bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract A111: Racial differences in the relationship between dimensions of smoking exposure and lung cancer risk: A pooled analysis from the International Lung Cancer Consortium Study
Authors: Arauz Rony F. , Freedman Neal D. , Inoue-Choi Maki , Schwartz Ann G. , Ryan Brid M.
Published: September 2020

Lung cancer incidence is higher among African Americans (AAs) compared with European Americans (EAs) and Asian Americans (AsA) in the United States. Although there has been a significant reduction in cigarette smoking, racial disparities in tobacco use and lung cancer risk persist in the US. While data exists suggesting that African Americans have a higher risk of lung cancer at lower cigs per day, data independently linking each measure of smoking exposures and lung cancer risk among AAs compared with EAs and AsA are limited. We conducted a pooled case-control study of 19,965 cases and 331,478 controls from 10 population-based case-control and cohort studies from the US within the International Lung Cancer Consortium (ILCCO). We used logistic regression models to examine associations between several smoking dimensions (status, age at initiation, duration, intensity, pack-years and cessation) and lung cancer risk. Overall, the magnitude of the relationship between each dimension of smoking exposure and lung cancer risk was higher among AAs. AAs who were light smokers had an increased odds of lung cancer compared with EAs and AsA (1-10 cigs/day: AA OR = 5.66, 95% CI: 4.73-6.76; EA OR = 2.86, 95% CI: 2.58-3.17; AsA OR = 2.82, 95% CI: 2.35-3.39) after adjustment for age, gender and study center. Similar trends were observed for age at smoking initiation (age at smoking initiation 25+ years: AA OR = 7.54, 95% CI: 6.35-8.96; EA OR = 5.49, 95% CI: 4.99-6.03; AsA OR = 4.00, 95% CI: 3.44-4.66). This study suggests that racial and ethnic differences between individual dimensions of smoking exposure and lung cancer exist. In general, at equal levels of exposure, AAs seem to be more susceptible than EAs and AsA. Future work will assess if these findings hold following adjustment for population specific smoking patterns.

Citation Format: Rony F. Arauz, Neal D. Freedman, Maki Inoue-Choi, Ann G. Schwartz, Brid M. Ryan. Racial differences in the relationship between dimensions of smoking exposure and lung cancer risk: A pooled analysis from the International Lung Cancer Consortium Study [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 A111.
Abstract A116: Occupational disparities in women’s employment after cancer
Authors: Ekenga Christine , Kwon Eunsun , Kim BoRin , Park Sojung
Published: September 2020

Background: Due to advances in early diagnosis and treatment, the population of working-age cancer survivor population has grown. However, few studies have examined long-term (10+ years) employment outcomes after treatment. We evaluated the impact of cancer on employment outcomes among women enrolled in the Health and Retirement Study (HRS), a nationally representative panel of non-institutionalized adults aged 51 and older in the United States Methods: Data came from nine waves of the HRS (1998-2014) (n = 7,088; Observations = 26,355). We conducted two sets of analyses: The first set of analyses examined the impact of cancer on employment status and the second set of analyses examined the impact of cancer on the number of work hours for women who were working full time (≥ 35 hours per typical work week) at baseline. For the analysis of employment status, we used a random intercept logistic regression in a multi-level growth curve framework to analyze change over time in likelihood of employment. For the analysis of hours of work per week, we used a mixed-effects coefficient regression to assess work hours trajectories in relation to cancer. Results: There were 7,088 working-age (51-64 years) women in the study sample. Approximately 7% (n=483) of the sample were cancer survivors, with a mean number of years since diagnosis of 9 years. After controlling for sociodemographic and health factors, women who were 6-10 year cancer survivors had a 2.3 times greater likelihood of being employed over time than women without a history of cancer; however, if these women had professional jobs, they were less likely to work over time (OR = 0.4) than professional women without a history of cancer. Long-term (10+ year) cancer survivors in professional occupations tended to work less hours per week at baseline (-4.1 hours) and over time (-2.4 hours) than professional women who without a history of cancer. Conclusions: Professional women may be vulnerable to job loss after cancer treatment. Identifying factors associated with continued employment for women will be key to developing strategies to promoting quality survivorship in the growing cancer survivor population.

