bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract C127: Prevalence of human papillomavirus infection in a sample of 21- to 29-year-old women living in Puerto Rico
Authors: Leon Yaritza , Ruiz Lynnette A , Calo William A , Vadaparampil Susan T , Velez-Cintron Rosa
Published: September 2020

Human Papillomavirus (HPV) is the most common sexually transmitted infection worldwide. High-risk HPV infections are observed in women with genotypes 16 and 18, among others, and are the main risk factor for cervical cancer. Cervical cancer is the seventh most diagnosed cancer among women in Puerto Rico, and accounts for 2.5% of mortality rates. The aim of this study was to establish the prevalence of high-risk HPV, in a large cohort of women ages 21 to 29 living in Puerto Rico during 2014-2016. Method: A retrospective longitudinal analysis was performed to a sample of 5,749 HPV results that were recorded in a clinical database of Puerto Rican women ages 21 to 29 from 2014-2016. Furthermore, the prevalence of the high-risk HPV genotypes, 16 and / or 18, was ascertained along with the proportion of women who resolved the initial positive infection during the study period. Results and Conclusion: We found that among those with a positive HPV result, about one-third (35.17%) had a high-risk HPV infection. Women between the ages 21 to 23 showed the highest prevalence (40.6%) of high-risk HPV compared to the other age groups. Among all high-risk HPV, genotype 16 was the most prevalent. About a subsample of 458 women had at least two positive results of HPV infection, 217 of those women had an initial positive result for HPV and only 108 (49.7%) showed a resolution of the infection. Our study confirms there is a high prevalence of high-risk HPV in young women compared to other age groups. Discussion: Women with persistent HPV infection have a major risk factor for developing cervical cancer. There is an urgent need to develop a good prevention strategy to reduce the high-risk HPV infections, especially in the younger population, as was shown in this study. Future research is needed to assess the impact of preventive methods, such as the HPV vaccine, and the outcome in the prevalence and incidence of cervical cancer and other HPV-related cancers. Promoting education and awareness could further reduce the HPV-associated cancer burden, prevalence and incidence in this minority population.

Citation Format: Yaritza Leon, Lynnette A Ruiz, William A Calo, Susan T Vadaparampil, Rosa Velez-Cintron. Prevalence of human papillomavirus infection in a sample of 21- to 29-year-old women living in Puerto Rico [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr C127.
Abstract C130: The cultural experiences of gender and sexual minorities accessing preventative breast cancer screenings: Making medical settings more inclusive to increase uptake
Authors: Tredway Kristi
Published: September 2020

In analyzing the cultural obstacles that gender and sexual minorities (GSM), specifically gender-nonconforming women and transpeople, face when accessing preventative breast cancer screenings, I have uncovered various intersections that are in play. The primary feature for this particular study is specific female body parts, the breasts, which may or may not produce conflicted feelings for GSM. Other intersections include gender performances, sex, race, and sexuality, along with educational status and economic status (which facilitates gaining health insurance) in terms of the importance, affordability, and understanding of breast cancer screenings. This is all done with the backdrop of a terrifying and deadly disease without early detection. GSM are the most underserved within this realm of medicine, and it is my contention that there are specific cultural obstacles causing this. Recently, there has been growing evidence that gender-nonconforming women and transpeople access breast screenings less often than their counterparts (Hiestand, Horne & Levitt, 2007; Wang, Griffiths & Grande, 2017, 2018; Barefoot, Warren & Smalley, 2017; Bazzi, Whorms, King & Potter, 2015; Tabaac, Sutter, Wall & Baker, 2018); however, as of yet, there have been no large-scale analyses to determine exactly what the cultural features are that are causing obstacles for these two groups in getting breast cancer screenings. Themes have emerged from my initial interviews for this project that will guide the much larger study. The underlying cultural features specific to GSM accessing medical settings as well as these themes that have emerged from the data will be the focus of my presentation.

Citation Format: Kristi Tredway. The cultural experiences of gender and sexual minorities accessing preventative breast cancer screenings: Making medical settings more inclusive to increase uptake [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr C130.
Abstract C135: Notch as an immunologic basis of cancer disparity
Authors: Shanker Anil , Massion Pierre P , Carbone David P , Dikov Mikhail M
Published: September 2020

