Usha Menon

University College London, Londinium, England, United Kingdom

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Publications (223)1237.09 Total impact

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    ABSTRACT: We reevaluated previously reported associations between variants in pathways of one-carbon (1-C) (folate) transfer genes and ovarian carcinoma (OC) risk, and in related pathways of purine and pyrimidine metabolism, and assessed interactions with folate intake.
    Molecular Nutrition & Food Research 07/2014; · 4.31 Impact Factor
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    ABSTRACT: Purpose: Biomarkers for the early detection of pancreatic cancer are urgently needed. The primary objective of this study was to evaluate whether increased levels of serum CA19-9, CA125, CEACAM1 and REG3A are present prior to clinical presentation of pancreatic cancer and to assess the performance of combined markers for early detection and prognosis. Experimental Design: This nested case control study within UKCTOCS included 118 single- and 143 serial-serum samples from 154 post-menopausal women who were subsequently diagnosed with pancreatic cancer and 304 matched non-cancer controls. Samples were split randomly into independent training and test sets. CA19-9, CA125, CEACAM1 and REG3A were measured using ELISA and/or CLIA. Performance of markers to detect cancers at different times prior to diagnosis and for prognosis was evaluated. Results: At 95% specificity, CA19-9 (>37 U/mL) had a sensitivity of 68% up to 1 year, and 53% up to 2 yrs before diagnosis. Combining CA19-9 and CA125 improved sensitivity as CA125 was elevated (>30 U/mL) in ~20% of CA19-9-negative cases. CEACAM1 and REG3A were late markers adding little in combined models. Average lead times of 20-23 months were estimated for test-positive cases. Pre-diagnostic levels of CA19-9 and CA125 were associated with poor overall survival (HR 2.69 and 3.15, respectively). Conclusions: CA19-9 and CA125 have encouraging sensitivity for detecting pre-clinical pancreatic cancer and both markers can be used as prognostic tools. This work challenges the prevailing view that CA19-9 is up-regulated late in the course of pancreatic cancer development.
    Clinical cancer research : an official journal of the American Association for Cancer Research. 06/2014;
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    ABSTRACT: Abstract Background: The purpose of this study was to identify beliefs about breast cancer, screening practices, and factors associated with mammography use among first-generation immigrant Muslim women in Chicago, IL. Methods: A convenience sample of 207 first-generation immigrant Muslim women (Middle Eastern 51%; South Asian 49%) completed a culturally adapted questionnaire developed from established instruments. The questionnaire was administered in Urdu, Hindi, Arabic, or English, based on participant preference. Internal-consistency reliability was demonstrated for all scales (alpha coefficients ranged from 0.64 to 0.91). Associations between enabling, predisposing, and need variables and the primary outcome of mammography use were explored by fitting logistic regression models. Results: Although 70% of the women reported having had a mammogram at least once, only 52% had had one within the past 2 years. Four factors were significant predictors of ever having had a mammogram: years in the United States, self-efficacy, perceived importance of mammography, and intent to be screened. Five factors were significant predictors of adherence (having had a mammogram in the past 2 years): years in the United States, having a primary care provider, perceived importance of mammography, barriers, and intent to be screened. Conclusions: This article sheds light on current screening practices and identifies theory-based constructs that facilitate and hinder Muslim women's participation in mammography screening. Our findings provide insights for reaching out particularly to new immigrants, developing patient education programs grounded in culturally appropriate approaches to address perceived barriers and building women's self-efficacy, as well as systems-level considerations for ensuring access to primary care providers.