Citation Format: Christine Ekenga, Eunsun Kwon, BoRin Kim, Sojung Park. Occupational disparities in women’s employment after cancer [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 A116.
Abstract A125: The impact of the 2010 Patient Protection and Affordable Care Act (ACA) on colorectal cancer screening in vulnerable populations: A systematic literature review
Authors: Yudkin Joshua S , Doria-Rose V. Paul
Published: September 2020

Background: Disparities have existed and continue to exist in colorectal cancer (CRC) screening. Disparities in screening are correlated with other factors including educational attainment, healthcare access/insurance, and family history knowledge. These factors impact different vulnerable communities differently. This paper explores the impact of the 2010 Patient Protection and Affordable Care Act (ACA) on CRC screening rates and disparities in the United States. Methods: A comprehensive systematic literature review conducted in June 2019 revealed 47 published articles that explore the impact of the ACA on CRC screening. Results: The ACA affected CRC screening primarily in three ways: 1) costs associated with screening and diagnostic follow-up were reduced among commercially-insured patients, removing financial barriers; 2) uninsured, non-Medicaid-eligible individuals were able to gain access to healthcare services such as CRC screening through insurance plans purchased through health exchanges; and 3) vulnerable and high-risk populations gained access through the expansion of and changes to Medicaid in 32 states. These three pathways reduced screening disparities between various ethnic and racial populations, yet disparities remain. Conclusions: The ACA expanded access to screening and treatment efforts in order to decrease cancer incidence, increase early detection, decrease costly CRC management, and extend life expectancy for CRC survivors. Yet, the limited literature shows mixed results in terms of the ACA’s impact, especially in its initial phase. While screening technologies and systemic changes by the ACA have made significant progress in reaching high-risk and vulnerable populations including ethnic and racial minorities, there is still a concerning gap in both access to CRC screening services and the associated disparities in mortality. Future research should focus on delayed impacts of the ACA.

Citation Format: Joshua S Yudkin, V. Paul Doria-Rose. The impact of the 2010 Patient Protection and Affordable Care Act (ACA) on colorectal cancer screening in vulnerable populations: A systematic literature review [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 A125.
Abstract B023: Cancer disparities and faith-based messaging in the African American church
Authors: Williams Tiffany H
Published: September 2020

Cancer disparities and faith-based messaging in the African American church.

Citation Format: Tiffany H Williams. Cancer disparities and faith-based messaging in the African American church [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 B023.
Abstract B030: See, Test, and Treat: Engaging vulnerable populations in cancer screening
Authors: Williams Michelle S , Wells Jimmie , Duhe Roy , Allen Timothy
Published: September 2020

Background: The breast cancer and cervical cancer mortality rates among women in Mississippi are higher than the national averages. Early detection and early treatment are associated with longer survival rates among women who are diagnosed with breast cancer or cervical cancer. However, the percentage of women in Mississippi who report having regular mammograms and in cervical cancer screenings is lower than the national average. Purpose: Clinicians and investigators at UMMC are actively working within transdisciplinary teams to implement evidence-based interventions aimed at reducing breast and cervical cancer mortality disparities in the state. Methods: See, Test, and Treat was a community-based cancer screening event that occurred on June 1, 2019 at the UMMC Cancer Center and Research Institute. The UMMC team provided breast, cervical and oral cancer screenings to 103 women. Healthy cooking and exercise demonstrations, were conducted to actively engage patients in health education activities. Participants completed a brief exit survey that was used to gather data on the effect of the program on the patients’ knowledge and attitudes towards cancer screenings, and intentions to changed cancer related health behaviors. Results: The short-term outcomes showed that 21 patients had abnormal mammograms. All of the patients with abnormal mammograms were immediately linked to follow-up care. No Pap tests were returned with abnormal results. However, the clinicians diagnosed 8 patients with Trichomonas. The majority of the patients indicated that their knowledge of and attitudes towards breast and cervical cancer screening changed positively and the majority intended to change their cancer related health behaviors. Conclusion: See, Test, and Treat is an effective community-based activity that can increase access to breast, cervical and oral cancer screenings by uninsured and underinsured women.

Citation Format: Michelle S Williams, Jimmie Wells, Roy Duhe, Timothy Allen. See, Test, and Treat: Engaging vulnerable populations in cancer screening [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 B030.
Abstract B047: Community-academic partners working in a small grants program
Authors: Sondgeroth Karoline , Palacios Rebecca , Unguez Graciela A , O'Connell Mary , Loest Helena B , Englund Kaitlin
Published: September 2020