Identification of the host immune factors that influence naturally occurring lymphocyte responses is an important prerequisite to successfully design a successful immunotherapeutic modality. Lymphocytes, such as T-cells and NK cells differ significantly in their ability to mediate antitumor responses depending on the genetic and immunophenotypic constitution of the individuals. The major histocompatibility and the leukocyte receptor complexes are the two most polymorphic regions of the human immune genome. Individuals with increasingly diverse repertoires of MHC class-I molecules have a greater potential for their polyclonal T cells and natural killer (NK) cells to be responsive. Our work suggested that lymphocyte repertoire varies with host backgrounds and that tumor antigen-reactive activated CD8+T cells could enhance intratumoral NK cell function. Furthermore, our data indicate that by modulating the expression of hematopoietic and dendritic cell (DC) Notch ligands, tumors negatively direct lymphocyte differentiation away from their effector phenotype. In human lung tumor infiltrates, we noted a significant correlation between Notch ligand Jag1 or Jag2-expressing dendritic cells with the programmed cell death protein PD-1-expressing CD8+T-effector-memory cells (p = 0.0005). PD-1 expression in T-cells signifies their exhaustion, thus diminishing their survival and antitumor function. These differences in Notch components could underlie poor prognosis in African-Americans (AA). In the clinical trial NCT00774176, the expression of mastermind-like protein-1 that affects Notch-dependent angiogenesis correlated with COPD exacerbation in AA. Also, Notch2 N-terminal-like protein (N2N) was upregulated in various carcinomas as per the TCGA database, with increased N2N expression in AA relative to Caucasians (p = 0.0037). N2N represses the transcriptional activities of Notch2 and Notch1 intracellular domains, which we showed are important for antitumor T-cell function and memory. The comparative analysis of Caucasians and AA lung cancer patient tumor samples show appreciable ethnicity-specific differences in T-cell Notch parameters. Correspondingly, disparities in the expression of Notch components in ethnic minorities can affect antitumor lymphocyte immunity and impact cancer relapse.

Citation Format: Anil Shanker, Pierre P Massion, David P Carbone, Mikhail M Dikov. Notch as an immunologic basis of cancer disparity [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr C135.
Abstract D008: Resolving disparities in cancer patient outcomes in Trinidad and Tobago
Authors: Monroe Nalisha
Published: September 2020

The Caribbean Cancer Research Initiative (CCRI) began as a result of the alarming rates of various cancer types in the Caribbean and the lack of data and credible sources of information on the prevalence of cancer in the region. What we do know is that Trinidad and Tobago has one of the highest cancer mortality rates in the Caribbean. Some explanations for this disparity can be lack of treatment innovation, educational gaps regarding screening, shortcomings in health care administration and cultural biases. Preliminary data indicates that Trinidad has one of the highest breast cancer mortality rates in the Americas. The five year breast cancer survival rate is at approximately 30% compared to over 90% in the US. The median time to diagnostic resolution based on preliminary research is 65 days, approximately 3 times what is it in US and Canada. CCRI’s mission is to build the cancer research capacity in the Caribbean starting in Trinidad which will aid in preventing more cancers and improving patient outcomes in the Caribbean. One of the main programs of the organization is the patient navigation service which is designed to meet the needs of persons diagnosed with cancer and their family members. This service has highlighted some of the contributing factors to cancer disparities in Trinidad. Examples of these that will be featured on this poster are socioeconomic factors, cultural phenomenon, geographical factors and poor access to proper care. The Caribbean Cancer Research Initiative is committed to assist patients to overcome their barriers to gain better outcomes, which will aid in resolving disparities in cancer health in Trinidad.

Citation Format: Nalisha Monroe. Resolving disparities in cancer patient outcomes in Trinidad and Tobago [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr D008.
Abstract D065: Investigating the Interplay of monocytes in the tumor microenvironment of glioblastomas
Authors: Tayyab Maryam , Gyamfi Maame , Caponegro Michael , Tsirka Dr. Styliani-Anna (Stella)
Published: September 2020

We are members of INDUCER- Increasing Diversity in Undergraduate Cancer Biology Education & Research. Our program strives to give opportunities to experience cancer research to underrepresented students interested in the biomedical sciences. We want to help bridge the gap in medicine between Caucasians and People of Color and combat racial disparity. We utilize the GL261 cell line in the murine model to study and understand glioblastomas and their tumor microenvironment, which includes microglia and macrophages. Microglia function as macrophages of the central nervous system, play a critical role in the innate and adaptive responses to pathogens and can take on a pro-inflammatory/anti-tumorigenic (M1) or anti-inflammatory/pro-tumorigenic (M2) phenotype. Our research introduces Colony Stimulating Factor 1 Receptor (CSF1R), which is expressed by both microglia and macrophages, whose signaling is critical for their proliferation and survival. Pexidartinib is a CSF1R inhibitor drug developed by Plexxikon Inc (PLX), a pharmaceutical company. They have generated PLX3397 and PLX5622. Each drug inhibits specific kinases, for example, PLX3397 inhibits c-KIT, CSF1R, and FLT3, which are key players in tumor proliferation, while PLX5622 is a specific inhibitor that only targets CSF1R signaling. Both PLX3397 and PLX5622, provided to mice in their chow, ablate microglia in the CNS of wild type mice, without affecting peripheral macrophages. Upon discontinuation of the diet, microglia repopulate the CNS. PLX73086 is a second generation CSF1R inhibitor, and little is known about its effects on microglia and macrophages. What is known is that it should only ablate macrophages in the periphery, not affecting the CNS because it is not expected to cross the Blood Brain Barrier. Upon the discontinuation of the diet, repopulation is similarly expected. In our research, we studied the effects of PLX73086 on macrophages and microglia of the murine glioma model, after being fed the diet for 7 days and 7 days off the diet. We compared the extent of ablation and repopulation of the tissue.

