and associations with physical functional limitations in breast cancer survivors

Bone health history in breast cancer patients on aromatase inhibitors

Changes in vitamin and mineral supplement use after breast cancer diagnosis in the Pathways Study; a prospective cohort study

Intrinsic subtypes from the PAM50 gene expression assay in a population-based breast cancer survivor cohort; Prognostication of short and long term outcomes

Intrinsic subtypes from PAM50 gene expression assay in a population-based breast cancer cohort; Differences by age, race, and tumor characteristics

Race and breast cancer survival by intrinsic subtype based on PAM50 gene expression

Obesity and Mortality After Breast Cancer by Race/Ethnicity; The California Breast Cancer Survivorship Consortium

The California Breast Cancer Survivorship Consortium (CBCSC); prognostic factors associated with racial/ethnic differences in breast cancer survival

Post-diagnosis Cruciferous Vegetable Consumption and Breast Cancer Outcomes; a Report from the After Breast Cancer Pooling Project

Postdiagnosis supplement use and breast cancer prognosis in the After Breast Cancer Pooling Project

Patient-physician interaction and quality of life in recently diagnosed breast cancer patients

Employment status and quality of life in recently diagnosed breast cancer survivors

High- and Low-Fat Dairy Intake, Recurrence, and Mortality After Breast Cancer Diagnosis

Identifying primary and recurrent cancers using a SAS-based natural language processing algorithm

Post-diagnosis Alcohol Consumption and Breast Cancer Prognosis in the After Breast Cancer Pooling Project

Smoking and survival after breast cancer diagnosis; a prospective observational study and systematic review

Validation of AJCC TNM staging for breast tumors diagnosed before 2004 in cancer registries

Patient awareness and knowledge of breast cancer-related lymphedema in a large, integrated health care delivery system

Weight Change and Survival after Breast Cancer in the After Breast Cancer Pooling Project