Community-based participatory research can help reduce health disparities among underserved populations. The New Mexico State University - Fred Hutchinson Cancer Research Center Partnership for the Advancement of Cancer Research (NMSU – Fred Hutch PACR) aims to reduce cancer health disparities in part through the establishment of community-academic partnerships. The Outreach Core of the PACR has supported a small grants program since 2015 to award funds to competitive community-academic partnership teams addressing regional cancer or health disparities issues through health education. Each year, the Outreach Core staff presents a grant-writing workshop to assist community groups in the development of competitive proposals and to identify academic partners at NMSU. Participants at the grant-writing workshop submit proposals, which are then reviewed by two NMSU faculty researchers. All participants, including the awardees, receive the reviewers’ feedback on their proposal. Over the past four cycles, the grant-writing workshop has trained 60 community members. The top two proposals are funded each year. To date, eight different proposals have been funded, six at $7500 each and two at $5,000 each. All of the funded projects undergo an IRB review at NMSU before the start of the research project. The NMSU academic partners are involved with the community groups through the design, submission of Human Subjects protocol to the IRB, and through data analysis and reporting. Examples of small grant proposals will be presented, including a discussion of how their partnerships worked. This interaction between the community groups and research academics increases the relevance of academic research by assisting the community groups in evaluating their novel educational interventions through robust research projects. Furthermore, these small grant partnerships may serve to provide pilot data for more extensive efforts funded by other agencies.

Citation Format: Karoline Sondgeroth, Rebecca Palacios, Graciela A Unguez, Mary O'Connell, Helena B Loest, Kaitlin Englund. Community-academic partners working in a small grants program [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 B047.
Abstract B049: Psychological underpinnings of cervical cancer screening intentions among the underserved: An examination of the influence of cancer fatalistic notions and associated cognitions
Authors: Garrido Carlos O
Published: September 2020

Cervical cancer screening participation is squarely determined by judgment and decision-making, but research examining the influence of cognitive biases on screening decisions remains scant. For instance, the implications of fatalistic views of cancer has been studied in the past, but no other research has furthered explored the psychological underpinnings of cancer fatalism and related constructs in relation to cervical cancer screening intentions. Critically important, however, is to explore the nature of the relationship between cancer fatalism and two related cognitions—cancer information overload (confusion and overwhelming feelings toward cancer information) and cancer information avoidance—for the development of effective psychological interventions. Another wrinkle is added when considering the social demographics of potential screening-seekers due to the health disparities of cervical cancer (Bazargan, Bazargan, Farooq & Baker, 2004) and high endorsement of cancer fatalism among minorities and other disadvantaged groups (for a review, see Espinosa de los Monteros & Gallo, 2011). Another chief aim of this current work was to examine the relationships between the constructs of interest in relation to the three components implicated by the theory of planned behavior (see Ajzen & Madden, 1986) as most predictive of behavioral intent. That is, attitude toward cervical cancer screening, subjective norms about cancer screening (what person believes others think she should do), and perceived behavioral control over getting cancer screening were the outcome variables. I recruited 90 community women from an online subject recruitment forum and presented them with the measures of interest in random order. Results showed that cancer fatalism and cancer information overload predicted negative attitudes toward cervical cancer screening. Cancer fatalism also predicted subjective norms but not perceived behavioral control. Educational attainment and access to health insurance were also associated with cancer fatalistic thoughts, but not minority status. Lastly, cancer information avoidance (effect modifier) interacted with cancer fatalistic thoughts in predicting attitudes toward cervical cancer screening and intentions to adhere to Pap exam recommendations. Theoretical and practical implications to public health promotion are discussed.

Citation Format: Carlos O Garrido. Psychological underpinnings of cervical cancer screening intentions among the underserved: An examination of the influence of cancer fatalistic notions and associated cognitions [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 B049.
Abstract B069: Upregulation of miR-130b contributes to risk of poor prognosis and racial disparity in African-American prostate cancer
Authors: Hashimoto Yutaka , Shiina Marisa , Tanaka Yuichiro , Dahiya Rajvir , Majid Shahana
Published: September 2020

Prostate cancer (PC) incidence and mortality rates are higher in African-American (AA) than in European-American (EA) men. The main objective of this study was to elucidate the role of miR-130b as a contributor to PC health disparity in AA patients. We also determined whether miR-130b is a prognostic biomarker and a new therapeutic candidate for AA PC. A comprehensive approach of using cell lines, tissue samples and the TCGA database was employed. We performed a series of functional assays such as cell proliferation, migration, invasion, RT2-PCR-array, qRT-PCR, cell cycle, luciferase reporter, immunoblot and immunohistochemistry. Various statistical approaches such as Kaplan-Meier, Uni- and Multivariate analyses were utilized to determine the clinical significance of miR-130b. Our results showed that elevated levels of miR-130b correlated with race disparity and PSA levels/failure and acted as an independent prognostic biomarker for AA patients. Two tumor suppressor genes, CDKN1B and FHIT, were validated as direct functional targets of miR-130b. We also found race-specific cell cycle pathway activation in AA PC patients. Functionally, miR-130b inhibition reduced cell proliferation, colony formation, migration/invasion and induced cell cycle arrest. Inhibition of miR-130b modulated critical PC related biological pathways in AA compared to EA PC patients. In conclusion, attenuation of miR-130b expression has tumor suppressor effects in AA PC. miR-130b is a significant contributor to PC racial disparity as its overexpression is a risk factor for poor prognosis in AA PC patients. Thus, regulation of miR-130b may provide a novel therapeutic approach for the management of PC in AA patients.