Citation Format: Maryam Tayyab, Maame Gyamfi, Michael Caponegro, Dr. Styliani-Anna (Stella) Tsirka. Investigating the Interplay of monocytes in the tumor microenvironment of glioblastomas [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr D065.
Abstract D066: A prospective study on chemotherapy-induced anemia using serial hemoglobin measurement in cancer patients undergoing treatment at National Hospital Abuja, Nigeria
Authors: Aruah Simeon Chinedu , Oyesegun Rasaq , Ogbe Oche , Ezikeanyi Sampson , Aniwada Elias , Dosanjh Manjit , Wroe Laurence , Coleman Norman
Published: September 2020

Introduction: Anaemia is a common complication of myelo-suppressive chemotherapy. Severe anaemia is usually treated with red blood cell transfusion, however, mild-to-moderate anaemia are most often managed conservatively. There is no universally established benchmark for haemoglobin of patients selected for cancer chemotherapy to guide a global best practice and enhance patients treatment outcome and their quality of life. Objective: The objective of this study is to examine the change in Hb levels of cancer patients undergoing chemotherapy measuring Hb after treatment. Materials & Methods: A total of 100 voluntary patients with solid malignancies were recruited within a period of eight (8) months. Baseline demographic characteristics and type of tumours were documented. Pre-treatment Hb level was measured on the first day of consultation and repeated every 2 weeks during and after the therapy until after three consecutive Hb readings (6 weeks). Results & Analysis: All data were analysed using IBM statistical package for Social Science (SPSS) version 20. 88 of the 100 cancer patients were female. Breast 68% (68) was the commonest site of tumour. Prevalence of anaemia in the study was 72% and majority of the patients had their Hb within the range of 9.60 g/dl to 10.62 g/dl at the end of their treatment. At P-value >0.05 and standard deviation there was no statistical significance on distribution of mean haemoglobin values, were independent of sex and type of treatment. Conclusion and Recommendation: Our results show that chemotherapy has no significant effect on Hb level between 11 g/dl to 12 g/dl. Prevalence of anaemia in the cohort of patients was 72%. We recommend a benchmark minimum of Hb of 11 g/dl for all patients being selected for chemotherapy in Nigeria.

Citation Format: Simeon Chinedu Aruah, Rasaq Oyesegun, Oche Ogbe, Sampson Ezikeanyi, Elias Aniwada, Manjit Dosanjh, Laurence Wroe, Norman Coleman. A prospective study on chemotherapy-induced anemia using serial hemoglobin measurement in cancer patients undergoing treatment at National Hospital Abuja, Nigeria [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr D066.
Abstract D077: Sociodemographic and geographic disparities in treatment for early-stage non-small cell lung cancer (NSCLC) patients in California
Authors: Obrochta Chelsea A , Nara Atsushi , Murphy James , Thompson Caroline A
Published: September 2020

Background: Lung cancer is the second most commonly diagnosed cancer and the leading cause of cancer-related death in the U.S. In 2013, the U.S. Preventive Services Task Force began recommending lung cancer screening, which has resulted in earlier stage diagnosis for many tobacco users. The National Comprehensive Cancer Network (NCCN) provides evidence-based cancer treatment recommendations. Evidence suggests that a patient’s receipt of guideline-concordant treatment (GCT) increases survival, especially for screen-detected, earlier stage cancers. The objective of this study is to describe receipt of timely GCT in California NSCLC patients by sociodemographic characteristics and geography. Methods: We studied 23,080 patients diagnosed with stage I/II NSCLC (2006-2015) in the California Cancer Registry. We classified treatment received as: undertreated, GCT, or over-treated according to NCCN guidelines, and timeliness (treatment began ≤ 45 days after diagnosis) among patients who received GCT. We describe the population according to treatment received, and timeliness by detailed race/ethnicity, stage of diagnosis, sex, age, insurance type, marital status, cancer approved program, and neighborhood socioeconomic status. We calculated absolute and relative inequalities in GCT and timeliness between race/ethnic groups. Hotspot analyses were conducted to identify regions at increased risk for under-treatment/overtreatment, and treatment delay by patient residential census tract. Results: Overall, 69.95% of patients received GCT, 14.53% were undertreated and 15.55% over-treated. Among patients who received GCT, 56.78% began treatment within 45 days of diagnosis. Under-treatment and treatment delay were more frequent in patients who were black or Hispanic, had public insurance, and were of lower socioeconomic status. We detected moderate absolute inequalities in receipt of GCT and timely care; no relative inequalities were observed. Cold and hot spots for under- and over-treatment and timeliness were identified within Metropolitan areas across California. Conclusion: Under-treatment and delayed treatment for early stage lung cancer disproportionately affect priority populations. With rising numbers of early stage lung cancers due to screening smokers, administration of timely proper treatment of lung cancer is critical.

