Meira Epplein, Ph.D.

Assistant Professor
Faculty Appointments
Assistant Professor of Medicine
Ph.D., EPIDEMIOLOGY, University of Washington, Seattle, WashingtonM.S., EPIDEMIOLOGY, University of Washington, Seattle, WashingtonM.A., INTERNATIONAL STUDIES (CHINA), University of Washington, Seattle, WashingtonB.A., University of North Carolina, Chapel Hill, North Carolina
Research Description
As a cancer epidemiologist with a focus on modifiable risk factors, particularly among ethnically diverse populations, I seek to understand the variations in lifestyle including, but not limited to, prevalence of infection, aspirin use, diet, physical activity, and anthropometry among groups of individuals with differing risks of disease. Currently my work is focused on Helicobacter pylori, a bacteria that lives in the lining of the stomach of approximately half of the world's population, and the dual nature of its relationship with disease. Specifically, infection with H. pylori is the most well-established risk factor for gastric cancer, but only a fraction of infected individuals will develop cancer, and there is evidence that carriage of the bacteria is inversely related with esophageal adenocarcinoma, a very fatal cancer that is currently increasing in incidence, and possibly with asthma, allergies, and gastroesophageal reflux disease as well. H. pylori prevalence varies widely by geographic region (30% in the United States compared to 80-90% in East Asia and Africa, for example), and by racial/ethnic group within regions as well (minorities in the United States, including African Americans and Asian Americans, have infection rates as high as seen in developing countries). Currently I am exploring the epidemiologic triangle of bacteria-host-environment through studies investigating H. pylori genetic diversity, host characteristics (including race and ancestry and individual inflammatory response) and lifestyle factors (such as diet and medication use) to better pinpoint who is at highest risk of disease, so that we make take preventive measures, especially among groups of under-served individuals who may be at particularly high risk.
Research Keywords
Cancer epidemiology; Modifiable risk factors; Health disparities; Gastric cancer; Helicobacter pylori
Epplein M, Bostick RM, Mu L, Ogino S, Braithwaite D, Kanetsky PA. Challenges and opportunities in international molecular cancer prevention research: An ASPO Molecular Epidemiology and the Environment and International Cancer Prevention Interest Groups Report. Cancer Epidemiol. Biomarkers Prev [print-electronic]. 2014 Nov; 23(11): 2613-7. PMID: 25277796, PMCID: PMC4221505, PII: 1055-9965.EPI-14-0848, DOI: 10.1158/1055-9965.EPI-14-0848, ISSN: 1538-7755.

Epplein M, Burk RF, Cai Q, Hargreaves MK, Blot WJ. A prospective study of plasma Selenoprotein P and lung cancer risk among low-income adults. Cancer Epidemiol. Biomarkers Prev [print-electronic]. 2014 Jul; 23(7): 1238-44. PMID: 24762559, PMCID: PMC4082447, PII: 1055-9965.EPI-13-1308, DOI: 10.1158/1055-9965.EPI-13-1308, ISSN: 1538-7755.

Epplein M, Peek RM, Blot WJ. Helicobacter pylori Biomarkers and Risk of Colorectal Oncogenesis--Response [letter]. Cancer Epidemiol. Biomarkers Prev [print-electronic]. 2014 Feb; 23(2): 366. PMID: 24285842, PMCID: PMC3946073, PII: 1055-9965.EPI-13-1191, DOI: 10.1158/1055-9965.EPI-13-1191, ISSN: 1538-7755.

Epplein M, Zheng W, Li H, Peek RM, Correa P, Gao J, Michel A, Pawlita M, Cai Q, Xiang YB, Shu XO. Diet, Helicobacter pylori strain-specific infection, and gastric cancer risk among Chinese men. Nutr Cancer [print-electronic]. 2014; 66(4): 550-7. PMID: 24666234, PMCID: PMC4068395, DOI: 10.1080/01635581.2014.894096, ISSN: 1532-7914.