Citation Format: Yutaka Hashimoto, Marisa Shiina, Yuichiro Tanaka, Rajvir Dahiya, Shahana Majid. Upregulation of miR-130b contributes to risk of poor prognosis and racial disparity in African-American prostate cancer [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 B069.
Abstract B076: The effect of C1q and gC1qR in breast cancer: Racial health disparities
Authors: Reyes Tiana N , Digiovanni Matthew G , Williams Jennie L , Ghebrehiwet Berhane
Published: September 2020

Breast cancer is one of the most highly diagnosed cancers in the US with African American (AA) women developing a more aggressive form of the cancer at a younger age. The complement system, part of the immune system, is tightly regulated and able to eliminate foreign invaders. Complement proteins can induce cancer cell apoptosis or increased proliferation. Cell surface expression of C1q, apart of the classical pathway of the complement system, and its receptor, gC1qR, is enhanced in malignant cells. Upon treatment with antibody to C1q, an antiproliferative effect in breast cancer cells was observed in vitro. Antibody recognizing gC1qR enhances breast cancer cell survival by promoting angiogenesis and metastasis. It was noted in a panel of breast cancer cell lines that MDA-MB-468, an AA derived cell line, did not express gC1qR compared to three Caucasian American (CA) derived cell lines. In a second study, a lower expression level of gC1qR in the membranes of three AA breast cancer cell lines (MDA-MB-468, HCC70, and HCC1500) compared to a CA cell line (MDA-MB-231) was observed. We hypothesize that treatment with anti-C1q will have an antiproliferative effect on breast cancer cell lines, while treatment with anti-gC1qR will have a pro-proliferative effect. One CA (MDA-MB-231) and three AA (MDA-MB-468, HCC1500, and HCC7) breast cancer cell lines were treated with anti-C1q in solution at increasing concentrations where an antiproliferative effect was observed. Coating the culture plate with C1q will determine differential expression. Therefore, the role of C1q and gC1qR on cytokinetics and in racial health disparities are being accessed.

Citation Format: Tiana N Reyes, Matthew G Digiovanni, Jennie L Williams, Berhane Ghebrehiwet. The effect of C1q and gC1qR in breast cancer: Racial health 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 B076.
Abstract B082: Association of CXCR6/CXCL16 axis in triple-negative breast cancer and racial disparity
Authors: Mir Hina , Thomas Jeronay K , Kapur Neeraj , Johnson Anita T , Singh Shailesh
Published: September 2020

Breast cancer (BrCa) is the most common cancer in women worldwide and remains an important global health issue. The American Cancer Society recorded 252,710 new cases of BrCa in the United States in 2017, with 40,610 deaths. Though the incidence of BrCa is higher in Caucasian American (CA), African American (AA) women are often diagnosed with more aggressive TNBC at a younger age. Also, in absence of targeted therapies, cytotoxic chemotherapy remains the backbone of treatment for TNBC. But the median survival of women with advanced TNBC remains dismal. Androgen receptor (AR) has emerged as a potential target for treating TNBC; higher AR expression is a favorable prognostic factor associated with a lower clinical stage, lower histologic grade, and lower mitotic score. Several novel anti-androgenic agents alone or in combination with other agents are currently under investigation. Unfortunately, anti-AR therapies are not as beneficial in AA since AR is often low or missing in AA TNBC. Also, outcome of TNBC in AA is worse than CA, which suggests racial differences in the molecular landscape of TNBC between the two races. Hence, defining the molecular differences in TNBC between racial/ethnic groups is vital in order to effectively reduce the observed disparity in BrCa outcome. There are strong indications of a positive linkage between chemokine, cancer and metastasis. Chemokine receptor CXCR6 and its natural ligand CXCL16 are overexpressed in many cancer cells. We have shown that CXCR6 and CXCL16 axis promotes cancer by cytoskeleton rearrangement and its significance in etiopathogenesis of BrCa is well established. Goal of this study was to establish the association of CXCR6/CXCL16 axis in BrCa disparity using TCGA data and BrCa cell lines. We show overexpression of CXCR6 and CXCL16 in BrCa tissues and cell lines. Expression was higher in AA TNBC compared to CA TNBC cell lines. TCGA data confirms higher CXCR6 and CXCL16 expression in AA compared to CA BrCa and inverse association between androgen receptor (AR) and CXCR6 expression. Low AR expression was found in TNBC expressing high CXCR6 and CXCL16. In addition to this, differential phosphorylation status of signaling molecules down stream of CXCR6 in AA and CA TNBC cells was observed. In conclusion, our work highlights association of CXCR6/CXCL16 in race specific biological differences and emphasizes the potential of CXCR6/CXCL16 as a target to reduce the racial gap in TNBC outcome.