Citation Format: Chelsea A Obrochta, Atsushi Nara, James Murphy, Caroline A Thompson. Sociodemographic and geographic disparities in treatment for early-stage non-small cell lung cancer (NSCLC) patients in California [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr D077.
Abstract D085: Differences in the use of proton beam therapy among patients diagnosed with American Society for Radiation Oncology Group 1 proton beam therapy indication cancer types in the United States
Authors: Sineshaw Helmneh M. , Yabroff K. Robin , Jemal Ahmedin , Nogueira Leticia M. , Efstathiou Jason A.
Published: September 2020

Purpose: To examine the extent of racial/ethnic and geographic differences in the use of proton beam therapy (PBT) among newly diagnosed cancer patients in the United States. Methods: We included all patients diagnosed from 2009 to 2016 with invasive single or first primary cancer categorized as Group 1 indication (recommended) for PBT by the American Society for Radiation Oncology. We conducted descriptive and multivariable multinomial logistic regression analyses to assess patient and facility characteristics associated with receipt of PBT. Results: Of the total 246,932 patients diagnosed with Group 1 indication cancer types, 0.6% received PBT. PBT use was lower in non-Hispanic (NH) blacks compared with NH whites (0.3% vs 0.6%). Patients who were older, uninsured, with low median income, higher comorbidity score, treated at low volume or community programs or at facilities located in the south, and residing in rural areas had the lowest PBT use. There was a 46% relative difference in PBT use between NH blacks and NH whites, with marked variation by geographic region of facility. NH black had 37% lower odds of receiving PBT compared with NH whites (odds ratio, 0.63; 95% confidence interval, 0.50-0.79), which became nonsignificant after accounting for difference in cancer type. Further, minority race/ethnicity, older age, high comorbidity score, uninsurance/non-private insurance, treatment out of NCI-designated center, and treatment out of facilities in the northeast region were significantly associated with lower odds of PBT use versus no radiation treatment. Conclusions: Despite very low overall PBT use in the United States, there were marked differences in PBT use among patients diagnosed with Group 1 indication cancer types by race/ethnicity and geographic region of treatment facility.

Citation Format: Helmneh M. Sineshaw, K. Robin Yabroff, Ahmedin Jemal, Leticia M. Nogueira, Jason A. Efstathiou. Differences in the use of proton beam therapy among patients diagnosed with American Society for Radiation Oncology Group 1 proton beam therapy indication cancer types in the United States [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr D085.
Abstract D087: Racial/ethnic differences in ovarian cancer incidence and mortality among adult women in the United States, 2001-2016
Authors: Guo Fangjian , Berenson Abbey B. , Kuo Yong-Fang
Published: September 2020

Background: Ovarian cancer is the fifth most common cause of cancer death among US women. Assessing racial/ethnic differences in ovarian cancer incidence and mortality will provide important information regarding improving efforts of prevention, early detection, and treatment in population groups that need to be targeted. Methods: We included adult women diagnosed with ovarian cancer ≥ ages 20 from the National Program for Cancer Registries and Surveillance, Epidemiology, and End Results Incidence Incidence–-U.S. Cancer Statistics 2001–2016 database. Incidence of ovarian cancer was age- adjusted to the U.S. standard population. Joinpoint analyses were used to assess incidence trend and calculate annual percentage change (APC). Hazard ratios (HRs) and 95% CIs were estimated from the Cox proportional hazard models for comparing differences in 5-year survival probability across races/ethnicities, after controlling for age at diagnosis and county of residence. Results: Among adult women ≥ 20 years old, ovarian cancer incidence decreased among Hispanics, non-Hispanic Whites, and non-Hispanic Blacks, from 9.4 per 100,000 in 2001 to 6.9 per 100,000 in 2016 (APC -1.8, 95% confidence interval (CI) -2.2 - -1.5) in Hispanics, from 11.0 per 100,000 in 2001 to 7.6 per 100,000 in 2016 (APC -2.1, 95% CI -2.3 - -1.9) in non-Hispanic Whites, and from 8.0 per 100,000 in 2001 to 6.6 per 100,000 in 2016 (APC -1.3, 95% CI -1.6 - -1.0) in non-Hispanic Blacks. No joinpoints were found among those racial/ethnic groups. Among ovarian cancer patients, observed 5-year ovarian-cancer-specific survival was 51.6% (95% CI 50.4%-52.8%) in Hispanics, 44.7% (95% CI 44.2%-45.1%) in non-Hispanic Whites, and 37.4% (95% CI 36.1%-38.8%) in non-Hispanic Blacks (HR for dying from ovarian cancer, Whites vs. Blacks 0.68, 95% CI 0.66-0.71; Hispanics vs. Blacks 0.73, 95% CI 0.69-0.76). Similar patterns were also observed for 5-year overall survival and 5-year relative survival among adult ovarian patients. Conclusions: Ovarian cancer incidence decreased across all three racial/ethnic groups from 2001 to 2016. Although Non-Hispanic Blacks had the lowest ovarian cancer incidence, they had the lowest survival rate. More efforts are needed to focus on this underserved population to target early detection and treatment of ovarian cancer.