    Journal of women's health (2002). 05/2014;
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    ABSTRACT: Objective To examine the psychological sequelae associated with abnormal screening in the United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS).DesignProspective, longitudinal randomised control trial.SettingSixteen UKCTOCS centres.SampleWomen aged 50–70 years randomised to annual multimodal screening, ultrasound screening or control groups.Methods Two groups were followed for 7 years: (1) a random sample (n = 1339), taken from all three study groups; and (2) an events sample (n = 22 035) of women with abnormal screens resulting in the need for repeat testing of either low or higher level intensity.Main outcome measuresPatient-reported measures of anxiety (scores ranging from 20 to 80) and psychological morbidity.ResultsIn the random sample the mean difference between anxiety scores after a repeat screening and those following an annual screening was 0.4 (95% CI −0.46, 1.27), and in the events sample it was 0.37 (95% CI 0.23, 0.51). The risk of psychological morbidity was only increased in the event sample for women requiring higher level repeat screening (OR 1.28; 95% CI 1.18, 1.39). The risk of psychological morbidity in women with ovarian cancer was higher at both 6 weeks (OR 16.2; 95% CI 9.19, 28.54) and 6 months (OR 3.32; 95% CI 1.91, 5.77) following surgery.Conclusions Screening does not appear to raise anxiety but psychological morbidity is elevated by more intense repeat testing following abnormal annual screens, and in women after surgical treatment for ovarian cancer.
    BJOG An International Journal of Obstetrics & Gynaecology 05/2014; · 3.76 Impact Factor
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    Ultrasound in Obstetrics and Gynecology 05/2014; 43(5):600-601. · 3.56 Impact Factor
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    ABSTRACT: Purpose/Objectives: To assess the efficacy of Korean Immigrants and Mammography-Culture-Specific Health Intervention (KIM-CHI), an educational program for Korean American (KA) couples designed to improve mammography uptake among KA women.Design: A two-group cluster randomized, longitudinal, controlled design.Setting: 50 KA religious organizations in the Chicago area.Sample: 428 married KA women 40 years of age or older who had not had a mammogram in the past year. The women and their husbands were recruited from 50 KA religious organizations.Methods: Couples were randomly assigned to intervention or attention control groups. Those in the KIM-CHI program (n = 211 couples) were compared to an attention control group (n = 217 couples) at baseline, as well as at 6 and 15 months postintervention on mammogram uptake.Main Research Variables: Sociodemographic variables and mammography uptake were measured. Level of acculturation was measured using the Suinn-Lew Asian Self-Identity Acculturation Scale. Researchers asked questions about healthcare resources and use, health insurance status, usual source of care, physical examinations in the past two years, family history of breast cancer, and history of mammography.Findings: The KIM-CHI group showed statistically significant increases in mammography uptake compared to the attention control group at 6 months and 15 months postintervention.Conclusions: The culturally targeted KIM-CHI program was effective in increasing mammogram uptake among nonadherent KA women.Implications for Nursing: Nurses and healthcare providers should consider specific health beliefs as well as inclusion of husbands or significant others. They also should target education to be culturally relevant for KA women to effectively improve frequency of breast cancer screening.
    Oncology Nursing Forum 05/2014; 41(3):E185-93. · 1.91 Impact Factor
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    ABSTRACT: Abstract Objectives: Racial discrimination experiences can negatively affect health. This study examined perceived discrimination and its relationship with mental health and substance use among Asian American and Pacific Islander (API) undergraduate and graduate students. Participants: A total of 113 API students aged 18-35 completed the study during February-June, 2011. Methods: We conducted a cross-sectional, anonymous survey online. Dependent variables included mental health (depressive, anxiety, and somatic symptoms) and substance use (alcohol problems, use of tobacco, marijuana or hashish, and other illegal drugs). Results: Students' perceived discrimination were significantly, positively associated with depressive, anxiety and somatic symptoms, but not with substance use. Ethnic identity moderated the relationship between perceived discrimination and somatic symptoms, but not depressive or anxiety symptoms. Conclusions: Our findings suggested the negative effect of racial discrimination on API students' mental health. The buffering effect of ethnic identity may increase resilience in these students when they face racial discrimination.
