bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract A118: Barriers and facilitators to cervical cancer screening among older Hispanic women living in San Antonio, TX
Authors: Vázquez-Otero Coralia , Cordova Audrey , Pedraza Rita , Baglini Selena , Ramírez Amelie G.
Published: September 2024

Background: Disparities among Hispanic women getting screened for cervical cancer compared to non-Hispanic White women continue to exist, despite Hispanic women having higher incidence and mortality rates of cervical cancer. Previous work has shown limited knowledge and awareness about cervical cancer and screening, low health literacy, and cultural aspects such as fatalism as barriers to screening. On the other hand, having health insurance, a family history of cervical cancer and religiosity have been found to facilitate cervical cancer screening among Hispanic women. Moreover, in Texas, research has shown that women older than 50 and Hispanic women have lower rates of screening. Methods: Informed by the social determinants of health framework, we are interviewing Hispanic women living in San Antonio, TX about their experiences regarding cervical cancer screening. Questions cover the areas of knowledge about cervical cancer and cervical cancer screening, and barriers and facilitators to cervical cancer screening. We have completed 11 out of 36 planned interviews. Data analysis is guided by applied thematic analysis techniques. Preliminary Results: Currently, ages range from 50 to 64 years old. Most women are married and half are retired. Preliminary analysis shows continued low levels of knowledge about cervical cancer and screening. Barriers include feelings of fear and embarrassment about the test, physician’s gender, and access to healthcare, such as issues with transportation. Facilitators include physician’s attitude, clinic reminders, and having health insurance. Conclusion: More research is needed to understand and address barriers and facilitators to cervical cancer screening in this age group. Targeted public health efforts, including educational and multilevel interventions, should continue to increase knowledge about cervical cancer, and acceptability and access to cervical cancer screening among older Hispanic women living in San Antonio, TX.

Citation Format: Coralia Vázquez-Otero, Audrey Cordova, Rita Pedraza, Selena Baglini, Amelie G. Ramírez. Barriers and facilitators to cervical cancer screening among older Hispanic women living in San Antonio, TX [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A118.
Abstract A156: Cervical cancer knowledge and attitudes towards self-sampling and community health worker-delivered screening services across racial groups in Indiana
Authors: Babu Mrithula Suresh , Kasting Monica L , Rodriguez Natalia M.
Published: September 2024

Introduction – In Indiana, Black women had 12 percent higher cervical cancer incidence and 21 percent higher mortality compared to White women during the years 2008 to 2017. HPV self- sampling delivered by community health workers (CHW) could increase cervical cancer screening rates among at-risk populations. This study aims to compare cervical cancer knowledge, screening practices and attitudes towards HPV self-sampling and CHW-delivered screening services across racial groups. Methods – We conducted a cross-sectional online survey among patients from three Planned Parenthood clinics in Lake County, IN, which has one of the highest cervical cancer mortality rates in Indiana. A comparative analysis across racial groups based on their willingness to self-sample, receive health education and other services from CHWs was conducted using logistic regression analyses. Results – In the final sample (N=140), the largest proportions were below age 30 (54.3%), aware of cervical cancer (78.6%), up-to-date on cervical cancer screening (84.3%), had no prior self-sampling experience (53.6%) and were aware of CHWs (52.1%). The Black (M=3.97, SD=1.94) population had a lower mean score for cervical cancer knowledge compared to the White population (M=4.67, SD=2.01). Multivariable logistic regression analyses showed Black patients had higher odds of being willing to self-sample at home (aOR=3.749, 95%CI=1.619-8.681), to receive health education from CHWs (aOR=4.952, 95%CI=2.124-11.548) and to receive health services from CHWs (aOR=3.305, 95%CI=1.479-7.388) compared to White patients. Patients with higher knowledge (aOR=1.245, 95%CI=1.009-1.535) and patients overdue for screening (aOR=3.674, 95%CI=1.077-12.538) had higher odds of being willing to self-sample at home. Conclusion – The results showed Black patients had lower cervical cancer knowledge but higher acceptability of HPV self-sampling and CHW delivery of cervical cancer screening services. Study findings can be used to inform future CHW-led interventions for outreach, education, and delivery of self-sampling interventions to increase cervical cancer screening rates among Black women.

