Heather Spencer Feigelson, PhD, MPH

Senior Investigator

Heather Spencer Feigelson, PhD, MPH, is a Cancer Epidemiologist and Senior Investigator at the Institute for Health Research. Dr. Feigelson has over 25 years of experience as a cancer epidemiologist with expertise in genetic susceptibility and genomics. She is committed to understanding factors that improve treatment response and survival in those living with cancer and has lead studies looking at factors associated with survival of breast cancer, ovarian cancer, colorectal cancer and melanoma. Dr. Feigelson is also developing methods to increase appropriate genetic screening and testing for familial cancers. Much of Dr. Feigelson’s research has focused on the etiology of breast cancer. Her current work includes understanding risk factors associated with second cancers among women with breast cancer, and molecular markers that predict progression of DCIS to invasive breast cancer. She also has a long-standing interest in steroid hormone metabolism and its role in cancer etiology, and has explored many factors associated with hormonal mechanisms, including genetics, obesity, hormone replacement therapy, and the gut microbiome.

Dr. Feigelson has spent much of her career developing large, prospective studies of cancer etiology. She currently leads a consortia of four Kaiser Permanente regions (Georgia, Hawaii, Northwest and Colorado) working with the National Cancer Institute and other health plans around the country to assemble a prospective cohort that will include up to 200,000 cancer-free adults followed over several decades with serial biospecimen collection. She also serves as lead scientist for the cancer cohort that is part of the Kaiser Permanente Research Bank . The KPRB has collected over 350,000 DNA specimens from members across all Kaiser Permanente regions. She also served as co-lead of the colorectal cancer cohort developed under the PCORI Patient Outcomes Research To Advance Learning (PORTAL) Study. This cohort included survey and medical record data from over 16,000 colorectal cancer patients across 6 health plans.

Dr. Feigelson earned her Master of Public Health degree from the San Diego State University and completed her doctoral training in epidemiology at the University of California, Los Angeles. She then completed a post-doctoral fellowship at the Norris Comprehensive Cancer Center at the University of Southern California.

Selected Research:

  • Leveraging Tumor Registries and Pathology Specimens to Facilitate Genetic Testing and Traceback for Ovarian Cancer
  • Despite recommendations that all ovarian cancer cases should receive genetic counseling and testing, rates remain low. This study aims to increase the identification of women and their families who have a higher cancer risk by applying a traceback testing approach to retrospectively identify women who have a prior diagnosis of ovarian cancer. This study will leverage tumor registries to identify prior cases of ovarian cancer diagnosed within the past 10 years at two managed care healthcare systems (Kaiser Permanente Northwest and Kaiser Permanente Colorado). The use of archived pathology samples for germline genetic testing will allow family members of both living and deceased women to receive familial genetic cancer risk information. We will assess: 1) the feasibility of and barriers associated with using tumor registries and archived pathology samples for a traceback testing approach; 2) explore the ethical, privacy, and policy implications associated with genetic testing in deceased patients to inform familial risk; 3) characterize barriers to receiving genetic counseling at the time of diagnosis, including barriers to referral, care access, and patient follow-up.

    • Funder: National Institutes of Health/National Cancer Institute
    • Award End Date: 02/28/2024

  • A New Prospective U.S. Cohort Set Within Health Care System Institutions to Study Cancer
  • This project is a collaboration of 4 Kaiser Permanente (KP) regions (Georgia, Hawaii, Northwest and Colorado) participating in the assembly of a prospective multi-center cohort study that will include up to 200,000 cancer-free adults aged 40-65 years. This cohort will serve an invaluable function in the conduct of research into cancer etiology and prevention. Kaiser Permanente represents the ideal environment to conduct this research as a pioneer in electronic medical record (EMR) technology and our decades of experience conducting research in these defined populations. We will capitalize upon these resources and experience to recruit KP members as part of this complex, intensive, prospective cohort study.

    • Funder: National Institutes of Health/National Cancer Institute
    • Award End Date: 11/03/2028

  • Clinical Sequencing Evidence-Generating Research (CSER2)
  • The goal of this project is to investigate the implementation of exome sequencing in practice settings that primarily serve racially, ethnically, and socioeconomically diverse patients while examining the needs of both patients and clinicians. We will evaluate the clinical utility of exome sequencing in healthy adults of reproductive age at risk for hereditary cancer syndromes (Lynch Syndrome and Hereditary Breast and Ovarian Cancer). We will evaluate and tailor for diverse populations the critical interactions in the program, including the consent process, choices for reporting additional findings, and the response to results disclosure.

    • Funder: National Human Genome Research Institute
    • Award End Date: 05/31/2021

  • Molecular Markers of Risk of Subsequent Breast Cancer in Women with Ductal Carcinoma in Situ
  • The aim of this study is to identify miRNA expression changes associated with risk of invasive breast cancer among a cohort of women initially diagnosed with DCIS.

    • Funder: National Cancer Institute
    • Award End Date: 07/31/2022

  • KP National Biobank
  • The KP National Biobank is a collaboration across all Kaiser regions funded by the Kaiser Foundation Health Plan. The goal of the biobank is to collect blood and/or tissue samples on 400,000 Kaiser Permanente members and utilize them, combined with survey data and medical information, to create a state-of-the-art resource for genetic and health services research.

    • Funder: Kaiser Foundation Health Plan
    • Award End Date: 06/2021

  • Late Effects of Breast Cancer Treatment: Mammographic Density and Risk of Contralateral Breast Cancer
  • The goal of this project was to investigate the association between breast density and risk of contralateral breast cancer.

    • Funder: National Cancer Institute
    • Award End Date: 07/31/2021