    Journal of American College Health 04/2014; · 1.45 Impact Factor
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    ABSTRACT: Survival in epithelial ovarian cancer (EOC) is influenced by the host immune response, yet the key genetic determinants of inflammation and immunity that impact prognosis are not known. The nuclear factor-kappa B (NF-κB) transcription factor family plays an important role in many immune and inflammatory responses, including the response to cancer. We studied common inherited variation in 210 genes in the NF-κB family in 10,084 patients with invasive EOC (5,248 high grade serous, 1,452 endometrioid, 795 clear cell, and 661 mucinous) from the Ovarian Cancer Association Consortium. Associations between genotype and overall survival were assessed using Cox regression for all patients and by major histology, adjusting for known prognostic factors and correcting for multiple testing (threshold for statistical significance-p < 2.5x10-5). Results were statistically significant when assessed for patients of a single histology. Key associations were with CARD11 (caspase recruitment domain family, member 11) rs41324349 in patients with mucinous EOC (HR 1.82, 95% CI 1.41-2.35, p=4.13x10-6) and TNFRSF13B (tumor necrosis factor receptor superfamily, member 13B) rs7501462 in patients with endometrioid EOC (HR 0.68, 95% CI 0.56-0.82, p=2.33x10-5). Other associations of note included TRAF2 (TNF receptor-associated factor 2) rs17250239 in patients with high-grade serous EOC (HR 0.84, 95% CI 0.77-0.92, p=6.49x10-5) and PLCG1 (phospholipase C, gamma 1) rs11696662 in patients with clear cell EOC (HR 0.43, 95% CI 0.26-0.73, p=4.56x10-4). These associations highlight the potential importance of genes associated with host inflammation and immunity in modulating clinical outcomes in distinct EOC histologies.
    Cancer Epidemiology Biomarkers &amp Prevention 04/2014; · 4.56 Impact Factor
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    ABSTRACT: The presence of regulatory T cells (Treg) in solid tumors is known to play a role in patient survival in ovarian cancer and other malignancies. We assessed inherited genetic variations via 749 tag single-nucleotide polymorphisms (SNP) in 25 Treg-associated genes (CD28, CTLA4, FOXP3, IDO1, IL10, IL10RA, IL15, 1L17RA, IL23A, IL23R, IL2RA, IL6, IL6R, IL8, LGALS1, LGALS9, MAP3K8, STAT5A, STAT5B, TGFB1, TGFB2, TGFB3, TGFBR1, TGRBR2, and TGFBR3) in relation to ovarian cancer survival. We analyzed genotype and overall survival in 10,084 women with invasive epithelial ovarian cancer, including 5,248 high-grade serous, 1,452 endometrioid, 795 clear cell, and 661 mucinous carcinoma cases of European descent across 28 studies from the Ovarian Cancer Association Consortium (OCAC). The strongest associations were found for endometrioid carcinoma and IL2RA SNPs rs11256497 [HR, 1.42; 95% confidence interval (CI), 1.22-1.64; P = 5.7 × 10(-6)], rs791587 (HR, 1.36; 95% CI, 1.17-1.57; P = 6.2 × 10(-5)), rs2476491 (HR, = 1.40; 95% CI, 1.19-1.64; P = 5.6 × 10(-5)), and rs10795763 (HR, 1.35; 95% CI, 1.17-1.57; P = 7.9 × 10(-5)), and for clear cell carcinoma and CTLA4 SNP rs231775 (HR, 0.67; 95% CI, 0.54-0.82; P = 9.3 × 10(-5)) after adjustment for age, study site, population stratification, stage, grade, and oral contraceptive use. The rs231775 allele associated with improved survival in our study also results in an amino acid change in CTLA4 and previously has been reported to be associated with autoimmune conditions. Thus, we found evidence that SNPs in genes related to Tregs seem to play a role in ovarian cancer survival, particularly in patients with clear cell and endometrioid epithelial ovarian cancer. Cancer Immunol Res; 2(4); 332-40. ©2014 AACR.
    Cancer immunology research. 04/2014; 2(4):332-40.