Epplein M, Xiang YB, Cai Q, Peek RM, Li H, Correa P, Gao J, Wu J, Michel A, Pawlita M, Zheng W, Shu XO. Circulating cytokines and gastric cancer risk. Cancer Causes Control [print-electronic]. 2013 Dec; 24(12): 2245-50. PMID: 24052422, PMCID: PMC3828746, DOI: 10.1007/s10552-013-0284-z, ISSN: 1573-7225.

Epplein M, Pawlita M, Michel A, Peek RM, Cai Q, Blot WJ. Helicobacter pylori protein-specific antibodies and risk of colorectal cancer. Cancer Epidemiol. Biomarkers Prev [print-electronic]. 2013 Nov; 22(11): 1964-74. PMID: 24045925, PMCID: PMC3828745, PII: 1055-9965.EPI-13-0702, DOI: 10.1158/1055-9965.EPI-13-0702, ISSN: 1538-7755.

Kweon SS, Shu XO, Xiang Y, Cai H, Yang G, Ji BT, Li H, Gao YT, Zheng W, Epplein M. Intake of specific nonfermented soy foods may be inversely associated with risk of distal gastric cancer in a Chinese population. J. Nutr [print-electronic]. 2013 Nov; 143(11): 1736-42. PMID: 23986366, PMCID: PMC3796344, PII: jn.113.177675, DOI: 10.3945/jn.113.177675, ISSN: 1541-6100.

Epplein M, Zheng W, Xiang YB, Peek RM, Li H, Correa P, Gao J, Michel A, Pawlita M, Cai Q, Shu XO. Prospective study of Helicobacter pylori biomarkers for gastric cancer risk among Chinese men. Cancer Epidemiol. Biomarkers Prev [print-electronic]. 2012 Dec; 21(12): 2185-92. PMID: 23035179, PMCID: PMC3518572, PII: 1055-9965.EPI-12-0792-T, DOI: 10.1158/1055-9965.EPI-12-0792-T, ISSN: 1538-7755.

Epplein M, Cohen SS, Sonderman JS, Zheng W, Williams SM, Blot WJ, Signorello LB. Neighborhood socio-economic characteristics, African ancestry, and Helicobacter pylori sero-prevalence. Cancer Causes Control [print-electronic]. 2012 Jun; 23(6): 897-906. PMID: 22527167, PMCID: PMC3475203, DOI: 10.1007/s10552-012-9960-7, ISSN: 1573-7225.

Nomura AM, Wilkens LR, Henderson BE, Epplein M, Kolonel LN. The association of cigarette smoking with gastric cancer: the multiethnic cohort study. Cancer Causes Control [print-electronic]. 2012 Jan; 23(1): 51-8. PMID: 22037905, PMCID: PMC4166441, DOI: 10.1007/s10552-011-9854-0, ISSN: 1573-7225.

Epplein M, Signorello LB, Zheng W, Cai Q, Hargreaves MK, Michel A, Pawlita M, Fowke JH, Correa P, Blot WJ. Helicobacter pylori prevalence and circulating micronutrient levels in a low-income United States population. Cancer Prev Res (Phila) [print-electronic]. 2011 Jun; 4(6): 871-8. PMID: 21436385, PMCID: PMC3107911, PII: 1940-6207.CAPR-10-0398, DOI: 10.1158/1940-6207.CAPR-10-0398, ISSN: 1940-6215.

Epplein M, Signorello LB, Zheng W, Peek RM, Michel A, Williams SM, Pawlita M, Correa P, Cai Q, Blot WJ. Race, African ancestry, and Helicobacter pylori infection in a low-income United States population. Cancer Epidemiol. Biomarkers Prev [print-electronic]. 2011 May; 20(5): 826-34. PMID: 21357376, PMCID: PMC3089670, PII: 1055-9965.EPI-10-1258, DOI: 10.1158/1055-9965.EPI-10-1258, ISSN: 1538-7755.

Epplein M, Zheng Y, Zheng W, Chen Z, Gu K, Penson D, Lu W, Shu XO. Quality of life after breast cancer diagnosis and survival. J. Clin. Oncol [print-electronic]. 2011 Feb 2/1/2011; 29(4): 406-12. PMID: 21172892, PMCID: PMC3058286, PII: JCO.2010.30.6951, DOI: 10.1200/JCO.2010.30.6951, ISSN: 1527-7755.