Citation Format: Mrithula Suresh Babu, Monica L Kasting, Natalia M. Rodriguez. Cervical cancer knowledge and attitudes towards self-sampling and community health worker-delivered screening services across racial groups in Indiana [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A156.
Abstract A162: The influence of parental barriers to healthcare on adolescent HPV vaccination uptake and completion among Latinos in Los Angeles
Authors: Kane Anju F. , Baezconde-Garbanati Lourdes
Published: September 2024

Objective: This study aims to investigate the association between parental barriers to healthcare access and HPV vaccination uptake among Latino adolescents in Los Angeles. Background: Human papillomavirus (HPV) induced cervical cancer (CC) remains a significant public health concern. Routine HPV vaccination has been recommended in the United States for girls since 2006 and boys since 2011 yet disparities in vaccine initiation and completion persist, particularly among Latino adolescents in Los Angeles. Methods: This cross-sectional study analyzed child data provided by mothers recruited from the Es Tiempo campaign (2016-2018). A total of 353 Latino adolescents aged 9 to 26 years were included in the sample. We used crosstabs to assess vaccine initiation and completion differences by child sex and birth order, while logistic regression models were used to evaluate the association between parental barriers to healthcare, such as lack of health insurance and access to a primary care provider (PCP), and HPV vaccination initiation. Results: Among the sample, 44% initiated the HPV vaccine, and 23% completed the series, with significantly higher rates among girls and firstborn children. Regarding barriers, lack of health insurance was associated with decreased odds of HPV vaccination uptake while access to a PCP showed a slight increase in vaccination uptake odds. Conclusion: HPV vaccination uptake among Latino adolescents in Los Angeles remains suboptimal, with disparities observed by gender and birth order. To improve public health outcomes, targeted interventions are needed to increase HPV vaccination uptake among Latino adolescent boys, and further research is needed to understand vaccine adherence patterns within families and among siblings. Moreover, while parental barriers to healthcare may influence vaccination uptake, future studies should also explore how factors like parental education level and socioeconomic status influence HPV vaccination status in combination with access barriers.

Citation Format: Anju F. Kane, Lourdes Baezconde-Garbanati. The influence of parental barriers to healthcare on adolescent HPV vaccination uptake and completion among Latinos in Los Angeles [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A162.
Abstract B010: Design of personalized neoantigen mRNA vaccines against breast cancer patients in Pakistan based on next-generation sequencing data
Authors: Raheem Kayode Yomi , Muddassar Muhammad
Published: September 2024

Breast cancer is the most common malignancy among women in Pakistan, with an outrageous increase in the incidence and mortality rate. Because of decreased effectiveness and lower survival rates, there is an urgent need for developing novel, personalized vaccines with enhanced activity. The development of a personalized mRNA vaccine illustrates a promising approach to combating the prevalence of breast cancer. We used the whole exome sequencing (WES) data of Pakistani tumor samples to predict immunogenic neoantigens. The WES data was aligned to the GRCM39 reference genome using BWA. The genome analysis toolkit (GATK) was employed for variant calling to identify somatic mutations. Using immune-bioinformatics tools, we predicted cytotoxic CD8+ T cell epitopes and helper CD4+ T cell epitopes within the identified neoantigens and designed vaccines by assembling the fusion of CTL neoepitopes, helper sequences, and adjuvants together with linkers. The Insilco ImmSim algorithm was used to examine the immune responses of the vaccine. The vaccine design was further explored by checking its simulation effect on the immune system, its physiochemical characteristics, its binding to specific immune system molecules, and cloning into an appropriate vector. In addition, molecular docking, MD simulation, and binding free energies were performed to investigate the interaction mechanism between the construct vaccine and Toll-like receptors (TLR2, TLR4, TLR7, and TLR9).By examining these factors, we aimed to ensure the vaccine's safety, stability, and ability to bind tightly to specific immune cells (class I MHC molecules), ultimately triggering a comprehensive immune response against breast cancer cells.

Citation Format: Kayode Yomi Raheem, Muhammad Muddassar. Design of personalized neoantigen mRNA vaccines against breast cancer patients in Pakistan based on next-generation sequencing data [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B010.
Abstract B033: Understanding Latinas’ decisions to participate in a unique breast cancer clinical trial: A qualitative constructivist grounded theory study
Authors: Ridley-Merriweather Katherine E. , Vogel Katherine
Published: September 2024

Background & Objective: Breast cancer is the most common cause of cancer death in Latinas in the United States; however, researchers often fail to use recruitment messaging targeted toward increasing Latina participation. Although the cancer disparities observed among this population are significant, these group members account for only 1.3% of cancer-related clinical trial participants in the United States. The barriers preventing Latinas’ participation in research are well-established, but there are few studies focused on comprehending the motivations of Latinas who previously volunteered for clinical trial participation. The aims of this study were to improve the understanding of Latinas’ decisions to participate in a unique breast cancer clinical trial and to propose future methods for increasing these group members’ motivations regarding medical research participation. Methods: Guided by constructivist grounded theory, twenty women (N= 20) who self-identified as Latina or Hispanic, and who had previously donated healthy breast tissue to a biobank that was part of a clinical trial, were interviewed regarding their medical research participation decisions. Participants were recruited through direct email and interviews were conducted over Zoom and Microsoft Teams. Results: Findings revealed three primary themes: (1) the availability of both bilingual recruitment materials and research team personnel were viewed as important motivators to participate, (2) the knowledge of their underrepresentation in medical research and the understanding that their participation may help Latinas in the future were revealed as important motivators to participate, and (3) individuals who received negative feedback from family and/or friends about their intended research participation remained resolute in their decision to donate tissue. Conclusions: Understanding the motivations of Latinas who have previously participated in cancer-related clinical trials can help researchers create targeted and/or tailored recruitment messaging. Messaging must emphasize the consequences of underrepresentation of Latinas in clinical trials, be bilingual, and communicate that participation in cancer clinical trials can positively impact the health of other Latinas in the future.