Citation Format: Fangjian Guo, Abbey B. Berenson, Yong-Fang Kuo. Racial/ethnic differences in ovarian cancer incidence and mortality among adult women in the United States, 2001-2016 [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr D087.
Abstract D113: Socioeconomic disparities underlie outcomes in patients with pancreatic neuroendocrine tumors
Authors: Underwood Patrick W , Riner Andrea N , Maduka Michael U , Reddy Sushanth , Rose J. Bart , Trevino Jose G
Published: September 2020

Background Disparities are known to underlie outcomes in pancreatic ductal adenocarcinoma (PDAC). Pancreatic neuroendocrine tumors (PNET) represent a rare yet deadly form of pancreatic cancer. Health disparities have not been well described in this patient population. We hypothesize that given the significant health disparities in PDAC, cancer health disparities exist in patients with PNETs. Methods Patients treated for PNETs were identified in a National Cancer Database (NCDB) Patient User File for the years 2004-2015. Kaplan-Meier analysis was performed to assess survival. Cox proportional hazards models were used to assess the effect of clinical and socioeconomic factors on survival. Results Review of the NCDB found 19,752 reported cases of PNETs. Of those, 15,589 (78.9%) were non-Hispanic white (NHW), 2,462 (12.5%) were black (B), and 1,710 (8.6%) were Hispanic, white (H). On univariate analysis, greater age, male sex, higher Charlson comorbidity score, higher disease stage, lack of insurance, decreased median household income in area of residence, and no surgery were associated with worse survival (p< 0.05). While not statistically significant and unlike pancreatic adenocarcinoma, black patients had greater median survival (89.6 months; 95% CI 77.9-101.196) compared to NHW (76.4 months; 95% CI 72.9-79.8) and H (80.1 months; 95%CI 70.7-89.5) patients. On multivariate analysis, the same factors from the univariate analysis were associated with worsened survival (p< 0.05). Sub-analyses of patients who received surgery and those who did not again showed no significant difference in survival based on race. Conclusion While insurance status, median income in area of residence, and sex were associated with clinical outcomes in PNETs, race was not a contributing factor. This is in contrast to literature in PDAC which has demonstrated that black patients have worse survival. The reasons for this difference are unclear, but may biologically driven. It is important to understand disparities from different types of pancreatic tumors. Further work to understand biologic contributions to health inequities are needed.

Citation Format: Patrick W Underwood, Andrea N Riner, Michael U Maduka, Sushanth Reddy, J. Bart Rose, Jose G Trevino. Socioeconomic disparities underlie outcomes in patients with pancreatic neuroendocrine tumors [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr D113.
Abstract D130: The importance of closing the gap in cancer disparities
Authors: Alexander Kimberly
Published: September 2020

My poster will outline the current state of cancer/multiple myeloma disparities and why it is important to close the gap.

Citation Format: Kimberly Alexander. The importance of closing the gap in cancer disparities [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr D130.
Abstract D135: Early low-dose lung cancer screening education
Authors: Reese David R
Published: September 2020

Research results of the Terminate Lung Cancer (TLC) low dose CT early lung cancer screening and detection campaign in three regional study groups in rural East Kentucky. Results include the identification of effective field-tested communication protocols for lung cancer prevention, screening and detection with rural Appalachian population that included many hard to engage participants.

Citation Format: David R Reese. Early low-dose lung cancer screening education [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr D135.
Abstract IA05: Sexual orientation, race/ethnicity, and human papillomavirus vaccination disparities among young U.S. women: An intersectional approach
Authors: Agénor Madina
Published: September 2020

Introduction: Human papillomavirus (HPV) vaccination, which is recommended for U.S. women and girls aged 11–26 years, effectively prevents cervical cancer. Researchers have identified HPV vaccination disparities among groups of women and girls defined in relation to sexual orientation identity or race/ethnicity. However, no study has used an intersectional approach to ascertain HPV vaccine uptake among sexual orientation identity and racial/ethnic subgroups of U.S. women and girls.

Methods: Using 2011–2015 National Survey of Family Growth data, we used multivariable logistic regression to estimate differences in the odds of HPV vaccination initiation (i.e., > one dose) across sexual orientation identity and racial/ethnic subgroups of black and white U.S. women aged 15–24 years (N = 2,413), adjusting for demographic factors. We also assessed whether socioeconomic and health care factors helped explain observed disparities.

