bluuebunny/crossref_metadata_2025 huggingface dataset:
P4-12-05: Impact of the Lifestyle Intervention Study in Adjuvant Treatment of Early Breast Cancer (LISA) Weight Loss Intervention upon Physical Activity.
Authors: Ligibel JA , Segal R , Pond G , Dion M-J , Pritchard KI , Levine M , Goodwin PJ
Published: June 2012

Observational evidence shows a relationship between obesity and poor prognosis in breast cancer (BC). Physical activity (PA) is an important component of weight loss and maintenance, but most large-scale interventions in BC patients have produced only modest improvements in activity. We sought to evaluate changes in PA in women participating in LISA, a randomized trial coordinated by the Ontario Clinical Oncology Group which was designed to examine the impact of a telephone-based weight loss intervention (WLI) upon disease free survival in BC patients.

Methods: Participants were randomized 1:1 to the WLI or educational control (EC) group. Eligibility included diagnosis of Stage I-III BC, BMI ≥24 kg/m2, and treatment with letrozole. The WLI, based on the Diabetes Prevention Program, focused on weight reduction through calorie restriction and increased physical activity. Delivery involved 19 calls, mailings and a participant manual. The PA goal was 150 minutes/week. PA was measured using the International Physical Activity Questionnaire (Short Form) at baseline, 6, 12, and 18 months. Changes in time (minutes/week) spent sitting and engaging in moderate, vigorous, and walking activities were compared between groups.

Results 338 women were randomized to WLI (n=171) or EC (n=167) from 20 centers in Canada and the USA. The study was discontinued due to loss of funding. The WLI arm lost significantly more weight than EC arm, with mean weight loss of 6.1% of body weight vs. 0.6% at 12 months (p<0.001). Activity data are presented in Table 1. At baseline, participants were inactive; median vigorous activity was zero minutes/week and median time spent sitting was more than 35 hours/week. WLI participants reported significantly higher participation in vigorous, moderate and walking activities, and lower levels of sedentary behavior, compared to controls at 6 and 12 months. Higher levels of PA were significantly associated with increased weight loss at all time periods. Factors associated with increases in activity included higher baseline BMI (p=0.014), lower baseline activity (p<0.001) and assignment to the WLI arm (p=0.02). Women assigned to WLI increased their PA during the intervention period (p=0.017) even after adjusting for other significant baseline factors.

Conclusion Participants in the LISA WLI reported significantly higher levels of PA compared with controls. Activity increased most in women who were heavier and less active at baseline. Further study of this WLI as a potential means to improve BC outcomes is warranted.

Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P4-12-05.
PD07-01: Sequential Treatment with Epirubicin/Cyclophosphamide, Followed by Docetaxel vs. FEC120 in the Adjuvant Treatment of Breast Cancer Patients with Extensive Lymph Node Involvement: Final Survival Analysis of the German ADEBAR Phase III Study.
Authors: Janni WJ , Harbeck N , Sommer H , Rack B , Salmen J , Augustin D , Simon W , Jueckstock J , Wischnik A , Anneke K , Melcher C , Friese K , Kiechle M
Published: June 2012

Background: Based on meta-analytic evidence, taxane containing adjuvant chemotherapy has been established as standard treatment in node-positive breast cancer. However, in the MA-21 study, adriamycin-cyclophosphamide, followed by paclitaxel (AC-P) was significantly inferior to the gold standard of anthracycline treatment, FEC120 (Burnell, SABCS 2006). We prospectively compared a sequential epirubicin-docetaxel chemotherapy regimen to FEC120. Patients and Methods:

The ADEBAR study was a multicenter phase III trial (n=1502) to evaluate whether breast cancer (BC) pts with > 3 axillary lymph node metastases benefit from a sequential anthracycline-docetaxel regimen (E90C-D: 4 cycles epirubicin [E] 90 mg/m2 plus cyclophosphamide [C] 600 mg/m2 q21 days followed by 4 cycles docetaxel [D] 100mg/m2 q21 days) compared to dose-intensive anthracycline-containing polychemotherapy (FE120C: 6 cycles E 60 mg/m2 d 1+8, 5-FU 500mg/m2 d 1+8 and C 75 mg/m2 d 1–14, q4 weeks). The median follow-up time will be 60 months.

Results: Treatment was stopped prematurely in 3.7% of the pts in the E90C-D arm and in 8.0% in the FE120C arm due to toxicity (p=0.0009). Antibiotic treatment was given in 10.4% (E90C-D) vs. 19.7% (FE120C), G-CSF support in 39.2% vs 61.4% and erythropoietin stimulation in 8.7% vs. 20.0%, respectively (p<0.0001). Haematological toxicity (leucopenia, neutropenic fever, thrombocytopenia, anemia) was significantly higher in the FE120C-arm.

Mature final 5-year-survival data will be presented at the SABCS meeting 2011.

Conclusion: Different toxicity profiles given, hematological toxicity in the FE120C group was more severe than in the E90C-D. Mature survival data will be discussed in this context.

Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr PD07-01.
Abstract A107: Income disparities in the receipt and adherence to adjuvant hormonal therapy in a cohort of young estrogen receptor-positive breast cancer cases
Authors: McDougall Jean A. , Li Christopher I.
Published: June 2012

This study aimed to investigate the relationship between income and the receipt and adherence to adjuvant hormonal therapy (AHT) in a cohort of estrogen receptor (ER)-positive, invasive breast cancer cases. Women age 20 to 45 with a first primary diagnosis of invasive breast cancer between 2004 and 2010 were identified from the Cancer Surveillance System of Western Washington and given a telephone interview to ascertain data on breast cancer risk factors, demographic characteristics, and treatment history. A total of 602 invasive ER-positive cases were available for this analysis which uses logistic regression to compare the odds of starting and discontinuing AHT, such as Tamoxifen, Letrozole, Anastrozole, or Leuprolide, by categories of annual household income adjusting for household size and age. 72% of women received any AHT and 14% of women had discontinued AHT by the time of the interview. Of those who discontinued AHT, 53% had discontinued after less than one year of starting. There were no differences in the likelihood of starting AHT by income. However, women with an income of less than $50,000 were 2.4 times more likely to report discontinuing use than women with an income of $50,000 or more (Odds ratio(OR)=2.42; 95% Confidence interval(CI)=1.32-4.41). The income disparity in the likelihood of discontinuing AHT is particularly stark when comparing women with an income of ≥$90,000 to those with an income of <$25,000 (OR=4.66; 95% CI = 1.91–11.36). The financial burden of breast cancer treatment may cause women with limited resources to discontinue AHT, putting them at greater risk of poor disease outcomes.

Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):A107.
Abstract A14: Esperanza y Vida: A community-based approach to increasing breast and cervical cancer screening for immigrant Latinas
Authors: Jandorf Lina , Thelemaque Linda , Erwin Deborah O.
Published: June 2012

As health disparities continue to plague our nation it is imperative that we find ways to reduce and eliminate this public health issue. Further, as Latinos have become the largest minority group in the United States, we must address disparities in breast and cervical cancer screening rates as well as find ways to successful reduce disparities in cancer survival. Breast cancer is the most frequently diagnosed cancer among Latinas; often diagnosed at advanced stages. The incidence rates for cervical cancer are higher than non-Latina white women. Latinas have faced many difficulties within the medical care system, including accessing health services. Patient navigation has become increasingly common as a way to increase adherence to treatment and more recently, as a method of increasing cancer screening. Esperanza y Vida was developed as an intervention to reach groups of women from diverse Latino backgrounds, as a culturally and linguistically appropriate approach to cancer education and screening. Following the educational component of the program, women were contacted 2-months later to determine their age-specific screening adherence status (mammography, clinical breast exam and/or Pap test). Women who were still non-adherent to screening were offered navigational assistance. Navigational services included assistance in locating bilingual services as well as free and/or low cost screening programs, logistical assistance, encouragement for screening and additional education about the importance of screening. All women were again contacted 8 months post the educational program. This presentation will focus on the outcomes following navigation. The sample included women who were reached for both the 2- and 8-month follow up assessments and received navigational services. We will demonstrate the success of navigation; of women who were non-adherent to mammography, 63% became adherent. Univariate predictors include where the programs were conducted (Arkansas, New York City and Western NY) and concurrent screening. For clinical breast exams, 61% of non-adherent women became adherent with significant predictors of program location, years living in the US, conducting breast self exams, and concurrent other screening. For Pap test, 59% of the women became adherent with significant predictors of program location, marital status, current screening and not being afraid of hear the results of medical exams. In multiple regression analyses, significant predictors of each screening test included adherence to the other screening exams, at the same time point. This is very encouraging, in that it appears that once we can connect women with clinical services, they are able to access other exams. Next steps include understanding why 40% of women still remained unscreened.

Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):A14.
Abstract A24: Does patient navigation improve time to diagnostic resolution of abnormal mammograms among depressed urban women?
Authors: Kronman Andrea C. , De La Cruz Ignacio I. , Freund Karen M. , Heeren Tim , Battaglia Tracy A.
Published: June 2012

Background: Depression is more common in women, lower socio-economic groups, certain racial/ethnic minorities, and is associated with higher breast cancer mortality. Patient navigation has been shown to improve access to timely cancer care in a patient-centered manner, by identifying and helping to overcome barriers to healthcare. Our objective is to determine if patient navigation improves time to diagnostic resolution after abnormal mammograms for vulnerable women who are depressed.

Methods: The Boston University Patient Navigator Research Program provided navigation for all patients who had an abnormal screening mammogram in 3 affiliated community health center (CHC) 2007–2008, with 3 CHCs serving as control sites and receiving usual care. A woman was categorized as “depressed” if depression was recorded in her medical record during the 12 months preceding the screening test abnormality. All women were followed for 12 months to determine if they completed diatnostic evaluation. Demographic characteristics of depressed and non-depressed women were compared through chi-square tests. Differences in the percent of women who did not complete diagnostic evaluation within 12 months for depressed vs. non-depressed women, and for navigated vs. control women, were tested through chi-square and described through odds ratios and 95% confidence intervals.