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    ABSTRACT: BACKGROUND:Regular aspirin use is associated with reduced risk of several malignancies. Epidemiologic studies analyzing aspirin, nonaspirin nonsteroidal anti-inflammatory drug (NSAID), and acetaminophen use and ovarian cancer risk have been inconclusive. METHODS: We analyzed pooled data from 12 population-based case-control studies of ovarian cancer, including 7776 case patients and 11843 control subjects accrued between 1992 and 2007. Odds ratios (ORs) for associations of medication use with invasive epithelial ovarian cancer were estimated in individual studies using logistic regression and combined using random effects meta-analysis. Associations between frequency, dose, and duration of analgesic use and risk of ovarian cancer were also assessed. All statistical tests were two-sided. RESULTS: Aspirin use was associated with a reduced risk of ovarian cancer (OR = 0.91; 95% confidence interval [CI] = 0.84 to 0.99). Results were similar but not statistically significant for nonaspirin NSAIDs, and there was no association with acetaminophen. In seven studies with frequency data, the reduced risk was strongest among daily aspirin users (OR = 0.80; 95% CI = 0.67 to 0.96). In three studies with dose information, the reduced risk was strongest among users of low dose (<100 mg) aspirin (OR = 0.66; 95% CI = 0.53 to 0.83), whereas for nonaspirin NSAIDs, the reduced risk was strongest for high dose (≥500 mg) usage (OR = 0.76; 95% CI = 0.64 to 0.91). CONCLUSIONS: Aspirin use was associated with a reduced risk of ovarian cancer, especially among daily users of low-dose aspirin. These findings suggest that the same aspirin regimen proven to protect against cardiovascular events and several cancers could reduce the risk of ovarian cancer 20% to 34% depending on frequency and dose of use.
    J Natl Cancer Inst. 02/2014; 106(2):djt431.
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    ABSTRACT: Abstract Purpose . To test the efficacy of a culturally targeted breast cancer screening educational program in increasing mammogram completion in Chinese-American immigrant women. Design . Randomized controlled study. Setting . Chinese communities, Portland, Oregon. Subjects . From April 2010 to September 2011, 300 women were randomized to receive a theory-based, culturally targeted breast cancer screening educational intervention (n = 147) or a mammography screening brochure published by the National Cancer Institute (n = 153). Intervention . The two-part intervention consisted of group teaching with targeted, theory-based messages followed by individual counseling sessions. Measures . Mammography completion, perceived susceptibility, perceived benefits, perceived barriers, perceived cultural barriers, and demographic variables. Analysis . A 2 × 3 mixed logistic model was applied to determine odds ratio of mammogram completion. Results . Behavior changed in both groups, with a total of 170 participants (56.7%) reporting a mammogram at 12 months. The logistic model indicated increased odds of mammogram completion in the intervention compared to the control group at 3, 6, and 12 months. When controlling for marital status, age, and age moved to the United States, the intervention group was nine times more likely to complete mammograms than the control group. Conclusion . The culturally targeted educational program significantly increased mammogram use among Chinese immigrant women. Further testing of effectiveness in larger community settings is needed. The intervention may also serve as a foundation from which to develop education to increase cancer screening among other minority subgroups.
    American journal of health promotion: AJHP 01/2014; · 2.37 Impact Factor
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    ABSTRACT: An estimated 17% of all new cancers in women worldwide are due to cancers of the cervix, the ovary and the uterus. Together, these cancers account for 14.6% of all female cancer deaths. This is a significant societal and economic burden, which can be limited through cancer screening. In the developed world, marked reductions of 50–90% in disease rates have been observed as a result of cervical cancer screening. By contrast, in developing countries, where more than 85% of all new cases and deaths from this cancer are reported, significant challenges need to be overcome. Although cytology remains a key component of cervical screening, the newer molecular tests offer a more targeted, risk-attuned approach. The situation for the other two gynecological cancers is different. The case for ovarian cancer screening has yet to be made with the results of key screening trials in high- and low-risk populations still pending. Screening for endometrial cancer is traditionally not advocated as women become symptomatic during the earlier, treatable stages of disease. However, consideration of screening options for these two cancers is warranted since endometrial cancer rates are on the increase and in ovarian cancer, the high case:fatality ratio remains unchanged.