Results: The overall prevalence of HPV vaccination initiation was 47.7%. Compared to white heterosexual women, black lesbians (odds ratio [OR] = 0.16; 95% confidence interval [95% CI]: 0.06, 0.46) had the lowest adjusted odds of HPV vaccination initiation, followed by white lesbians (OR = 0.33; 95% CI: 0.13, 0.82) and black heterosexual women (OR = 0.63; 0.47, 0.85). Including socioeconomic factors in the model only slightly attenuated the HPV vaccination initiation odds ratios for black lesbians (OR = 0.19; 95% CI: 0.06, 0.56), white lesbians (OR = 0.37; 95% CI: 0.15, 0.90), and black heterosexual women (OR = 0.70; 95% CI: 0.52, 0.93) compared to white heterosexual women. Adding health care factors only slightly additionally attenuated the odds ratio comparing black lesbians and white heterosexual women (OR = 0.21; 95% CI: 0.07, 0.67).

Conclusions: Our findings identified black lesbians as a particularly underserved subgroup and suggest that sexual orientation identity and race/ethnicity may have a compounding effect on HPV vaccination initiation among black and white U.S. women and girls. Evidence-based interventions that are adapted to the specific needs and experiences of black lesbians and other multiply marginalized groups are needed to promote equity in HPV-related outcomes.

Citation Format: Madina Agénor. Sexual orientation, race/ethnicity, and human papillomavirus vaccination disparities among young U.S. women: An intersectional approach [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr IA05.
Abstract IA06: What do we know about sexual minorities and cancer and where do we go from here?
Authors: Boehmer Ulrike
Published: September 2020

Lesbian, gay, bisexual, and individuals with same-sex partners are defined as sexual minority individuals and have been recognized as an underserved population. By reviewing key findings from population-based studies of sexual minority and heterosexual cancer survivors, we can determine characteristics of sexual minorities with cancer that are consistent across existing studies. Moreover, existing studies allow for the identification of potential mechanisms for consideration in interventions and to move towards development of tailored programs and interventions that improve sexual minority survivors’ well-being. At the same time, it is important to describe gaps in knowledge about sexual minorities and cancer to direct future research needs to more fully understand sexual minority cancer survivorship.

Citation Format: Ulrike Boehmer. What do we know about sexual minorities and cancer and where do we go from here? [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr IA06.
Abstract IA12: Border Health Consortium of the Californias
Authors: Quijada Prisci
Published: September 2020

San Diego County is a minority-majority region, in which non-Hispanic whites are not the majority population (46%). Hispanics comprise 33.5% of the population and Asian Pacific Islanders (APIs) make up 12.8%. For risk factor burden, data based on California Health Interview Survey and Behavioral Risk Factor Surveillance System show that Hispanics in San Diego County have the lowest colorectal, breast, and cervix cancer screening rates, the highest obesity prevalence, and the highest proportion of no physical activity. The mission of the Border Health Consortium of the Californias-Binational Cancer Work Group is to promote cancer-free lives and erase borders in our region. We will identify and characterize priority cancer topics for our border region, organize along the cancer control continuum, identify key border region cancer activities and resources (binational), and identify key border region cancer needs (binational). To reach our objectives we will optimize collaboration, coordination, and cooperation.

Citation Format: Prisci Quijada. Border Health Consortium of the Californias [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr IA12.
Abstract IA26: Breast tumor microenvironment in black women: A distinct signature of CD8+ T-cell exhaustion
Authors: Yao Song , Cheng Ting-Yuan , Elkhanany Ahmed , Yan Li , Omilian Angela , Abrams Scott I. , Evans Sharon , Hong Chi-Chen , Qi Qianya , Davis Warren , Liu Song , Bandera Elisa V. , Odunsi Kunle , Takabe Kazuaki , Khoury Thaer , Ambrosone Christine B.
Published: September 2020

Background: Blacks tend to have a stronger inflammatory immune response than Whites. We hypothesized that racial differences in host immunity also manifest in the tumor microenvironment (TME), constituting part of a distinct tumor biology underlying more aggressive breast cancer and higher mortality in Black women.

Patients and Methods: Pathologic and gene expression profiling approaches were used for comprehensively characterizing infiltrating immune cells in breast TME from 1,315 patients from the Women’s Circle of Health Study (WCHS). Racial differences in tumor immune phenotypes were compared, with results validated in data from The Cancer Genome Atlas (TCGA). Prognostic associations of immune phenotypes were assessed in WCHS, TCGA and Molecular Taxonomy of Breast Cancer International Consortium (METABRIC) cohorts.

Results: We found marked and consistent differences in tumor immune responses between Black and White patients. Not only did tumors from Blacks display a stronger overall immune presence, but the composition and quality of immune infiltrates differed, independent of tumor subtypes. Black patients had a stronger humoral immunity response, and further, a more exhausted CD8+ T-cell profile featuring the coexpression of PD-1, LAG3, and CTLA4. A signature indicating a higher ratio of exhausted CD8+ T cells to total CD8+ T cells (ExCD8-r) was consistently associated with poorer survival, particularly among hormone receptor-positive patients. Combinations of the absolute fraction of CD8+ T cells and ExCD8-r signature identified the CD8-low/ExCD8-r-high subgroup, the most prevalent among Blacks, as having the worst survival.