Results: Among 1299 women with abnormal mammograms, 17% were depressed, 12% had anxiety. Most of the women were non-White: 28% Hispanic, 35% Black, and 11% Vietnamese; English was the primary language in 58%, and less than one third had private health care insurance. Depression was positively associated with white race and Hispanic ethnicity (P < 0.01), English and Spanish language (P <0.001), older age (P =0.03), anxiety (P < 0.001), and public health insurance status (P < 0.001); and negatively associated with no insurance status (P < 0.001). Among controls, there was a suggestion that non-depressed women were more likely to complete diagnostic resolution compated to depressed women (14% vs. 8%, OR 1.95 (0.94, 4.03), p=0.072). Among depressed women, those who were navigated were significantly more likely to complete diagnostic resolution (14% vs. 5%, OR 3.24 (1.03, 12.26), p=0.046).

Depression is common in women needing diagnostic testing for abnormal cancer screening, and depressed women may particularly benefit from patient navigation.

Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):A24.
Abstract A4: Integrative genomic analysis of lung cancer: Focus on health disparities
Authors: Robles Ana I. , Mathé Ewy , Bowman Elise D. , Ryan Brid M. , Haznadar Majda , Harris Curtis C.
Published: June 2012

Racial differences in the incidence and mortality of lung cancer are well documented. Many factors are known to influence the risk and outcome of this most deadly disease, including exposure, behavior, access to health care, as well as inherent susceptibility. There is a paucity of data regarding the existence, if any, of biological differences among tumors that reflect inherent susceptibilities to known etiological factors and may contribute to some of the disparities observed among African Americans and Caucasians. Our laboratory employs a multipronged strategy to study the interaction of genetic, molecular, and etiological factors leading to lung cancer risk and survival, that encompasses mRNA and microRNA (miRNA) expression, DNA methylation, metabolomics, as well as genetic susceptibility in the form of Single Nucleotide Polymorphisms (SNPs). In this study, a cohort of sixty paired cancerous/non-cancerous lung tissues excised from stage I lung cancer patients (16 African Americans and 48 Caucasians) recruited through our longstanding Case-Control Study at University of Maryland, Baltimore, are being characterized by miRNA quantitation (Nanostring nCounter Human miRNA Expression Assay), mRNA expression profiling (Illumina HumanRef-8 v3 Expression Beadchip arrays), and methylation profiling (Illumina Infinium Human Methylation27 Beadchip arrays). When gene expression profiles on cancerous tissues from African Americans and Caucasians were compared, three genes were differentially expressed (FDR<10%), namely CRYBB2, PPIL3, and COMMD5. A similar comparison on non-cancerous tissues yielded 12 genes (FDR<10%), which included CRYBB2 and PPIL3. CRYBB2, Crystalline Beta B2, has previously been associated with prostate cancer in African Americans, and is upregulated in this sample cohort. We are currently analyzing and integrating these different data types with the purpose of finding biomarkers for lung cancer prognosis, associating DNA methylation, mRNA and miRNA abundance with clinical features of lung cancer (including race, gender, histology, and smoking), and correlating methylation, mRNA and miRNA patterns. Our goal is to delineate the most important transcriptional networks operational in lung cancer and specifically focus on those that may illuminate racial disparities associated with this disease.

Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):A4.
Abstract A50: Targeting nanotherapeutics for breast, ovarian, and prostate cancer
Authors: Olivos David John , Saunders Mary R. , Ramirez Laura , Banford Nicholas , Quattrocchi Julie-Marie , Lam Kit S.
Published: June 2012

African Americans have the highest incidence and mortality rates from cancer despite representing a minority of the population of the United States. In particular, breast and prostate cancer significantly contribute to these disproportionate rates in African American women and men respectively compared to other ethnic groups. We have developed a series of novel self-folding combinatorial libraries composed of cholic acid or cholesterol functional groups with single and branched hexamer peptide arms. Fixed hydrophobic amino acids near the N-terminus (position 5) of the peptide arms interact with the hydrophobic face of the planar cholic acid or cholesterol molecule to form 3-Dimensional compact molecules offering a variety of unique peptide sequence presentations. Receptors overexpressed on cancerous cells serve as the targets for these synthetic molecules. Screening of One-Bead One-Compound (OBOC) combinatorial libraries under stringent conditions provides a powerful approach to test hundreds of thousands to millions of compounds in one batch. Novel cholic-peptide hybrid molecules containing RGD motifs binding to vβ3 integrin were discovered against MDA-MB-231 breast cancer. An NGR motif known to target receptors up regulated in the tumor vasculature and perivascular cells were found in cholesterol-peptide protein conformation mimetics binding to A2780 chemo-resistant ovarian cancer. Targeting ligands to PC3N and LnCap prostate cancers from both cholesterol and cholic acid library sets were discovered. Based on these findings, focused libraries were constructed and screened for enhanced affinity and specificity. Candidate peptidomimetics are equipped on our novel cholic acid nanocarriers enhancing nanotherapeutic targeting, efficacy, and limiting toxicity. The reduced toxicity stemming from tumor targeting and increased efficacy from the combination of nanocarrier EPR effects and targeting ligands result in longer, more tolerable therapeutic cycles that might significantly extend the life expectancy and quality of life of breast and prostate cancer in patients, for which current treatment options are ineffective. Developing novel treatment strategies which include the selective delivery of cytotoxic agents for the treatment of cancers disproportionately afflicting minority populations may be translated for clinical development as a promising diagnostic and therapeutic tools.

Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):A50.
Abstract A52: A pilot study to examine patient awareness and provider discussion of the impact of cancer treatment on fertility in a registry-based sample of African American women with breast cancer
Authors: Christie Juliette , Pal Tuya , Quinn Gwendolyn , Fleming Patrice , Stowe Caitlin , Bower Bethanne , Vadaparampil Susan
Published: June 2012

Introduction: Although African American (AA) women are more likely to be diagnosed with early onset breast cancer (i.e., ≤ age 50) during their reproductive years, little is known about patient awareness of or provider discussion related to fertility concerns in this specific demographic group. In an effort to better understand how fertility concerns are addressed in the context of clinical care, this study seeks to document the prevalence of patient awareness and patientprovider discussion of infertility risk associated with cancer treatment in AA breast cancer patients.

Method: As part of a larger study examining the role of genetic factors in AA women with early onset breast cancer, data were collected using a cross-sectional survey. Demographic and clinical variables were compared using chisquare tests for equal proportions or exact tests between participants who: (a) did and did not indicate awareness about potential fertility loss, and (b) did and did not report discussion of potential fertility loss with their health care providers.

Results: Approximately 46% of the women in our sample (N = 48) reported awareness and 56.3% reported provider discussion of the potential impact of cancer treatment on fertility. Bivariate analyses demonstrated that awareness was significantly higher in women who were diagnosed at age ≤ 45 (p < .05), were nulliparous (p < .01), and/or did not have tubal ligation (p < .001). Provider discussion was more often reported by patients who were diagnosed in stages 2–3 (p < .05) and/or had no children (p < .01).

Nearly half of early onset AA breast cancer patients are unaware and/or report no provider discussion of the potential impact of cancer treatment on fertility. Study results underscore missed clinical opportunities to provide fertility information that may impact long-term quality of life in early onset AA breast cancer patients.

Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):A52.
Abstract A62: Secular trends and disparity of adjuvant hormone therapy use for ductal carcinoma in situ: National Cancer Database, 1998–2007
Authors: Hou Ningqi , Yao Katharine , Winchester David J. , Jaskowiak Nora , Winchester David P. , Huo Dezheng
Published: June 2012

Background: Randomized trials have shown clinical benefit for tamoxifen for patients with ductal carcinoma in situ (DCIS). We surveyed the secular trend and disparities of adjuvant hormone therapy (AHT) utilization for DCIS for the decade following dissemination of these trials.

Methods: We utilized the National Cancer Database, a joint project of the American College of Surgeons and the American Cancer Society to examine secular trends of AHT use among 1,735,160 breast cancer patients diagnosed with breast cancer during 1998–2007. Trends of AHT use were evaluated in DCIS cases, and we stratified the analysis by race/ethnicity, age of diagnosis, and estrogen receptor (ER)/progresterone receptor (PR) status. ER/PR status was available for 2004–2007 only. The general estimating equation (GEE) model with logit link was performed to assess the odds of AHT treatment as a function of the aforementioned variables, clustering on facility to account for within-group correlations.

Results: 258,593 DCIS and 1,360,235 invasive breast cancer cases were included in the analysis. The use of AHT has increased in DCIS patients over time, from 11.7% in 1998, to 23.6% in 1999, and 29.7% in 2007 despite only a 4% increase in the number of DCIS cases over the same time period. Among ER/PR-positive DCIS patients, 37.2% received AHT, whereas only 6.9% ER/PR-negative patients received AHT. Among the ER/PR-positive DCIS patients, we observed a significant disparity of AHT use by race/ethnicity in 2004, but this disparity lost significance in 2006 and 2007; 36.0% white, 31.4% black and 29.9% Hispanic patients used AHT treatment in 2004 (p=0.001), compared to 38.6% white, 37.1% black and 39.5% Hispanic patients in 2007 (p=0.4). Racial disparity also diminished in the GEE model, which removes between-facility differences. AHT use was significantly less in academic/research oriented facilities than in community hospitals (OR=0.74, 95% CI: 0.66–0.83, p<0.0001), and it also varied across facility location. In addition, AHT use varied by age of diagnosis: compared with ER/PR-positive patients at age 50–59, the OR for patients <40 years was 0.58 (95% CI: 0.52–0.65), for patients 40–49 years 0.89 (95% CI: 0.85–0.95), patients 60–69years 0.95 (95% CI:0.90-1.00), patients 70–79 years 0.72 (95% CI: 0.67–0.77), and for patients 80 years or older 0.40 (95% CI: 0.37–0.45). For ER/PR-positive patients 40–69 years old the use of AHT was 39.9%.