Citation Format: Katherine E. Ridley-Merriweather, Katherine Vogel. Understanding Latinas’ decisions to participate in a unique breast cancer clinical trial: A qualitative constructivist grounded theory study [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B033.
Abstract B103: Friend-to-friend: Culturally tailored health education for East African communities
Authors: Abbenyi Adeline , Abbadi Manal , Ali Khadija , Ahmed Fatuma
Published: September 2024

Purpose: The Mayo Clinic Comprehensive Cancer Center (MCCCC) serves its communities through every pillar of the cancer continuum from prevention to survivorship. To effectively educate our communities along this continuum, MCCCC partnered with a trusted community partner, leveraged the stories of survivors, and addressed stigma in a safe space for community members to ask vulnerable questions. Methods: The MCCCC partnered with Pamoja Women on the Friend-to-Friend initiative. Pamoja Women is a trusted community partner supporting East African women and their families, some of whom are refugees. They provided the space to hold each event, an environment where the women were comfortable with support from their community. The program highlighted cancer education, screening, and risk reduction through culturally appropriate discussions between friends. Topics were identified based on community interest and the cancer incidence in the community. Survivors shared their personal stories and medical experts discussed prevention, risk reduction, screening, addressed myths, answered questions, and showcased discoveries in research and treatment methods. Results: We have held 3 events covering breast, cervical, and HPV vaccination. Each event saw an increase in participation with almost 50 participants attending the series. Furthermore, there was an increase in awareness of screening methods, prevention, and risk reduction. Pamoja Women provided navigation to screening through transportation to and advocacy during appointments. This continuity from education to screening led to heading the call to action for screening. Due to its success, the four-part series has been expanded to include the topics of endometrial, prostate cancer, and breast cancer for a second time. Conclusion: Partnering with trusted community organizations has led to safe spaces for cancer education with friends. This approach has led to successful education and navigation to screening in communities that do not always have access to this essential information.

Citation Format: Adeline Abbenyi, Manal Abbadi, Khadija Ali, Fatuma Ahmed. Friend-to-friend: Culturally tailored health education for East African communities [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B103.
Abstract B134: Socioeconomic, social, and clinical factors associated with loneliness among African American breast cancer survivors
Authors: Campbell Kelsie , Sanogo Fatimata , Beard Trista , Jefferson Melanie , Sahlia Bodhour , Halbert Chanita Hughes
Published: September 2024

Importance: Social connections are an important driver of cancer risk and outcomes and animal studies have shown that social isolation is important to breast cancer initiation and progression. However, limited empirical data are available on perceived loneliness among patient groups who are at increased risk for breast cancer morbidity and mortality. Objectives: The purpose of this study was to characterize the nature and distribution of loneliness in a sample of African American breast cancer patients and identify clinical and social factors having significant independent associations with perceived loneliness among these survivors. Methods: The study included African American breast cancer patients (n=110) who provided self-reported data on loneliness as part of a participating in a prospective observational study and randomized trial that examined stress reactivity using the Trier Social Stress Test. Loneliness was measured using a short form of the Loneliness Scale; scores were dichotomized using the median split to characterize patients as experiencing high versus low levels of loneliness. Multivariate logistic regression analysis was used to identify factors having significant associations with loneliness. Results: Over half (51.82%) of patients reported experiencing high levels of loneliness. Clinical and social factors that had significant independent associations with loneliness included marital status (OR=2.853, CI=1.066, 7.635, p=0.037), financial strain (OR=3.240, CI=1.114, 9.422, p=0.031), and the number of co-morbidities. Compared to patients who did not have any co- morbidities, those who had one, two, or three or more comorbidities had seven (CI=1.066, 40.645; p=0.029), eleven (CI=1.858, 66.716, p=0.008), and eleven (CI=1.757, 65.244; p=0.010) times the odds, respectively, of experiencing loneliness. Conclusions and Relevance: Many African American breast cancer patients in this study reported high levels of loneliness. Greater efforts are needed to identify patients who may benefit from interventions that enhance social connections, especially if they are married, experiencing financial strain, and have co-morbid conditions.