Conclusions: Our findings of a distinct exhausted CD8+ T-cell signature in Black breast cancer patients indicates an immunobiologic basis for their more aggressive disease, and also a rationale for the use of immune checkpoint inhibitors targeting the exhaustion phenotype.

Citation Format: Song Yao, Ting-Yuan Cheng, Ahmed Elkhanany, Li Yan, Angela Omilian, Scott I. Abrams, Sharon Evans, Chi-Chen Hong, Qianya Qi, Warren Davis, Song Liu, Elisa V. Bandera, Kunle Odunsi, Kazuaki Takabe, Thaer Khoury, Christine B. Ambrosone. Breast tumor microenvironment in black women: A distinct signature of CD8+ T-cell exhaustion [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr IA26.
Abstract IA30: Population-level problems require system level solutions: Using collective impact approaches to solving cancer disparities
Authors: Rhoads Kim F.
Published: September 2020

Disparities in cancer incidence and mortality are longstanding and tenacious. The disproportionate burden of disease is borne by racial/ethnic minority groups, as well as those living in economically depressed conditions, regardless of race/ethnicity. Although there is no physiologic or genetic link between some of these disparate populations, the similarities in the experience of cancer outcomes suggests that they may be driven by socioeconomic conditions and inequities that underpin the US health care system. Despite the multilevel nature of the drivers of disparate outcomes, public health facing solutions have largely focused on interventions aiming to change individual level health behaviors, such as risk reduction, increasing screening, and early detection. Historically, much less attention and intervention have been directed toward addressing systemic factors, either inside or outside of the health care system, that contribute. Accordingly, gaps in cancer survival have persisted over time, and in some cases those gaps have widened. More recent discourse on cancer and other health disparities has emphasized the importance of the Social Determinants of Health (SDOH); in doing so have made clear the necessity for a multilevel, multisectoral approach to eliminate these differences. “Collective impact” is one such approach. Collective impact is defined as the commitment of a group of key actors from different sectors to a common agenda for solving a specific social problem. The five conditions of a collective impact approaches include a common agenda, shared measurement systems, mutually reinforcing activities; continuous communication, and backbone support organizations. This presentation will review some successes and lessons learned from well-established collective impact activities addressing noncancer conditions at our institution. We will then explore the establishment of a collective impact approach to addressing the burden of cancer in San Francisco and other surrounding counties. We will emphasize early successes in both big “P” as well as small “p” policy realms and highlight the role of the Comprehensive Cancer Centers in supporting system-level solutions to this longstanding population-level challenge.

Citation Format: Kim F. Rhoads. Population-level problems require system level solutions: Using collective impact approaches to solving cancer disparities [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr IA30.
Abstract IA34: The impact of ancestry on mutational signatures in population with African ancestry
Authors: Polak Paz
Published: September 2020

Mutational processes generate variations in DNA that fuel tumor devolvement. These processes include DNA damage due to exposure to environmental carcinogens and DNA repair. Different processes may lead to varying rates and types of mutations in cancers. Mutational processes can be inferred from whole-exome sequencing data using a computational method called mutational signatures framework. Sequencing tumors across populations can reveal population-specific signatures that can be mapped to specific environmental exposures or genetics. Knowing how mutational processes lead to tumor formation is key to understating the etiology of cancer. We analyzed The Cancer Genome Atlas data and discovered a mutational signature characteristic of homologous recombination deficiency (HRD). We found that this HRD signature was mainly attributed to germline mutations in BRCA1/BRCA2 in whites and promoter methylation of BRCA1/RAD51C in patients of African ancestry. Patients with BRCA mutation will likely benefit from cisplatin inhibitors in both neoadjvant and at time of recurrence. Clinical trials suggest TNBC patients with methylation of BRCA1 are less likely to benefit from cisplatin at the time of recurrence. Hence our initial observation might indicate that black TNBC patients might benefit from other treatment strategies.

Citation Format: Paz Polak. The impact of ancestry on mutational signatures in population with African ancestry [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr IA34.
Abstract PR15: Intratumoral heterogeneity in Latino gastric adenocarcinomas
Authors: Toal Ted , Echeverry Guadalupe P. , Sahasrabudhe Ruta , Bohorquez Mabel , Torres Javier , Urayama Shiro , Kirane Amanda , Echeverry Magdalena , Carmona Luis G. Carvajal
Published: September 2020