Citation Format: Hina Mir, Jeronay K Thomas, Neeraj Kapur, Anita T Johnson, Shailesh Singh. Association of CXCR6/CXCL16 axis in triple-negative breast cancer and racial 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 B082.
Abstract B100: Developing an integrated understanding of access to care and tumor characteristics patterns by race and age in the Carolina Breast Cancer Study Phase III, 2008 – 2013
Authors: Emerson Marc A , Golightly Yvonne M , Tan Xianming , Aiello Allison E , Reeder-Hayes Katherine E , Olshan Andrew F , Earp Shelley A , Troester Melissa
Published: September 2020

Purpose: Understanding breast cancer mortality disparities by race and age is complex due to disease heterogeneity, comorbid disease, and the range of factors influencing access to care. We compared socioeconomic status (SES) and comorbidity factors from the Carolina Breast Cancer Study Phase III (CBCS3, 2008-2013) to North Carolina and examined factors related to race and age in CBCS. Methods: Distributions of SES and comorbidity factors in CBCS3 cases were compared to those of North Carolina women in the 2010 Behavioral Risk Factor Surveillance Study. Using latent class analysis of CBCS3 data, we identified covariate patterns by SES/comorbidities, barriers to care, and tumor characteristics and examined their associations with race and age using multinomial logistic regression. Results: Major SES and comorbidity patterns in CBCS3 participants were generally similar to patterns in the state. Latent classes were identified for SES/comorbidities, barriers to care, and tumor characteristics that varied by race and age. Compared to white women, black women had lower SES (odds ratio (OR)=6.3, 95% confidence interval (CI); 5.2, 7.8), more barriers to care (OR=5.6, 95% CI; 3.9, 8.1) and several aggregated tumor aggressiveness features. Compared to older women, younger women had higher SES (OR=0.5, 95% CI; 0.4, 0.6), more barriers to care (OR=2.1, 95% CI; 1.6, 2.9) and aggregated tumor aggressiveness features. Conclusions: CBCS3 is representative of North Carolina on comparable factors. Patterns of access to care and tumor characteristics are intertwined with race and age, suggesting that interventions to address disparities will need to target both access and biology.

Citation Format: Marc A Emerson, Yvonne M Golightly, Xianming Tan, Allison E Aiello, Katherine E Reeder-Hayes, Andrew F Olshan, Shelley A Earp, Melissa Troester. Developing an integrated understanding of access to care and tumor characteristics patterns by race and age in the Carolina Breast Cancer Study Phase III, 2008 – 2013 [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 B100.
Abstract B111: Integrated molecular approach to identify biologic factors contributing to breast cancer disparities in Chicago
Authors: Casiano Ashlie M Santaliz
Published: September 2020

African American (AA) women have much higher risk of death from estrogen receptor positive (ER+) breast cancer than non-Hispanic white (Caucasian) women even though these racial groups have same incidence rates. The aim of this study is to explore whether there are racial differences in biological mechanisms that drive ER+ breast cancer and if they might be linked to a higher rate of metastasis and resistance to endocrine therapy. Eligible cases -AA and white women, aged 20-79, with a new diagnosis of stage I-III ER+ breast cancer- were recruited from 3 cancer institutions in Chicago. Control subjects -AA and white women presenting for a screening mammogram without breast symptoms and no history of cancer- have been recruited from the corresponding mammography centers. Serum was collected from AA and white cases and controls in order to conduct a metabolomics and proteomics analysis to identify oncometabolites that might promote aggressive phenotypes in ER/PR breast cancer cells. A follow up on previously established protocol and results from a total of new 266 subjects will be presented.