Citation Format: Kelsie Campbell, Fatimata Sanogo, Trista Beard, Melanie Jefferson, Bodhour Sahlia, Chanita Hughes Halbert. Socioeconomic, social, and clinical factors associated with loneliness among African American breast cancer survivors [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B134.
Abstract B146: Themes of importance among underrepresented men with prostate cancer: CEASAR 2.0
Authors: Murray Nicole , Horns Joshua J. , Chipman Jonathan , Sokeye Joshua , O'Neil Brock
Published: September 2024

Background: The etiology regarding why men of underserved populations experience worse health outcomes is multifaceted and complex. Due to social and economic issues, underrepresented men may be choosing to undergo less curative treatment options. Materials and Methods: The Comparative Effectiveness Analysis of Surgery and Radiation (CEASAR) study is a prospective cohort study which is uncovering decision drivers to prostate cancer (PCa) treatment among low risk prostate cancer patients (n=3691). A subset of CEASAR participants were contacted for qualitative interviews and questionnaires (n = 66). Phone interviews were conducted from November 2020 and August 2021 by the CEASAR research team. Interviews were transcribed, and themes of importance were analyzed from patients who were considered to be low SES background and/or racially and ethnically minoritized patients. Results: Overall 24% (n=16) of CEASAR patients who completed qualitative interviews were of low SES background and/or racially and ethnically minoritized. Three themes of importance emerged from of underserved men: financial toxicity 25% (n = 4/16), role as a primary caregiver 13% (n = 2/16), and lack of cultural acceptability 19% (n = 3/16). Discussion: Although most men within the CEASAR study were highly educated and had access to resources, qualitative work suggests there may be different aspects of care that impact a subset of underserved prostate cancer survivors. Financial toxicity, serving as a primary caregiver, and lack of cultural acceptability may serve as contributors to the decisions of underserved men with PCa. This may help explain worse health outcomes among these survivors. Conclusion: Socioeconomic factors regarding underrepresented men with PCa’s decision to undergo less curative treatment, is poorly understood in the literature. In this longitudinal prospective cohort study, we were able to identify three themes of importance contributing to underrepresented men’s decision making around PCa treatment. Further investigation exploring barriers to care among underserved men with PCa is needed to determine effective treatment regimen for these patients that experience worse outcomes.

Citation Format: Nicole Murray, Joshua J. Horns, Jonathan Chipman, Joshua Sokeye, Brock O'Neil. Themes of importance among underrepresented men with prostate cancer: CEASAR 2.0 [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B146.
Abstract B176: Are there disparities in adherence to treatment guidelines among Asian American ovarian cancer patients?
Authors: Lee Alice W. , Chang Jenny , Siddiqui Sannia , Ziogas Argyrios , Bristow Robert E.
Published: September 2024

Background: The National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines reflect the most current and accepted standards for ovarian cancer treatment. Studies show that adherence to NCCN guidelines is associated with improved ovarian cancer survival. Asian Americans have been found to have higher ovarian cancer survival than non-Hispanic Whites although the likelihood of receiving adherent care appears to be comparable between the two racial groups. It is unclear whether there may be ethnic-specific differences in the receipt of adherent care among disaggregated Asian American subgroups. Methods: We leveraged data from the California Cancer Registry and analyzed 31,230 non-Hispanic White and Asian/Pacific Islander ovarian cancer cases diagnosed between 1996 and 2020. Multivariable logistic regression with odds ratios (ORs) and 95% confidence intervals (CIs) was used to evaluate the likelihood of receiving NCCN adherent care for each Asian ethnic subgroup compared to non-Hispanic Whites. NCCN adherent care was defined as having received surgery and chemotherapy ovarian cancer treatment that met NCCN guidelines. Demographic, socioeconomic, and tumor characteristics were considered in the analyses. Results: Overall, 39.3% of non-Hispanic White and 39.1% of Asian/Pacific Islander ovarian cancer patients received care that adhered to NCCN guidelines. Across the Asian ethnic subgroups, the highest percentage receiving adherent care was observed among South Asians (45.9%) whereas the lowest percentage was among Other Asians (31.9%) and Pacific Islanders (33.9%). After adjusting for relevant factors, Koreans and Other Asians showed significantly lower odds of receiving NCCN adherent care relative to non-Hispanic Whites (OR=0.76, 95% CI 0.61-0.96 and OR=0.65, 95% CI 0.54-0.77, respectively). Conclusion: There appears to be some variation in ovarian cancer treatment across Asian ethnic subgroups, highlighting possible disparities in patient care. Given the critical role treatment plays in disease prognosis, future research should explore why some ovarian cancer patients may be less likely to receive adherent care as this could inform strategies to ensure such care is provided which in turn may help improve their survival.