Piazuelo MB, Epplein M, Correa P. Gastric cancer: an infectious disease. Infect. Dis. Clin. North Am. 2010 Dec; 24(4): 853-69, vii. PMID: 20937454, PMCID: PMC2954127, PII: S0891-5520(10)00065-6, DOI: 10.1016/j.idc.2010.07.010, ISSN: 1557-9824.

Epplein M, Shu XO, Xiang YB, Chow WH, Yang G, Li HL, Ji BT, Cai H, Gao YT, Zheng W. Fruit and vegetable consumption and risk of distal gastric cancer in the Shanghai Women's and Men's Health studies. Am. J. Epidemiol [print-electronic]. 2010 Aug 8/15/2010; 172(4): 397-406. PMID: 20647333, PMCID: PMC2950795, PII: kwq144, DOI: 10.1093/aje/kwq144, ISSN: 1476-6256.

Reed SD, Newton KM, Garcia RL, Allison KH, Voigt LF, Jordan CD, Epplein M, Swisher E, Upson K, Ehrlich KJ, Weiss NS. Complex hyperplasia with and without atypia: clinical outcomes and implications of progestin therapy. Obstet Gynecol. 2010 Aug; 116(2 Pt 1): 365-73. PMID: 20664397, PMCID: PMC2949551, PII: 00006250-201008000-00018, DOI: 10.1097/AOG.0b013e3181e93330, ISSN: 1873-233X.

Epplein M, Novotny R, Daida Y, Vijayadeva V, Onaka AT, Le Marchand L. Association of maternal and intrauterine characteristics with age at menarche in a multiethnic population in Hawaii. Cancer Causes Control [print-electronic]. 2010 Feb; 21(2): 259-68. PMID: 19862633, PMCID: PMC2811221, DOI: 10.1007/s10552-009-9457-1, ISSN: 1573-7225.

Epplein M, Nomura AM, Wilkens LR, Henderson BE, Kolonel LN. Nonsteroidal antiinflammatory drugs and risk of gastric adenocarcinoma: the multiethnic cohort study. Am. J. Epidemiol [print-electronic]. 2009 Aug 8/15/2009; 170(4): 507-14. PMID: 19584132, PMCID: PMC2727180, PII: kwp162, DOI: 10.1093/aje/kwp162, ISSN: 1476-6256.

Epplein M, Franke AA, Cooney RV, Morris JS, Wilkens LR, Goodman MT, Murphy SP, Henderson BE, Kolonel LN, Le Marchand L. Association of plasma micronutrient levels and urinary isoprostane with risk of lung cancer: the multiethnic cohort study. Cancer Epidemiol. Biomarkers Prev [print-electronic]. 2009 Jul; 18(7): 1962-70. PMID: 19531680, PMCID: PMC2755047, PII: 1055-9965.EPI-09-0003, DOI: 10.1158/1055-9965.EPI-09-0003, ISSN: 1538-7755.

Reed SD, Newton KM, Clinton WL, Epplein M, Garcia R, Allison K, Voigt LF, Weiss NS. Incidence of endometrial hyperplasia. Am. J. Obstet. Gynecol [print-electronic]. 2009 Jun; 200(6): 678.e1-6. PMID: 19393600, PMCID: PMC2692753, PII: S0002-9378(09)00223-3, DOI: 10.1016/j.ajog.2009.02.032, ISSN: 1097-6868.

Reed SD, Voigt LF, Newton KM, Garcia RH, Allison HK, Epplein M, Jordan D, Swisher E, Weiss NS. Progestin therapy of complex endometrial hyperplasia with and without atypia. Obstet Gynecol. 2009 Mar; 113(3): 655-62. PMID: 19300331, PMCID: PMC2680496, PII: 00006250-200903000-00014, DOI: 10.1097/AOG.0b013e318198a10a, ISSN: 0029-7844.