Citation Format: Ashlie M Santaliz Casiano. Integrated molecular approach to identify biologic factors contributing to breast cancer disparities in Chicago [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 B111.
Abstract B118: Characteristics of patients with pseudoangiomatous stromal hyperplasia (PASH): A retrospective cohort study
Authors: Bukenya George , Hufnagel Demetra , Anyawu Nneka , Kurita Stephanie , Beeghly-Fadiel Alicia
Published: September 2020

Background: Pseudoangiomatous stromal hyperplasia (PASH) is a proliferative mesenchymal lesion of the breast histologically defined by dense collagenous stroma with spindle-shaped myofibroblasts. Characterization of patients with PASH has largely been limited to histologic and radiographic studies with small sample sizes due to the rarity of this benign condition. Furthermore, no existing studies of PASH have yet to consider race. Objectives: We undertook this study to identify subjects with PASH from electronic medical records (EMR) at the Vanderbilt University Medical Center (VUMC) and evaluate patient characteristics, including differences by race. Approach: We used natural language processing (NLP)-assisted searches to identify 283 subjects with pathology reports containing ‘PASH’ or ‘pseudoangiomatous stromal hyperplasia’. Results: We confirmed PASH by pathology report for 229 subjects (80.9%). The majority were Caucasian women, although 24 African Americans (10.5%) and 4 males (1.7%) with PASH were also identified. A total of 27 (11.8%) had a diagnosis of cancer as some point in their EMR, most frequently breast (74.1%) or thyroid (14.8%) cancer. The median age at PASH diagnosis was 45.4 years (range: 12.9-84.6) but this seemed lower among Asians (31.4 years). PASH was found more frequently in the left breast (54.8%) and was ascertained most often by core needle biopsy (76.0%), stereotactic needle biopsy (11.8%), or excision (7.0%). Among initially biopsied patients, 20 (9.9%) and 39 (19.3%) had subsequent biopsies and excisions, respectively. No significant differences in any of these characteristics by race were identified. Conclusions: This data confirms that PASH is not exclusive to Caucasians and suggests that patient characteristics do not differ by race. Analysis of additional characteristics and patient outcomes, with inclusion of EMR time, is currently underway.

Citation Format: George Bukenya, Demetra Hufnagel, Nneka Anyawu, Stephanie Kurita, Alicia Beeghly-Fadiel. Characteristics of patients with pseudoangiomatous stromal hyperplasia (PASH): A retrospective cohort study [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 B118.
Abstract C019: The battle of multiple myeloma means impeccable strength
Authors: Sarrabo Yolanda Brunson
Published: September 2020

The battle of multiple myeloma means impeccable strength is- The Battle=Though the disease has our bodies captive and our minds unsure of the future. We’re stuck in how do we move forward, as the writing seems to be clear on the wall. We see death immediately. Impeccable Strength= Once the cries and whys are taken care of that a patient calls on their inner core and strength to bring them to a different mindset. This journey may be different like no other, and a revelation of what you’re really made of is about to take center stage. The time to be a warrior is now with dignity and grace.

Citation Format: Yolanda Brunson Sarrabo. The battle of multiple myeloma means impeccable strength [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 C019.
Abstract C062: Silent sanctuary city—impacts on women’s healthcare
Authors: Dauria Mary Kay
Published: September 2020

Houston is world renowned as a city on the cutting edge of medical research and top tier medical facilities. But there is another story. Over 38% of residents of Houston speak a language other than English. A vast majority of this population are not able to get medical insurance and do not get regular health screenings. Although federal monies are available to provide free mammograms and PAP tests for the uninsured, Texas stipulates that a valid Texas ID must be presented to get access. This poster addresses the impact a dedicated group of volunteer medical and lay staff are making to serve the underserved.

Citation Format: Mary Kay Dauria. Silent sanctuary city—impacts on women’s healthcare [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 C062.
Abstract C066: Association of ethnic density with social support and social isolation among Chinese immigrants in Philadelphia
Authors: Tseng Marilyn , Walton Emily , Fang Carolyn
Published: September 2020

The Asian American population is the fastest growing minority population in the US. Mental health status in Asian Americans is increasingly recognized as an important determinant of physical health outcomes, but it is understudied in Asian Americans, who are also less likely to seek treatment for mental health problems. Ethnic enclave residence is thought to be protective by providing greater social support and reducing social isolation, but evidence for this is limited and inconsistent, and few studies have focused on Asian immigrants. Our objective was to examine whether Chinese immigrants in areas of higher ethnic density report greater social support and less social isolation. Our analysis included 640 men and women recruited 1/16-5/19 through community organizations and contacts throughout the Philadelphia region. Residences were geocoded and linked to American Community Survey data from 2013-2017. Ethnic density was operationalized as percent of Census tract residents who were Chinese and categorized into quintiles. Social support was assessed using the Provisions of Social Relations scale, which captures support from family and friends, and low social support was defined as a score in the lowest quintile. Social isolation was assessed using a 17-item scale measuring social disconnectedness and perceived isolation, and high social isolation was defined as a score in the highest quintile. We ran logistic regression models using Generalized Estimating Equations to account for clustering within Census tracts, adjusting for age, sex, and at the Census tract level, median household income and percent of adults in poverty. We found that participants in the highest vs. lowest quintile of ethnic density (mean 12.6% vs. <1% Chinese in Census tract) were less likely to report low social support (odds ratio (OR) 0.40 (95% confidence interval (CI) 0.21, 0.75, trend p=0.02), and also less likely to report high social isolation (OR 0.40, 95% CI 0.17, 0.92, trend p=0.056). Despite suggestive trend p-values, however, ORs did not decrease in a dose-dependent manner. Our findings support the possibility that ethnic enclaves provide social resources that may protect against mental or even physical health problems. Lack of dose-dependence, however, indicates that the association is more complex and merits further exploration.