Conclusions: AHT utilization nearly doubled from 1998 to 1999 presumably because of the randomized trials but has only slightly increased from 1999–2007. Racial disparities in AHT use among DCIS patients disappeared from 2004 to 2007 but AHT use still varies by patient age, facility type and location.

Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):A62.
Abstract A73: Improving colorectal cancer surveys for New Mexico Hispanics
Authors: Gonzales Melissa , Otero Maria , Hoffman Richard
Published: June 2012

The goal of this research is to produce Spanish- and English-language versions of a colorectal cancer (CRC) risk factor survey that is easily answered by the three main Hispanic sub-populations in New Mexico - US-born and Mexico-born Mexican Americans and native Spanish New Mexicans. We began by conducting an in-depth review of validated surveys covering the domains of demographics, acculturation, personal and family medical history, diet, height and weight, physical activity, smoking and alcohol use. We next evaluated how New Mexico Hispanics interpret and comprehend survey questions and recall information to answer the questions. Our methodology included, in-person field interviewing of self-identified Hispanics age 40 years and older using cognitive-interviewing techniques. All interviews were conducted by a trained, bilingual interviewer. The survey was tested, revised and retested in a new group of participants who met the eligibility requirements. Three results are highlighted here. First, in a novel approach to reconstructing life histories of body mass index (BMI) and physical activity as indicators of energy balance over time, participants reconstructed their body size (height and weight for BMI estimates), work and leisure time physical activity patterns at age 15, 30, 50 years of age and during the previous year. We noted that respondents a) did not easily understand that the activity levels represented a range of physical exertion from none to vigorous, and b) felt they could not select a level if they had not done any of the example activities listed. The instructions were revised to explain the range and the description of the activity levels simplified incorporating the activities our respondents reported performing. Second, the descriptions provided in the gastrointestinal (GI) cancer and CRC screening questions were confusing. Descriptions were simplified for GI cancer risk questions (e.g. familial polypsis, history of polyps) and the CRC screening questions were replaced with modified versions of Behavioral Health Risk Factor Surveillance Survey questions. Last, a memory aide was designed to help the respondents answer the life history questions. The memory aid and revised versions of life history questions, were tested in a second round of field interviews. The memory aid was determined to be an effective method for reconstructing not only body size and activity pattern history, but also lifetime patterns of cigarette smoking and alcohol use. There is a critical need for this CRC survey in our state, where the incidence of CRC among Hispanics is equal to or higher than the incidence in non-Hispanic Whites.

Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):A73.
Abstract A75: Preexisting kidney disorders and risk of renal cell carcinoma: Results from a population-based case-control study of Caucasians and African Americans
Authors: Hofmann Jonathan N. , Schwartz Kendra , Chow Wong-Ho , Ruterbusch Julie J. , Rothman Nathaniel , Wacholder Sholom , Colt Joanne S. , Purdue Mark P.
Published: June 2012

Background: In the United States, the incidence of renal cell carcinoma (RCC) is higher among African Americans (AA) than among Caucasians. However, few studies have investigated potential risk factors that may contribute to racial disparities in RCC incidence. Established risk factors for RCC include smoking, obesity, and hypertension. Beyond these factors the etiology of RCC remains largely unknown, though previous observations suggest that patients with end-stage renal disease on long-term dialysis may be at increased risk of developing RCC.

Methods: We conducted an investigation of RCC risk in relation to pre-existing kidney disorders in a population-based case-control study of AAs and Caucasians in the metropolitan regions of Chicago and Detroit. Personal interviews were conducted to obtain information on history of kidney disorders and other covariates from 1,217 RCC cases (361 AAs and 856 Caucasians) and 1,235 controls (523 AAs and 712 Caucasians). Odds ratios (OR) and 95% confidence intervals (CI) were estimated using sample weighted unconditional logistic regression models adjusted for age, sex, race, level of education, smoking status, body mass index, history of hypertension, family history of cancer, and study center. Analyses stratified by race and time since kidney disease diagnosis were also performed.

Results: A statistically significant increased risk of RCC was observed among subjects who had been previously diagnosed with chronic renal failure (OR 4.7, 95% CI 2.2–10.1) or were on dialysis (OR 18.0, 95% CI 3.6–91.1). Stronger associations were observed among subjects who had renal failure or were on dialysis 10 or more years prior to RCC diagnosis. The association between chronic renal failure and RCC was considerably stronger among AAs than among Caucasians (ORs of 8.7 and 2.0, respectively; P-interaction=0.03). Among AAs, history of kidney stones, kidney cysts, and nephrotic syndrome were all associated with an elevated risk of RCC (OR≥2.0), though these findings were not statistically significant.

Conclusions: The results of this large population-based study suggest that chronic renal failure and dialysis may be important risk factors for RCC development in both AAs and Caucasians. Our findings of differences in risk estimates by race, to our knowledge the first such report, require replication.

Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):A75.
Abstract B29: Attitudes and beliefs of college students on biospecimen collection
Authors: Iweriebor Ebere , Murray Kate , Barnack-Tavlaris Jessica , Klonoff Elizabeth
Published: June 2012

Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):B29.
Abstract B40: micro-RNA-128 regulated gene expression in head and neck squamous cell carcinoma
Authors: Hauser Belinda , Hao Yubin , Gu Xinbin , Califano Joseph
Published: June 2012

Purpose: Each year in the United States there are more than 65,000 Americans diagnosed with head and neck cancer and 25,000 die from this disease. Head and neck squamous cell carcinoma (HNSCC) is a heterogeneous disease with complex molecular abnormalities. African Americans have an incidence approximately twice higher than Caucasian men. The overexpression of BMI1 polycomb ring finger oncogene (BMI-1) and epidermal growth factor receptor (EGFR) in HNSCC cases has been shown to be an indicator of poor prognosis and survival in HNSCC. MicroRNAs are a class of posttranslational regulators of gene expression and have been shown to regulate a number of biological processes. In this study, we investigate that mechanism of microRNA-128 (miR-128) involved the regulation of BMI-1 and EGFR gene expressions in HNSCC.

Methods: We generated stably expressing exogenous miRNA-128 in HNSCC of the Larynx (JHU-22) using lentivirus infection, performed colony formation assays to determine cell growth and proliferation, QRT-PCR to analyze gene expression, and western blot analysis to evaluate protein expression.

Results: The transfected JHU-22miR-128 cell line stably expressed exogenous miR-128 in vitro and in vivo tumor xenografts. Compared with the control vector cells, the cell growth and proliferation decreased significantly in JHU-22miR-128 cells and JHU-22miR-128 tumor xenografts. However, the level of BMI-1proteins was decreased more than EGFR in transfected JHU-22miR-128 cells.

Conclusion: miR-128 is able to significantly inhibit BMI-1protein expression, partially affects EGFR protein expression. miR-128 has a putative target site within the mRNA 3′UTR of Bmi-1 and EGFR. Therefore, miR-128 regulates the proliferative pathway in HNSCC. MiR −128 have potential to serve as a therapeutic approach to specifically target EGFR in HNSCC.

This work was supported in part by grants P20 CA118770 from National Cancer Institute.

Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):B40.
Abstract B42: A comprehensive resequence-analysis of 250kb region of 8q24 in Africans
Authors: Chung Charles C. , Boland Joseph , Boland Joseph , Chanock Stephen J. , Hsing Ann W. , Yeager Meredith , Yeboah Edward , Biritwum Richard , Tettey Yao , Adjei Andrew , De Marzo Angelo , Netto George
Published: June 2012

The centromeric region flanking the MYC oncogene on 8q24 harbors at least 5 independent loci associated with prostate cancer as well as additional loci associated with distinct cancers of the breast, colon, bladder, and chronic lymphocytic leukemia, all discovered in genome-wide association studies (GWAS). One of the regions has been defined as a 250kb span of 8q24 by linkage disequilibrium (LD) pattern and recombination hotspots (chr8:128050768-128300801, hg19) that contains prostate cancer susceptibility loci rs13254738 and rs16901979, as well as a locus rs2456449 associated with chronic lymphocytic leukemia. Because GWAS identify genetic markers, fine-mapping, based on sequence analysis is necessary to define the optimal variants for biological follow-up. Sequence analysis in distinct populations can provide important insights into the differences in patterns of LD and thus narrow down high interest variants. We have resequenced this region in samples of African ancestry using next-generation technology to comprehensively catalogue variations. Our study sample set included a total of 128 individuals from a population-based study in Ghana. In comparison to the 1000 genome data, we have identified additional variants, which could be important in establishing priorities for future functional work, designed to explain the biological basis of the association signal for both prostate cancer and chronic lymphocytic leukemia.

Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):B42.
Abstract B47: Identification of health care access factors and psychosocial correlates of cervical cancer screening among Vietnamese American women
Authors: Ma Grace X. , Fang Carolyn Y. , Gao Wanzhen , Tan Yin , Nguyen Joseph An , Feng Ziding
Published: June 2012

Background: Despite the proven survival benefits associated with cervical cancer screening, utilization of the Pap test continues to be suboptimal in certain populations. In particular, Vietnamese American women have one of the lowest rates of screening compared to other ethnic/racial subgroups in the United States (US). A greater understanding of how demographic, psychosocial, and healthcare access factors may be associated with screening behaviors in this population will inform future public health efforts to increase screening and reduce cervical cancer disparities in this population.

Objective: The objective of this study was to characterize demographic, psychosocial, and healthcare access factors that are associated with cervical cancer screening among Vietnamese women.

Methods: Vietnamese women (n=1,525) were recruited into the study from 30 Vietnamese community-based organizations located in Pennsylvania and New Jersey. Participants completed assessments of demographic background, acculturation, and health care access factors in either English or Vietnamese language. In addition, guided by Social Cognitive Theory and the Health Belief Model, participant perceptions of benefits and barriers to screening and self-efficacy in obtaining screening were also assessed.