Citation Format: Alice W. Lee, Jenny Chang, Sannia Siddiqui, Argyrios Ziogas, Robert E. Bristow. Are there disparities in adherence to treatment guidelines among Asian American ovarian cancer patients? [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B176.
Abstract C002: Investigating racial and ethnic healthcare disparities in screenable gynecologic cancers
Authors: Blanco Daniela P.
Published: September 2024

In this systematic scoping literature review, we analyzed peer-reviewed literature to develop a comprehensive understanding of the racial and ethnic healthcare inequity regarding the management and treatment of gynecologic cancers. This approach allows for novel summative data to inform future research and equitable treatment of gynecologic. For the analytical review, PubMed was primarily used to retrieve research articles exploring the impact of race and ethnicity on gynecologic cancer outcomes and screenings, focusing on cervical, ovarian, endometrial, fallopian tube, and vulvar cancers from 2015 to 2023. Non-original studies and studies published prior to 2015 were excluded from being reviewed. To ensure the reliability and relevance of the subsequent analysis, findings were uniformly summarized using a synthesis matrix, highlighting common themes across articles. Based on the articles investigated, there is strong evidence pointing to increased incidence of gynecologic cancers diagnosed at later, more aggressive stages in African American and Hispanic women than in Non-Hispanic White women. Additionally, disparities were found in screenings and treatment management. Women-of-color were less likely to be offered education from their healthcare providers on gynecologic cancers, and less likely to be offered preventative screening or vaccines. The disparities in treatment management were most pronounced in African American women, who were less often offered access to lifesaving treatments, such as brachytherapy. However, utilizing outreach programs and enhancing both provider competency and patient education initiatives has lead to an increase in the likelihood of African American and Hispanic women in vaccine compliance and adherence to regular check-ups. Our ongoing review continues to unveil racial and ethnic healthcare inequities and their impact on preventative care, patient-physician relationships, and patient education. The preliminary findings suggest that racial/ethnic disparities contribute to reduced adherence to recommended obstetric screenings and established effective treatment regimens. Additionally, the data shows that increased utilization of outreach programs and patient education helps mitigate these disparities.

Citation Format: Daniela P. Blanco. Investigating racial and ethnic healthcare disparities in screenable gynecologic cancers [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C002.
Abstract C014: Lower negative predictive value of prostate MRI in Black men
Authors: Sandlow Sarah , Carbunaru Samuel , Sun Zequn , Ofori Bernice , Hollowell Courtney M. P. , Vidal Patricia , Li Eric , Schaeffer Edward M. , Gann Peter , Ross Ashley , Kundu Shilajit , Murphy Adam B.
Published: September 2024

Introduction: PIRADS scoring with multiparametric-MRI (MRI) has a pooled 90% negative predictive value (NPV) allowing men to defer biopsy while enhancing Gleason Grade group 2-5 (GG2-5) prostate cancer (PCa) detection. PSA density (PSAD) ≥0.15ng/ml/cm3 has been shown to enhance NPV of the prostate MRI in non-Black men. We assessed the performance of the prostate MRI in Black vs. non-Black men by evaluating sensitivity and NPV, and identified a PSAD threshold providing ≥90% NPV in Black men. Methods: We prospectively recruited Black and non-Black men referred to outpatient urology clinics for abnormal PSA or prostate exam in three similar biomarker validation studies from 2017–23 before MRI-informed diagnostic transrectal or transperineal prostate biopsy. We combined this research cohort with a retrospective clinical cohort of clinically similar Black and non-Black men from one academic institution who also underwent prostate MRIs and MRI-informed biopsies for elevated PSA. Trained radiologists used PIRADS version 2.0 or 2.1 for scoring. Results: Following the combination of the research and clinical cohorts, 286 Black men and 965 non-Black men with PSA<15.0ng/ml were included in the analysis. PIRADS ≥3 had an NPV of 77.1% versus 87.6% and a sensitivity of 90.7% vs. 96.3% for GG2-5 PCa in Black versus non-Black men, respectively (both p<0.05). Using PSAD ≥0.09 for Black men with PIRADS 1-2 lesions increased sensitivity to 92.9%. For PIRADS 1-2, GG2-5 PCa frequency was 5.3% higher in Black versus non-Black men with PSAD<0.15, and 11.0% higher in Black versus non-Black men with PSAD≥0.15. For PIRADS=3, GG2-5 PCa frequency was 9.1% higher in Black men with PSAD<0.15 and 27.9% higher for PSAD≥0.15. For PIRADS=4, GG2-5 PCa frequency was 15.9% higher in Black men with PSAD<0.15, and 9.5% higher for PSAD≥0.15. Conclusion: The PIRADS ≥3 threshold has a lower NPV and sensitivity in Black men. A negative prostate MRI requires a PSAD ≥0.09 threshold for safe biopsy deferral in Black men to maintain a sensitivity ≥90%.