Citation Format: Marilyn Tseng, Emily Walton, Carolyn Fang. Association of ethnic density with social support and social isolation among Chinese immigrants in Philadelphia [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 C066.
Abstract C072: Maximum body mass index and breast cancer incidence in Black women
Authors: Gathirua-Mwangi Wambui G. , Palmer Julie R. , Champion Victoria , Adams-Campbell Lucile L. , Marley Andrew , Forman Michele , Rosenberg Lynn , Bertrand Kimberly A.
Published: September 2020

Introduction: The prevalence of obesity is high in African American (AA) women. Excess weight is an established risk factor for postmenopausal breast cancer (and inversely associated with premenopausal breast cancer), but studies of recent body mass index (BMI) in AA women have shown relatively modest associations. The use of maximum BMI attained during adulthood, which is less likely to be influenced by recent illness, has been suggested as an alternative exposure metric and has yielded stronger associations for some outcomes. Whether maximum BMI attained during adulthood is associated with risk of breast cancer has not yet been evaluated. Methods: We evaluated associations of maximum BMI attained during follow-up with incidence of all breast cancer and with breast cancer subtypes in 56,919 AA women in the prospective Black Women’s Health Study. From 1995 to 2013, we identified a total of 2708 breast cancers, of which 2008 were invasive cancers, including 1446 estrogen receptor (ER) positive and 652 ER negative. We used multivariable Cox proportional hazards regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for associations by ER status and menopausal status. Results: Compared to a maximum BMI of <25 kg/m², having a maximum BMI of ≥35 kg/m² (Obese II) was associated with increased risk of ER+ (HR=1.29, 95% CI 1.05-1.59) and postmenopausal breast cancer (HR=1.38, 95% CI 1.12-1.70), after adjustment for BMI at age 18 and other breast cancer risk factors. The association of maximum BMI with ER+ breast cancer was observed among postmenopausal women (HR=1.63, 95% CI 1.24-2.15) but not premenopausal women. The associations observed for maximum BMI were stronger in magnitude than associations for recent BMI in the same dataset. Conclusion: A maximum attained BMI of ≥35 kg/m² is associated with substantially increased risk of ER+ breast cancer among postmenopausal AA women. These findings provide new insights into the impact of obesity on breast cancer risk in this population, and suggest that maximum BMI may be a useful metric for understanding associations between adiposity and breast cancer risk.

Citation Format: Wambui G. Gathirua-Mwangi, Julie R. Palmer, Victoria Champion, Lucile L. Adams-Campbell, Andrew Marley, Michele Forman, Lynn Rosenberg, Kimberly A. Bertrand. Maximum body mass index and breast cancer incidence in Black women [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 C072.
Abstract C076: Effect of obesity and inflammation on prostate cancer disease risk and mortality among African and European American men
Authors: Pichardo Margaret S , Minas Tsion , Tang Wei , Dorsey Tiffany , Cook Michael , Ambs Stefan
Published: September 2020

Prostate cancer (PCa) is a major cause of cancer death in U.S. men. Age-adjusted mortality rates for men of African ancestry (40.8 per 100,000) are more than twice that of men of European ancestry (18.2 per 100,000). Men of African ancestry are more likely to have advanced stage cancer at diagnosis and lower prostate cancer survival rates relative to men of European ancestry of similar age and stage at diagnosis. Risk factors that may explain this survival disparity remain poorly understood. Obesity, a major risk factor for cancer development, aggressiveness and progression, disproportionately affects US men of African ancestry. Age-adjusted prevalence of obesity are higher among men of African ancestry (38.0%) compared to men of European ancestry (34.7%). While it has been previously suggested that obesity may worsen disease-related outcomes among prostate cancer patients, the relationship of obesity and prostate cancer mortality remains unclear, with studies showing mixed or null results in men of African ancestry. Less is known about the underlying biological mechanisms that may contribute to the racial differences observed in the link between obesity and prostate cancer. We previously reported an obesity paradox among African-American men in the NCI-Maryland Prostate Cancer-Case Control Study, with overweight and obese men having a lower risk of being diagnosed with the disease. Here, using Cox proportional hazard regression modeling, we estimated the risk of a PCa mortality for the 976 cases in the study. Our primary analysis suggests an obesity paradox, where obesity may protect against disease mortality among the African-American men. In subsequent analyses, we will examine the role of immune and inflammation markers in mediating or moderating the observed relationship of obesity with PCa in these men.