Results: In this sample of underserved Vietnamese women, the rate of ever having had a Pap test was 53%. To examine factors associated with screening, univariate and multivariate logistical regression analyses were conducted with screening as the outcome variable. Women who were married, were born in the US, or had lived longer in the US were more likely to have obtained screening. As expected, healthcare access variables were associated with screening behavior, such that women who had insurance and had received a physician recommendation for screening were more likely to have obtained screening. With respect to psychosocial beliefs, women who believed that screening can prolong life and who were confident in their ability to get screened were more likely to have undergone screening. In contrast, women's perceived barriers (i.e. a lack of understanding regarding Pap test procedures and embarrassment) were associated with lower rates of screening.

Conclusion: These results highlight the need to address not only health care access issues, but also psychosocial perceptions that may hinder cervical cancer screening behavior in this population. Intervention programs that attend to these various system- and individual-level factors may enhance utilization of cervical cancer screening services among underserved Vietnamese women.

Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):B47.
Abstract B9: Community strategies for investigating the biology of breast and cervical cancer initiation in African-American women
Authors: Frye Endya L. , Ford Anne , Banks LaMisha , Boyce Xiomara , Robertson Stephanie , Ibarra-Drendall Catherine , Seewaldt Victoria
Published: June 2012

Background: African-American women have the highest overall cancer death rate from breast and cervical cancer and shortest survival of any racial and ethnic group in the United States. These disparities are heightened in the Southern United States. For example, the US breast cancer death rate is 23.0 (per 100,000) for Caucasian women, as compared to 34.3 for African-American women. The North Carolina breast cancer death rate is 27.2 for Caucasian women and 38.0 for African Americans; and in our study area, Durham County, the breast cancer death rate is 27.5 for Caucasians and 42.0 for African-Americans. The causes of these inequalities are complex and interrelated, but arise, at least in part, from disparities in income, education, nutrition, and access to healthcare. For complex historical reasons, African-Americans have had mixed experiences in accessing care and in the quality of care they receive. In addition, distrust has arisen within the African-American community regarding the intents and purposes of health care researchers.

Cutting edge breast imaging technology, prevention, and early detection trials exist at academic that could potentially improve early diagnosis and increase our chance of understanding the complex relationship between disparities, genetics, diet, and the environment in promoting breast cancer. Lack of access, mistrust, and community barriers all play a key role in preventing young African-American women from benefiting from state-of-the-art breast imaging and new strategies for early detection of breast and cervical cancer.

Methods and Results: To address the unacceptably high death rate among young African-American women from breast and cervical cancer, we have used a multi-disciplinary intervention that includes: 1) community Navigators, 2) access to breast and cervical cancer prevention and early detection services through free community clinics, 3) community partnered breast and cervical cancer prevention trials, and 4) opportunities for mentorship and career development. As a result, we have been able to improve access to early detection strategies in a community based setting and have provided mentorship for 27 young Minority scholars to enter medical school and graduate programs. Our community based breast MRI trial for underserved women has performed over 600 breast MRI since 2004. Over 50% of these women entered in this trial are Women-of-Color.

Conclusion: A community based strategy can be highly successful for improving early detection of breast and cervical cancer but only if there is community participation during the initiation of clinical trials and joint community-academic mentorship of young Minority Scholars.

Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):B9.
Abstract ED03-04: Using epigenetic biomarkers as prognostic and predictive markers in non-small cell lung cancer (NSCLC) and the promise of epigenetic therapy
Authors: Brock Malcolm V. , Juergens Rosalyn A. , Wrangle John , Vendetti Frank P. , Murphy Sara , Zhao Ming , Coleman Barbara , Sebree Rosa , Rodgers Kristen , Hooker Craig M. , Franco Noreli , Lee Beverly , Tsai Salina , Delgado Igor Espinoza , Rudek Michelle A. , Belinsky Steven , Herman James G. , Baylin Stephen B. , Rudin Charles M.
Published: June 2012

Epigenetic gene silencing mediated through aberrant DNA methylation and histone deacetylation is a key contributor to lung carcinogenesis. We have defined the utility of a panel of promoter region DNA methylation markers as a robust potential molecular system for re-staging stage 1 non small cell lung cancer (NSCLC) to molecular stage 3 disease. The significance of our finding is that silencing of these gene markers represents not only prognostic markers, but also these genes may serve as potential targets for a unique new epigenetic approach to re-express the silenced genes. We have just completed a phase 2 trial of epigenetic therapy in NSCLC with documented objective responses. The personalization of this therapy with epigenetic biomarkers may make it especially useful for the medically underserved.

Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):ED03-04.
Abstract PL01-02: The mechanism of Epstein-Barr virus persistent infection and the origins of associated lymphomas
Authors: Thorley-Lawson David A.
Published: June 2012

Epstein-Barr virus is a human herpesvirus that is a paradigm for understanding persistent infection. It infects >90% of the human population usually early in life and then remains for the life of the human host. This persistent infection is almost always benign but occasionally is associated with the development of cancers several of which constitute significant health problems. These include immunoblastic, Hodgkin's and Burkitt's lymphomas. We have presented a large body of evidence in support of a model, which is now generally accepted, of how EBV establishes and maintains this infection. The essence of this model is that EBV usurps the normal biology of the B lymphocyte. Specifically EBV uses a series of B cell stage specific transcription programs to first activate the newly infected B cell then drive it through a germinal center reaction (the site where B cells usually undergo affinity maturation of their immunoglobulin genes) to emerge as a latently infected resting memory B cell – the site of long term persistence. Ultimately reactivation of the virus from these cells occurs when they are triggered into terminal differentiation to become plasma cells. This infectious virus then becomes amplified through lytic infection of the epithelium at the mucosal surface prior to release into saliva – the vehicle via which the infection is spread. When the progression of newly infected cells into the memory compartment is compromised at any given stage this can give rise to EBV associated lymphoma. In this presentation I will review the model of EBV persistence, where and how it becomes dysregulated leading to lymphoma with especial focus on Burkitt's lymphoma This will include new evidence implicating viral miRNAs in the development of these tumors.

Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):PL01-02.
Abstract PL01-03: Molecular patterns of endemic, sporadic, and AIDS-related Burkitt's lymphoma: Clues to distinct biology of subtypes
Authors: Mbulaiteye Sam M.
Published: June 2012

Burkitt's lymphoma (BL) is a monoclonal B-cell non-Hodgkin lymphoma (NHL) with three clinical-epidemiological subtypes: endemic BL occurs mostly in Africa, tropical areas of Latin America, and Papua New Guinea and is linked to Epstein-Barr virus (EBV); sporadic BL occurs worldwide in children and young adults less than 20% of cases are linked to EBV; and AIDS-associated BL, which occurs in the setting of HIV infection in developed countries. Except for the later, BL is generally recognized to be a pediatric lymphoma with some cases that occur in young adults and, rarely, in the elderly. The central molecular abnormality in all subtypes is deregulation of cellular MYC gene, due to t(8;14), or infrequently, variant translocations. All subtypes are histologically indistinguishable. We have recently observed non-monotonic age-specific incidence peaks in sporadic and AIDS-related BL in the U.S., suggesting a mixture of BL with different etiologies and/or biology, and peaks during childhood, adulthood, and in the elderly. The molecular correlates of age-specific peaks of BL are not well established, but may include viral markers linked to BL (EBV and HIV) or other unknown factors. The presentation will compare and contrast age, sex, anatomic site, viral, and molecular patterns of endemic, sporadic, and AIDS-related BL and advance the hypothesis that age-related peaks may represent an alternative approach to identify BL with different etiology and/or biology.

Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):PL01-03.
Abstract PL02-02: Community-centered HBV/liver cancer control interventions for Asian Americans
Authors: Chen Moon S. , Stewart Susan L. , Bastani Roshan , Maxwell Annette E. , Dang Julie H.T. , Nguyen Tung T.
Published: June 2012

Hepatitis B virus (HBV) induced liver cancer represents the most glaring cancer health disparity facing Asian Americans. While liver cancer is relatively uncommon in the U.S., it leads all other cancer sites in the percentage increase in mortality, with dismal survival rates. The disease disproportionately affects all populations of color, but particularly Asian Americans, who experience the highest rates of liver cancer.

Community-centered interventions to control HBV/liver cancer among Asian Americans, operationally defined as organized activities to increase awareness of HBV risks among Asian Americans and the promotion of HBV screening and vaccination, include programs working in policy/advocacy, screening, and community-based controlled intervention trials.

These interventions have led to: 1) fostering the adoption of universal hepatitis B vaccination at birth, credited with averting at least 700,000 deaths annually; 2) community-based screenings that reach more than 21,000 individuals per year, catalyzing referrals for additional screening and treatment; and 3) the initiation of at least seven community-centered controlled intervention trials to increase vaccination or serological testing among Asian Americans. Despite the many advantages and accomplishments of community-centered interventions, large numbers of Asian Americans remain unaware of their HBV status and concerns exist regarding the validity of self-reported serological testing or vaccination for HBV as the measure of intervention effectiveness. In addition, in order to reduce the rate of liver cancer and other complications, there is a need to ensure continued community-centered HBV education and appropriate quality of care provided to those who have chronic hepatitis B diagnosed by screening. Greater integration of community-centered efforts with clinic-based interventions, which have complementary assets, appears to be a promising approach to reduce the unnecessary HBV/liver cancer disparities among Asian Americans as well as all populations at risk.

Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):PL02-02.
Abstract PL06-04: Patient navigation and patient satisfaction with cancer-related care
Authors: Fiscella Kevin
Published: June 2012

Patient navigation represents a promising means to address racial, ethnic, and socioeconomic disparities in cancer-related outcomes. The Patient Navigation Research Program sponsored by the National Cancer Institute and the American Cancer Society was designed to assess the impact of patient navigation on patient outcomes. Patients with breast, cervical, colorectal, or prostate cancer screening abnormalities and/or diagnosed cancer from nine sites across the country were assigned to patient navigators or to usual care. A trained patient navigator met with assigned patients, collaboratively assessed patient barriers to cancer-related care and sought to address patient barriers. Using a validated measure of patient satisfaction with cancer related care, this presentation compares scores from navigated and un-navigated patients and discusses implications of these findings.

Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):PL06-04.