Citation Format: Sarah Sandlow, Samuel Carbunaru MD, Zequn Sun PhD, Bernice Ofori MPH, Courtney M. P. Hollowell MD, Patricia Vidal MD, Eric Li MD, Edward M. Schaeffer MD, PhD, Peter Gann MD, ScD, Ashley Ross MD, PhD, Shilajit Kundu MD, Adam B. Murphy MD, MBA, MSCI. Lower negative predictive value of prostate MRI in Black men [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C014.
Abstract C027: Nanoscale-metal organic frameworks as drug delivery vehicles for novel hepatocellular carcinoma therapy
Authors: Jackson Karl T.
Published: September 2024

Metal-organic frameworks (MOFs) are porous crystalline materials composed of organic linkers connected by metal clusters. Recently, MOFs have garnered significant interest in biomedical applications due to their high porosity and ability to be tailored to accommodate various guest molecules. Their use as drug delivery vehicles in cancer treatment has been extensively explored as an alternative to traditional chemotherapy, aiming to enhance efficacy and reduce harmful side effects. Beyond serving as carriers, MOFs can be functionalized with moieties that selectively bind to cancer cells, enabling advanced targeting capabilities. This presentation examines current research on using Zr-based MOF, UiO-66 as a drug delivery vehicle for novel small molecule inhibitor PDZ1i in combinatorial therapies for hepatocellular cancer. PDZ1i targets MDA-9, a pro-metastatic and pro-angiogenic gene associated with various cancers.

Citation Format: Karl T. Jackson. Nanoscale-metal organic frameworks as drug delivery vehicles for novel hepatocellular carcinoma therapy [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C027.
Abstract C050: Breast cancer in Ghana: assessment of multidrug-resistant genes among breast cancer patients
Authors: Boaitey Gloria Agyekum , Martini Rachel , Djeddar Nourddine Dean , Stonaker Brian , Patino Stevens M. , White Jason , Bonsu Ernest Osei , Boaitey Yaw Agyekum , Obirikorang Christian , Davis Melissa B. , Fondjo Linda Ahenkorah
Published: September 2024

Breast cancer (BC) is the most frequently diagnosed cancer among women globally and chemotherapy plays a crucial role in its management in sub-Saharan Africa. The long-term BC survival rate remains poor due to chemoresistance. Over 80% of currently used chemotherapy drugs are substrates of ABC transporter genes, ABCB1, ABCC1 and ABCG2. Possessing the wild-type genotype and alleles of these genes reduces intracellular drug accumulation and leads to poorer treatment outcomes due to the upregulation of efflux function. This study therefore determined the allelic and genotype frequencies of three variant alleles, rs1045642, rs28706727 and rs2231142 in these transporter genes, and assessed the association between the variant statuses and BC recurrence or metastasis in the Ghanaian BC population. A quantitative, observational, case-control study was conducted using a purposive and convenience sampling method. Sociodemographic and clinical data were collected from study participants using questionnaires and a review of medical records. Extracted blood DNA from participants was used to determine the gene variants in ABCB1, ABCC1 and ABCG2 genes using the TaqMan Allelic Discrimination assays. A significantly high frequency (p ≤ 0.001) of the homozygous wild-type genotypes and alleles (ABCB1 had 77.3%/88% for CC/C, ABCC1 had 95.3%/97.7% for GG/G and ABCG2 had 100%/100% for CC/C) was found in both case and control groups. The wild-type genotypes and alleles of ABCB1, ABCC1 and ABCG2 may contribute to poor BC treatment outcomes among Ghanaian BC patients receiving chemotherapy.

Citation Format: Gloria Agyekum Boaitey, Rachel Martini, Nourddine Dean Djeddar, Brian Stonaker, Stevens M. Patino, Jason White, Ernest Osei Bonsu, Yaw Agyekum Boaitey, Christian Obirikorang, Melissa B. Davis, Linda Ahenkorah Fondjo. Breast cancer in Ghana: assessment of multidrug-resistant genes among breast cancer patients [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C050.
Abstract C070: Barriers to genomic testing reduce clinical trial eligibility for diverse populations
Authors: McCleary Nadine J.
Published: September 2024