    Expert Review of Obstetrics &amp Gynecology 01/2014; 8(2).
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    ABSTRACT: Over 150 delegates from the UK, USA and Europe with a core interest in risk prediction and screening for ovarian cancer attended the International Conference on Ovarian Cancer Screening held on 29–30 November 2011 in London, UK. The scientific program was driven by two experts in the field – Usha Menon and Ian Jacobs – with assistance from the scientific committee, which included Steve Skates, Jatinderpal Kalsi, Anna Lokshin, Uzi Beller, Tim Mould and Ranjit Manchanda. Over the 2 days, key opinion leaders and researchers reported on the latest developments, and debated the future of risk prediction and screening for ovarian cancer.
    Expert Review of Obstetrics &amp Gynecology 01/2014; 7(2).
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    ABSTRACT: Objective To test whether the Coping in Deliberation (CODE) framework can be adapted to a specific preference-sensitive medical decision: risk-reducing bilateral salpingo-oophorectomy (RRSO) in women at increased risk of ovarian cancer. Methods We performed a systematic literature search to identify issues important to women during deliberations about RRSO. Three focus groups with patients (most were pre-menopausal and untested for genetic mutations) and 11 interviews with health professionals were conducted to determine which issues mattered in the UK context. Data were used to adapt the generic CODE framework. Results The literature search yielded 49 relevant studies, which highlighted various issues and coping options important during deliberations, including mutation status, risks of surgery, family obligations, physician recommendation, peer support and reliable information sources. Consultations with UK stakeholders confirmed most of these factors as pertinent influences on deliberations. Questions in the generic framework were adapted to reflect the issues and coping options identified. Conclusions The generic CODE framework was readily adapted to a specific preference-sensitive medical decision, showing that deliberations and coping are linked during deliberations about RRSO. Practice Implications: Adapted versions of the CODE framework may be used to develop tailored decision support methods and materials in order to improve patient-centred care.
    Patient Education and Counseling 01/2014; · 2.60 Impact Factor
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    ABSTRACT: To evaluate the validity of self-reported hysterectomy against the gold standard of uterine visualisation using pelvic ultrasound. Prospective cohort study. UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) based in 13 National Health Service (NHS) Trusts in England, Wales and Northern Ireland. Between April 2001 and October 2005, 48 215 postmenopausal women aged 50-74 randomised to the ultrasound screening arm of UKCTOCS underwent the first (initial) scan on the trial. At recruitment, the women completed a recruitment questionnaire (RQ) which included previous hysterectomy. The sonographer asked each woman regarding previous hysterectomy (interview format, IF) prior to the scan. At the scan, in addition to ovarian morphology, endometrial thickness (ET)/endometrial abnormality were captured if the uterus was visualised at the scan. Self-reported hysterectomy at RQ or IF was compared to ultrasound data on ET/endometrial abnormality (as surrogate uterine visualisation markers) on the first (initial) scan. Of 48 215 women, 3 had congenital uterine agenesis and 218 inconclusive results. The uterus was visualised in 39 121 women. 8871 self-reported hysterectomy at RQ, 8641 at IF and 8487 at both. The uterus was visualised in 39 123, 39 353 and 38 969 women not self-reporting hysterectomy at RQ, IF or both. Validity, sensitivity, specificity, positive predictive value and negative predictive value of using RQ alone, IF or both RQ/IF were 99.6%, 98.9%, 99.7%, 98.9% and 99.7%; 98.9%, 98.4%, 99.1%, 95.9% and 99.7%; 99.8%, 99.6%, 99.9%, 99.4% and 99.9%, respectively. Self-reported hysterectomy is a highly accurate and valid source for studying long-term associations of hysterectomy with disease onset. International Standard Randomised Controlled Trial Number (ISRCTN)-22488978.
    BMJ Open 01/2014; 4(3):e004421. · 1.58 Impact Factor
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    ABSTRACT: Hopelessness is an important construct in psychosocial epidemiology, but there is great pressure on the length of questionnaire measures in large-scale population and clinical studies. We examined the validity and test-retest reliability of two brief measures of hopelessness, an existing negatively worded two-item measure of hopelessness (Brief-H-Neg) and a positively worded version of the same instrument (Brief-H-Pos).