Citation Format: Margaret S Pichardo, Tsion Minas, Wei Tang, Tiffany Dorsey, Michael Cook, Stefan Ambs. Effect of obesity and inflammation on prostate cancer disease risk and mortality among African and European American men [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 C076.
Abstract C104: A community guide systematic review of interventions engaging community health workers to increase appropriate breast, cervical, and colorectal cancer screening: Findings in underserved populations
Authors: Cobb Jamaicia , Peng Yinan , Okasako-Schmucker Devon
Published: September 2020

Background: Underserved adults in the United States are disproportionately not up-to-date with cancer screening. This systematic review examined the effectiveness of interventions engaging community health workers (CHWs) to increase breast, cervical and colorectal cancer (CRC) screening, especially among underserved populations. Methods: Potentially relevant publications were identified through a literature search from 1960 to July 2017. Included studies reported recent or repeat breast, cervical, or colorectal cancer screening. CHWs were recruited from or had close knowledge of the intervention community, received training to become a CHW, and implemented part or all of the intervention. Stratified analyses were conducted to examine intervention effectiveness among underserved populations. Results: Sixty-six studies with seventy study arms were included. Overall, screening rates increased for all three cancer types. Majority of the included studies examined interventions implemented among underserved populations. These interventions were effective for study populations that were 100% minority or majority minority (median increase of 12.8pct pts across cancer types, 51 study arms), majority low income (median increase of 12.7pct pts across cancer types, 30 study arms), majority uninsured (median increase of 15.0pct pts across cancer types, 12 study arms), or lived in rural areas (median increase of 10.2pct pts across cancer types, 12 study arms). Conclusions: Interventions engaging CHWs were effective in increasing breast, cervical, and CRC screening for underserved populations.

Citation Format: Jamaicia Cobb, Yinan Peng, Devon Okasako-Schmucker. A community guide systematic review of interventions engaging community health workers to increase appropriate breast, cervical, and colorectal cancer screening: Findings in underserved populations [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 C104.
Abstract D021: Chinese E-Women Project: A community-based approach to improving breast cancer knowledge among Chinese American women
Authors: Lee Alice W , Puga Cindy , Tsai Michelle , Huang Sherry
Published: September 2020

Background: Breast cancer is the most common cancer for Chinese women living in the United States (U.S.). Despite overall rates being significantly lower than other races and ethnicities, incidence has steadily increased over the last few decades. This is concerning given that Asian Americans are the fastest growing racial group in the U.S. and Chinese Americans constitute the largest Asian American ethnic population. In addition, mammography screening rates are low among Chinese American women, and this may be attributable to a lack of breast cancer knowledge and awareness. Methods: The Chinese E-Women Project (CEWP) is a breast health education and engagement program developed by the Orange County Herald Center (OCHC), a non-profit organization that serves the Chinese American community in Orange County, California. Two key CEWP components are the Community Gatekeeper Education Session (CGES), which is a formal education session led by trained OCHC staff to engage and educate Chinese American community leaders, and the E-Women Tea Time (EWTT), which is an informal peer group education session led by a past CGES participant. All CGES and EWTT events presented information on breast cancer epidemiology, biology, and screening. Questionnaires testing breast cancer knowledge were administered before and after the education session at each event. We pooled data across the CGES and EWTT events separately and used Wilcoxon signed rank test to evaluate change in participants’ overall knowledge. We also examined change in knowledge by question using McNemar’s test. Results: Our analysis included a total of 94 CGES and 149 EWTT female participants. For both CGES and EWTT, we observed significant improvements in overall breast cancer knowledge after the education session (both p<0.0001). Although we did identify one question related to mammography and another question related to personal breast health that did not show significant improvement after the session, knowledge for all other questions significantly improved (all p<0.05). Conclusions: These findings highlight community-based education sessions as effective ways of both informing Chinese American women about breast cancer and engaging them to become advocates of breast health wellness in their community. Future research should evaluate whether these types of sessions can lead to positive individual changes in behavior and screening practice.

Citation Format: Alice W Lee, Cindy Puga, Michelle Tsai, Sherry Huang. Chinese E-Women Project: A community-based approach to improving breast cancer knowledge among Chinese American women [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 D021.