Tumor genomic testing and cancer clinical trials expand access to precision therapeutics, enhancing patient experience. However, physician and patient barriers impact participation of historically underrepresented patients (HUP), limiting generalizability for those most negatively affected by cancer. We interviewed patients to identify factors impacting genomic testing uptake and clinical trial enrollment. From 09/2021 - 12/2021 we interviewed 16 HUP diagnosed with cancer seen at an ambulatory oncology center: 3 spoke a language other than English, 9 identified as Black, 6 Hispanic/Latinx, 3 other race, and 3 older adult (age 70+). Individual interviews utilized a structured interview guide and lasted 45 minutes. Participants were recruited until thematic saturation was reached and transcripts were coded for major themes. Patients were unsure if they received genomic testing or if testing was recommended (citing possible confusion with medical information). Barriers included education (unclear benefit to participation, investigational drug/device identity, procedures involved), mistrust of research (data privacy concerns), and logistical accessibility (cost, time away from work, transportation). Those tested found it to be an easy process. Several cited that a patient advocate would be a beneficial resource to navigate the process. Barriers around clinical trial enrollment included education (risks of participating, size of the study, investigational drug/device identity), mistrust of research (data privacy, inclusion of HUP in trial, loss of autonomy in decision-making), and logistical accessibility (time commitment). HUP who participated in a trial appreciated additional psychosocial support and clinical monitoring. Patients were emphatically interested in genomic testing and cancer clinical trials when presented as the best course of care, though concerns about side effects from trials persisted. Patient barriers to genomic testing and clinical trials center around education, mistrust in research, and logistical accessibility. Patients who participated in genomic testing and clinical trials had a positive experience. Barriers may be addressed with tailored education, including supportive resources referral.

Citation Format: Nadine J. McCleary. Barriers to genomic testing reduce clinical trial eligibility for diverse populations [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C070.
Abstract C108: ANPEP regulates one-carbon metabolism in prostate cancer
Authors: El-Kenawi Asmaa , Putney Ryan , Berglund Anders , Yamoah Kosj
Published: September 2024

In the year 2023, prostate cancer (PCa) contributed to 34,700 cancer-related fatalities within the United States. Notably, African American men (AAM) experience disproportionately higher rates of both PCa incidence and mortality compared to their European American counterparts (EAM). To investigate some of the biological factors which contribute to these disparities, we carried out an unbiased genomic expression analysis of PCa stratified by ancestry using retrospective and prospective clinical cohorts. In these analyses, we identified aminopeptidase N (ANPEP, APN, CD13), as the most differentially expressed gene in both self-identified and ancestry derived AAM compared with EAM. Previous studies demonstrated that the aminopeptidase ANPEP cleaves N termini of numerous hormones, cytokines, and chemokines involved in oncogenic signaling, cancer relapse and Inflammation. Specifically, ANPEP trims peptides with an N-terminal L-alanine and (L-cysteinylglycine)-S-conjugates while releasing alanine and glycine, respectively. While the role of ANPEP in cytokine activation is well studied, the contribution of ANPEP to amino acids homeostasis remains unknown. Herein, we aim to characterize the metabolic function of ANPEP and whether ANPEP regulates therapeutic efficacy. Using computational analyses, we demonstrate that expression of ANPEP predominantly correlates with various amino acid transporters. By employing untargeted metabolomics, we subsequently revealed a significant enrichment of one-carbon metabolism in cells that overexpress ANPEP. The one-carbon metabolism connects a series of metabolic pathways including the methionine cycle which in turn regulates methylation of various cellular substrates. We then performed genome-wide methylation profiling demonstrates that ANPEP overexpression is associated with elevated methylation of DNA. Because elevated methylation of DNA which is a determinant of therapeutic efficacy in prostate cancer, future studies will assess whether ANPEP regulation of methylation capacity impacts therapeutic efficacy and disease progression. To clinically validate our findings, we them carried out a fluxomic approach in ex vivo human tumor slice culture from 20 patients of prostate cancer. These studies demonstrate that PCa from AAM exhibit higher demand for methionine and cystine highlighting dominance of one-carbon metabolism. In conclusion, we discovered a new function of ANPEP in regulating one-carbon metabolism in prostate cancer.

Citation Format: Asmaa El-Kenawi, Ryan Putney, Anders Berglund, Kosj Yamoah. ANPEP regulates one-carbon metabolism in prostate cancer [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C108.
Abstract C114: DNA methylation signatures linked to different grades of prostate tumors from African American and European American patients
Authors: Gonzalez-Smith Leonardo , Stensrud Colton , Stevens Claire , Mack Jenaye , Arigbede Olumide , Buxbaum Sarah G , Falzarano Sara M. , Rhie Suhn K.
Published: September 2024