Epplein M, Shvetsov YB, Wilkens LR, Franke AA, Cooney RV, Le Marchand L, Henderson BE, Kolonel LN, Goodman MT. Plasma carotenoids, retinol, and tocopherols and postmenopausal breast cancer risk in the Multiethnic Cohort Study: a nested case-control study. Breast Cancer Res [print-electronic]. 2009; 11(4): R49. PMID: 19619335, PMCID: PMC2750110, PII: bcr2338, DOI: 10.1186/bcr2338, ISSN: 1465-542X.

Epplein M, Wilkens LR, Tiirikainen M, Dyba M, Chung FL, Goodman MT, Murphy SP, Henderson BE, Kolonel LN, Le Marchand L. Urinary isothiocyanates; glutathione S-transferase M1, T1, and P1 polymorphisms; and risk of colorectal cancer: the Multiethnic Cohort Study. Cancer Epidemiol. Biomarkers Prev. 2009 Jan; 18(1): 314-20. PMID: 19124514, PMCID: PMC2715873, PII: 18/1/314, DOI: 10.1158/1055-9965.EPI-08-0627, ISSN: 1055-9965.

Epplein M, Reed SD, Voigt LF, Newton KM, Holt VL, Weiss NS. Endometrial hyperplasia risk in relation to recent use of oral contraceptives and hormone therapy. Ann Epidemiol. 2009 Jan; 19(1): 1-7. PMID: 19064186, PMCID: PMC2615384, PII: S1047-2797(08)00284-6, DOI: 10.1016/j.annepidem.2008.08.099, ISSN: 1873-2585.

Epplein M, Nomura AM, Hankin JH, Blaser MJ, Perez-Perez G, Stemmermann GN, Wilkens LR, Kolonel LN. Association of Helicobacter pylori infection and diet on the risk of gastric cancer: a case-control study in Hawaii. Cancer Causes Control [print-electronic]. 2008 Oct; 19(8): 869-77. PMID: 18369531, PMCID: PMC2799111, DOI: 10.1007/s10552-008-9149-2, ISSN: 1573-7225.

Epplein M, Reed SD, Voigt LF, Newton KM, Holt VL, Weiss NS. Risk of complex and atypical endometrial hyperplasia in relation to anthropometric measures and reproductive history. Am. J. Epidemiol [print-electronic]. 2008 Sep 9/15/2008; 168(6): 563-70; discussion 571. PMID: 18682485, PMCID: PMC2727194, PII: kwn168, DOI: 10.1093/aje/kwn168, ISSN: 1476-6256.

Sun LM, Epplein M, Li CI, Vaughan TL, Weiss NS. Trends in the incidence rates of nasopharyngeal carcinoma among Chinese Americans living in Los Angeles County and the San Francisco metropolitan area, 1992-2002. Am. J. Epidemiol [print-electronic]. 2005 Dec 12/15/2005; 162(12): 1174-8. PMID: 16282240, PII: kwi345, DOI: 10.1093/aje/kwi345, ISSN: 0002-9262.

Epplein M, Schwartz SM, Potter JD, Weiss NS. Smoking-adjusted lung cancer incidence among Asian-Americans (United States). Cancer Causes Control. 2005 Nov; 16(9): 1085-90. PMID: 16184474, DOI: 10.1007/s10552-005-0330-6, ISSN: 0957-5243.

Carr DB, Epplein M, Johnson CO, Easterling TR, Critchlow CW. A sister's risk: family history as a predictor of preeclampsia. Am. J. Obstet. Gynecol. 2005 Sep; 193(3 Pt 2): 965-72. PMID: 16157095, PII: S0002-9378(05)00878-1, DOI: 10.1016/j.ajog.2005.06.034, ISSN: 0002-9378.

Epplein M, Koon KP, Ramsey SD, Potter JD. Genetic services for familial cancer patients: a follow-up survey of National Cancer Institute Cancer Centers. J. Clin. Oncol. 2005 Jul 7/20/2005; 23(21): 4713-8. PMID: 16034046, PII: 23/21/4713, DOI: 10.1200/JCO.2005.00.133, ISSN: 0732-183X.