The goal of this study was to examine gastric (stomach) cancer mutational intratumoral heterogeneity (ITH) in Latinos using multiregion sequencing (MSEQ). Gastric cancer is the 2nd leading cause of cancer-related death worldwide. It is diagnosed in 25,000 Americans each year, with Latinos twice as likely to succumb as Whites. Treatment is currently limited to a few molecularly guided therapies, but TCGA data show that 70% of GC patients have a mutation in a gene targetable with existing drugs. Significant ITH has been identified in a variety of tumor types to date, although a GC study has yet to be published. ITH is an important consideration for personalized therapy. Driver gene mutations are frequently found to be nonclonal, a crucial factor when assessing effective druggability. In this study, two to five tumor biopsies and adjacent normal tissue were obtained from 33 Latino patients, totaling 120 tumor (T) biopsies and 33 normal (N) samples. DNA was extracted from the tissues and the coding regions of 762 cancer-related genes were sequenced using Agilent target enrichment and Illumina sequencing. For each biopsy, estimates were made of sample purity and ploidy, somatic mutations were called using joint analysis of all T and N sequence data for each patient, cancer cell fraction (CCF) was estimated for each mutation, and copy number variation (CNV) was called across the genome. Somatic mutations and copy number changes were analyzed for clonality in each patient. We found a high degree of heterogeneity, both intratumoral and interpatient, with the fraction of functional somatic mutations that are clonal ranging from 0 to 68%, the fraction private to one biopsy ranging from 32% to 100%, and the fraction shared between multiple but not all biopsies ranging from 0 to 42%. For 10 of the 33 samples there was at least one gene, containing a clonal functional mutation, for which there is an FDA-approved targeted therapy. In summary, our study is the first to assess ITH in GC. Our results are important to understand the genetic diversity and clonal architecture of these tumors and to improve molecular diagnostics.

This abstract is also being presented as Poster D107.

Citation Format: Ted Toal, Guadalupe P. Echeverry, Ruta Sahasrabudhe, Mabel Bohorquez, Javier Torres, Shiro Urayama, Amanda Kirane, Magdalena Echeverry, Luis G. Carvajal Carmona. Intratumoral heterogeneity in Latino gastric adenocarcinomas [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr PR15.
How Drosophila Can Inform the Emerging Paradigm of the Role of Antioxidants in Cancer
Authors: Saucedo Leslie J. , Triolo Rosalie E. , Segar Kate E.
Published: September 2020

Drosophila melanogaster has proven to be an effective model system in uncovering both genetic and cellular contributions to human cancer. Many elusive genes and signaling pathways that control oncogenic growth were first identified using flies. In many cases, these discoveries were not driven by a direct search for novel genes involved in cancer but rather stemmed from research programs to uncover mechanisms that control growth and development. However, the bounty of genetic tools and the shared evolution of multicellular organisms places Drosophila in a powerful position to purposefully elucidate observations seen in human cancers. In the past decade, the role of antioxidants in cancer progression has shifted dramatically. This review highlights major findings driving this change in perspective and underscores an array of existing work and resources in laboratories using Drosophila that can make significant contributions to how the redox environment affects cancer progression.
Abstract A01: YAP1 drives ependymoma-like tumor formation in the brain
Authors: Eder Noreen , Dolmart Marie-Charlotte , Claxton Suzanne , Cotton Jennifer , Mao Jun-Hao , Snijders Bram , Roncaroli Federico , Thompson Barry , Ultanir Sila
Published: September 2020

Ependymoma is the third most common pediatric brain cancer. YAP1 gene fusions have been observed in a subset of pediatric ependymomas. Here we show that increased YAP1 activity has a causative role in ependymoma-like tumor formation. YAP1 protein is strongly expressed and localized in the nucleus in a subset of human ependymomas. In the developing brain, YAP1 expression is normally found in subventricular zone neural progenitor cells, and NEX/NeuroD6-Cre induced conditional expression of active nuclear YAP1 (YAP1-5SAnls) is sufficient to drive brain tumor formation. YAP1 drives tumor formation by maintaining a nestin positive neural stem cell-like specification and preventing hippocampal neuronal differentiation. Dual conditional deletion of LATS1 and LATS2 kinases in the NEX-Cre lineage also generates similar tumors. Genetic rescue experiments in mice show that either YAP1 or its homolog TAZ can drive tumor formation downstream of LATS1/2 kinases. YAP1/TAZ activity causes tumors that display histologic and molecular characteristics of ependymoma, including ultrastructural features microvilli and tight junctions. Our results show that disruption of YAP1/TAZ activity in neuronal precursor cells leads to ependymoma-like tumors.

Citation Format: Noreen Eder, Marie-Charlotte Dolmart, Suzanne Claxton, Jennifer Cotton, Jun-Hao Mao, Bram Snijders, Federico Roncaroli, Barry Thompson, Sila Ultanir. YAP1 drives ependymoma-like tumor formation in the brain [abstract]. In: Proceedings of the AACR Special Conference on the Hippo Pathway: Signaling, Cancer, and Beyond; 2019 May 8-11; San Diego, CA. Philadelphia (PA): AACR; Mol Cancer Res 2020;18(8_Suppl):Abstract nr A01.