Prostate cancer is the second leading cause of cancer-related deaths among men in the United States. Health disparities in men diagnosed with prostate cancer are observed between patients of African and those of European ancestry. To develop biomarkers and elucidate the molecular mechanisms behind prostate tumorigenesis and racial disparities, we collected formalin-fixed paraffin-embedded (FFPE) prostate tissues from African American (AA) and European American (EA) patients. By comparing global DNA methylation profiles among normal samples and different grades of tumor samples from AA and EA, we revealed distinct prostate cancer subgroups with variable DNA methylated regions. We identified thousands of differentially methylated regions between normal and tumor samples, defining hypermethylated and hypomethylated regions. When we examined the frequency of differentially methylated regions among different grades of tumor samples, we found that low-grade tumor samples exhibited fewer hypermethylated regions while high-grade tumors exhibited numerous hypermethylated regions across AA and EA samples. However, we found that a subset of low-grade tumors exhibited many hypomethylated regions similar to high-grade tumors. By clustering prostate tumor samples with the identified differentially methylated regions, we revealed distinct prostate cancer subgroups with unique DNA methylation patterns. By integrating immunohistochemistry data with DNA methylation profiles, we found that the identified subgroups are tightly linked to the overexpression status of ERG, surpassing the ethnicity-related variations. Associating DNA methylation patterns with clinicopathological features and integrating this data with other molecular features, we are characterizing the molecular mechanisms underlying prostate tumorigenesis and health disparities. This study will pave the way to identify novel DNA methylation biomarkers and therapeutic targets linked to different prostate cancer subgroups.

Citation Format: Leonardo Gonzalez-Smith, Colton Stensrud, Claire Stevens, Jenaye Mack, Olumide Arigbede, Sarah G Buxbaum, Sara M. Falzarano, Suhn K. Rhie. DNA methylation signatures linked to different grades of prostate tumors from African American and European American patients [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C114.
Abstract C133: The missing cancer and palliative care in displaced community in Northeast India
Authors: Acharya Suryakanta
Published: September 2024

Introduction: Cancer is a chronic illness needing long treatment. This includes late toxicity management in case of cure and palliative care if cure is a distant possibility. Northeast part of India shares international border with Bangladesh and both sides had witnessed geopolitical uncertainty since India’s independence in 1947. Unrest and military rule in East Pakistan made the citizens to flee to India which continued even after the creation of the new country Bangladesh in 1971. However, the poor migrants are not eligible under the public health scheme due to lack of proof of citizenship. Methods: We have analyzed the public health scheme and issues of migrants in Northeast India after observing discontinuity in care. Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) is a national public health insurance scheme of the Government of India that aims to provide free access to health insurance coverage for low- income earners in the country. The scheme is applicable to Indian citizens. In 2019 Government of India passed the Citizenship Amendment Act (CAA) to provide Indian citizenship to the illegal migrants who entered India on or before 31st December 2014. However, the exercise to identify migrants as per the Act is a tedious process and not yet over.: Results: Until the exercise of granting citizenship under the Citizenship Amendment Act is done, the poor migrants who have no proof of citizenship cannot take benefit under AB PM-JAY scheme. Unfortunately, some internally displaced Indian citizens are lacking proof of citizenship and many of them are suffering from chronic illnesses and cancer, however neither afford to pay for treatment nor eligible to get free treatment under AB PM-JAY scheme. Conclusions: Northeast India migrant issue is a special situation where poor migrants from other country and some displaced poor Indians are not eligible to get cancer care under public health insurance scheme. The Citizenship Amendment Act provides a solution by granting citizenship. However, the tedious process is taking long time and no solution being offered in the interim period.

Citation Format: Suryakanta Acharya. The missing cancer and palliative care in displaced community in Northeast India [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C133.
Abstract C145: EPHA4 correlates with different functions and clinical outcomes in different breast cancer subtypes
Authors: Liu Wenchao , Rosner Marsha
Published: September 2024

Ephrin receptor A4, or EPHA4, is a receptor tyrosine kinase that regulates neuronal stem cell maintenance and is implicated in multiple neuronal diseases. Accumulating studies have shown that EPHA4 may also play important roles in cancer progression, and pharmacological EPHA4 modulators have been tested in preclinical models as potential therapies. In breast cancer, EPHA4 is shown to regulate cancer cell invasion, stemness, and immune response. However, as breast cancer is a heterogenous disease, it is unclear whether and to what extend EPHA4 regulates these functions across different breast cancer subtypes and patient populations. To determine EPHA4 functions and potential benefit of targeting EPHA4 in different patient populations, we analyzed clinical and gene expression data from three patient cohorts: TGCA Firehose, I-SPY2 and SCAN-B. Our results show EPHA4 may be involved in angiogenesis and cell migration across all subtypes. While EPHA4 most strongly correlates with immune response in the Her2 subtype, its correlation with stemness and therapeutic resistance is more prominent in the triple negative/basal subtype. We conclude that EPHA4 inhibition maybe most beneficial for triple negative/basal patients.

Citation Format: Wenchao Liu, Marsha Rosner. EPHA4 correlates with different functions and clinical outcomes in different breast cancer subtypes [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C145.