    BMJ Open 01/2014; 4(5):e005093. · 1.58 Impact Factor
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    ABSTRACT: BRCA1 mutation carriers have an 85% risk of developing breast cancer but the risk of developing non-hereditary breast cancer is difficult to assess. Our objective is to test whether a DNA methylation (DNAme) signature derived from BRCA1 mutation carriers is able to predict non-hereditary breast cancer.
    Genome Medicine 01/2014; 6(6):47. · 4.94 Impact Factor
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    ABSTRACT: Evidence of a mortality benefit continues to elude ovarian cancer (OC) screening. Data from the US Prostate Lung Colorectal and Ovarian (PLCO) Cancer Screening trial which used a screening strategy incorporating CA125 cut-off and transvaginal ultrasound has not shown mortality benefit. The United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) is using the Risk of Ovarian Cancer (ROC) time series algorithm to interpret CA125, which has shown an encouraging sensitivity and specificity however the mortality data will only be available in 2015. The article explores the impact of growing insights into disease etiology and evolution and biomarker discovery on future screening strategies. A better understanding of the target lesion, improved design of biomarker discovery studies, a focus on detecting low volume disease using cancer specific markers, novel biospecimens such as cervical cytology and targeted imaging and use of time series algorithms for interpreting markers profile suggests that a new era in screening is underway.
    Gynecologic Oncology 12/2013; · 3.93 Impact Factor
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    ABSTRACT: A missense single nucleotide polymorphism in the immune modulatory gene IL1A has been associated with ovarian cancer risk (rs17561), but the functional implications of this polymorphism are undefined. IL-1α is regulated by and activated by NF-κB, a transcription factor family that induces transcription of IL1A along with other pro-inflammatory genes and is an important modifier in carcinogenesis. We therefore tagged SNPs in over 200 genes in the NF-κB pathway for a total of 2,282 SNPs (including rs17561) for genotype analysis of 15,604 cases of ovarian cancer in patients of European descent, including 6,179 of high grade serous (HGS), 2,100 endometrioid, 1,591 mucinous, 1,034 clear cell and 1,016 low grade serous (LGS), including 23,235 control cases spanning 40 studies in the Ovarian Cancer Association Consortium (OCAC). In this large population, we confirmed the association between rs17561 and clear cell ovarian cancer (OR=0.84, 95% CI: 0.76-0.93; p=0.00075), which remained intact even after excluding participants in the prior study (OR=0.85, 95% CI: 0.75-0.95; p=0.006). Considering a multiple-testing-corrected significance threshold of p< 2.5x10-5, only one other variant, the TNFSF10 SNP rs6785617, was associated significantly with a risk of ovarian cancer (low malignant potential (LMP) tumors OR=0.85, 95% CI: 0.79-0.91; p=0.00002). Our results extend the evidence that borderline tumors may have a distinct genetic etiology. Further investigation of how these SNPs might modify ovarian cancer associations with other inflammation related risk factors is warranted.
    Cancer Research 11/2013; · 8.65 Impact Factor
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    ABSTRACT: Epithelial ovarian cancer (EOC) is a heterogeneous cancer with both genetic and environmental risk factors. Variants influencing the risk of developing the less-common EOC subtypes have not been fully investigated. We performed a genome-wide association study (GWAS) of EOC according to subtype by pooling genomic DNA from 545 cases and 398 controls of European descent, and testing for allelic associations. We evaluated for replication 188 variants from the GWAS [56 variants for mucinous, 55 for endometrioid and clear cell, 53 for low-malignant potential (LMP) serous, and 24 for invasive serous EOC], selected using pre-defined criteria. Genotypes from 13,188 cases and 23,164 controls of European descent were used to perform unconditional logistic regression under the log-additive genetic model; odds ratios (OR) and 95 % confidence intervals are reported. Nine variants tagging six loci were associated with subtype-specific EOC risk at P < 0.05, and had an OR that agreed in direction of effect with the GWAS results. Several of these variants are in or near genes with a biological rationale for conferring EOC risk, including ZFP36L1 and RAD51B for mucinous EOC (rs17106154, OR = 1.17, P = 0.029, n = 1,483 cases), GRB10 for endometrioid and clear cell EOC (rs2190503, P = 0.014, n = 2,903 cases), and C22orf26/BPIL2 for LMP serous EOC (rs9609538, OR = 0.86, P = 0.0043, n = 892 cases). In analyses that included the 75 GWAS samples, the association between rs9609538 (OR = 0.84, P = 0.0007) and LMP serous EOC risk remained statistically significant at P < 0.0012 adjusted for multiple testing. Replication in additional samples will be important to verify these results for the less-common EOC subtypes.
    Human Genetics 11/2013; · 4.63 Impact Factor

Publication Stats

4k Citations
1,237.09 Total Impact Points

Institutions

  • 2004–2014
    • University College London
      • Institute for Women's Health
      Londinium, England, United Kingdom
  • 2013
    • Calgary Laboratory Services
      Calgary, Alberta, Canada
  • 2012–2013
    • The Ohio State University
      • College of Nursing
      Columbus, Ohio, United States
    • Simmons College
      Boston, Massachusetts, United States
    • King's College London
      • Department of Psychology
      London, ENG, United Kingdom
  • 2011–2013
    • Moffitt Cancer Center
      • Program in Cancer Epidemiology (CE)
      Tampa, Florida, United States
    • Georgetown University
      Washington, Washington, D.C., United States
    • University of South Florida
      • Moffitt Cancer Center
      Tampa, FL, United States
  • 2010–2013
    • Mayo Foundation for Medical Education and Research
      • Department of Health Sciences Research
      Rochester, MI, United States
    • Harvard University
      Cambridge, Massachusetts, United States
  • 2009–2013
    • University of Cambridge
      • Department of Oncology
      Cambridge, England, United Kingdom
    • Vanderbilt University
      • School of Nursing
      Nashville, MI, United States
    • British Gynaecological Cancer Society
      Londinium, England, United Kingdom
    • University of Bristol
      Bristol, England, United Kingdom
  • 2007–2013
    • UCL Eastman Dental Institute
      Londinium, England, United Kingdom
    • Tufts Medical Center
      • Institute for Clinical Research and Health Policy Studies
      Boston, MA, United States
    • Tufts University
      Georgia, United States
    • The Royal Marsden NHS Foundation Trust
      Londinium, England, United Kingdom
  • 2010–2012
    • Queensland Institute of Medical Research
      Brisbane, Queensland, Australia
  • 2010–2011
    • Arizona State University
      • College of Nursing and Health Innovation
      Mesa, AZ, United States
  • 2007–2010
    • University of Reading
      Reading, England, United Kingdom
  • 2005–2010
    • University of Illinois at Chicago
      • • School of Public Health
      • • College of Nursing
      Chicago, IL, United States
  • 2001–2010
    • Fred Hutchinson Cancer Research Center
      • Epidemiology Program
      Seattle, Washington, United States
  • 2008
    • Portland State University
      Portland, Oregon, United States
  • 2005–2008
    • Oregon Health and Science University
      • School of Nursing
      Portland, OR, United States
  • 1997–2007
    • Indiana University-Purdue University Indianapolis
      • School of Nursing
      Indianapolis, IN, United States
  • 1999–2006
    • Queen Mary, University of London
      • • Oral Pathology
      • • Barts Cancer Institute
      Londinium, England, United Kingdom
  • 2003
    • University of Utah
      • College of Nursing
      Salt Lake City, Utah, United States
    • Salt Lake City Community College
      Salt Lake City, Utah, United States
    • Massachusetts General Hospital
      Boston, Massachusetts, United States
  • 2000
    • Royal Cornwall Hospitals NHS Trust
      Truro, England, United Kingdom