bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract A08: Leveraging technology to promote smoking cessation in primary care medical offices
Authors: Saad-Harfouche Frances G. , Rodriguez Elisa M. , Twarozek Annamaria Masucci , Widman Christy A. , Erwin Deborah O. , Underwood Willie , Fox Chester , Mahoney Martin C.
Published: March 2017

Purpose of the Study: While smoking represents the leading preventable cause of premature morbidity and mortality in the U.S., research has demonstrated that only a limited scope of cessation services are delivered to patients in many medical offices. We examined the use of an automated voice recognition (AVR) messaging intervention among smokers from primary care practices located in underserved urban and rural communities as a strategy to promote smoking cessation.

Methods: We utilized community-based participatory research (CBPR) involving smokers as a foundation for creating AVR messaging and partnered with urban and rural primary care medical office sites (n=7), including community clinics and federally qualified health centers. Current smokers, 18 years and older, who had an office visit within the previous 12 months, from these sites were used to create a smoker's registry (n=5,872). Between 2012 and 2014 participants were contacted over six month intervals using the AVR system. Smoker's registry data including demographic variables, medical office, and phone contact information. AVR results from each practice were aggregated and analyzed to assess cessation outcomes.

Results: Of the seven practice sites, a total of 5,872 smokers were accrued of whom 1,899 (32%) were reached through the AVR system. The average number of calls to smokers was 44 (median 51). 28% of the smokers reached were African American, 79% were age 40 and over, and 57% were female. Self-reported quit rates among reached smokers were 30%; quit rates were variable across selected variables.

Conclusions: An AVR based smoking cessation intervention provided added value beyond typical tobacco cessation efforts available in these primary care offices. This intervention required no additional clinical staff time and served to satisfy a component of patient center medical home requirements for many of these practices. Building partnerships with primary care medical offices can aid in the development and testing of community-based interventions such as smoking cessation delivered to medically underserved and diverse patient populations.

Citation Format: Frances G. Saad-Harfouche, Elisa M. Rodriguez, Annamaria Masucci Twarozek, Christy A. Widman, Deborah O. Erwin, Willie Underwood, III, Chester Fox, Martin C. Mahoney. Leveraging technology to promote smoking cessation in primary care medical offices. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr A08.
Abstract A62: [Advocate Abstract:] Breast Cancer Screening Among African Immigrants and Refugees
Authors: Richards-Waritay Oni
Published: March 2017

“Breast Cancer Screening Among African Immigrants and Refugees” provides insight into the community-based breast cancer education and access to screening activities of the African Family Health Organization (AFAHO) for African women living in the greater Philadelphia area. The poster provides information about client recruitment; age, primary language and country of origin of clients; awareness about breast cancer before and after our educational activities and screening activities.

Citation Format: Oni Richards-Waritay. [Advocate Abstract:] Breast Cancer Screening Among African Immigrants and Refugees. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr A62.
Abstract A65: Identifying perceptions of cancer prevention education needs and outreach strategies among young population in Puerto Rico
Authors: Ramos Francisco , Ramos Axel , Castro Eida , Jimenez Julio
Published: March 2017

Cancer is leading cause of death worldwide. It's well established that educating young population in prevention is better and more cost-effective, yet insufficient educational programs aimed at this population continues in Puerto Rico. Focus groups were developed to examine the opinions, perceptions and beliefs about cancer and cancer prevention education, and outreach strategies among young adults. The final goal of this study is to establish bases to develop a cancer educational program tailored to young population in Puerto Rico.

This qualitative study developed four focus groups (n=40), divided by age (18-20/21-24) and sex. The objectives listed were explored using 7 open-ended questions. The sessions were recorded, transcribed and analyzed with a content analysis perspective, using the constant comparative method, was performed to identify key themes. A thematic framework was established to classify and organize data according to key themes, concepts, and categories.

Four categories emerged from the transcribed material: concept related to cancer, concepts related to cancer prevention, need for cancer prevention education among young population, and challenges to cancer education among young population. When describing their perception of cancer, the participants mentioned words such as: death, horrible, suffering and struggle. Participants perceived prevention as a way to care for oneself and cancer prevention education as an educational strategy. They acknowledge the importance of cancer prevention education and recognized some of the challenges that educators face when educating young population. Suggested strategies included: social media, media, apps, classrooms, art and public figures. Strategies that don't work included: written materials, flyers, traditional workshops, radio campaigns.

These results confirm the importance of educating young population in cancer prevention. This study shows the relevance of to incorporate adolescent and young adults during the process to develop cancer prevention education programs under the community based participatory research approach.

Note: This abstract was not presented at the conference.

Citation Format: Francisco Ramos, Axel Ramos, Eida Castro, Julio Jimenez. Identifying perceptions of cancer prevention education needs and outreach strategies among young population in Puerto Rico. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr A65.
Abstract A79: Influence of culture and religion on fatalistic cancer beliefs
Authors: Farr Deeonna E. , Brandt Heather M. , Friedman Daniela B. , Armstead Cheryl A. , Heiney Sue P. , Adams Swann A. , Green Wanda , Hébert James R.
Published: March 2017

Background Cancer-related beliefs, including cancer fatalism, have been shown to influence Blacks' adherence to cancer screening behaviors. Healthcare discrimination, religious beliefs, income, and education are known determinants of cancer fatalism, however, it is unclear whether other cultural and cancer-related beliefs and/or experiences play a role in fatalistic beliefs. Purpose To determine how sociodemographic characteristics, cancer-related and cultural beliefs contribute to cancer fatalism in a sample of Black adults. Methods A statewide survey was completed by 194 Black adults ≥18 years without a history of cancer from November 2014-July 2015. Sociodemographic characteristics, cancer worry, perceived cancer risk, knowing someone with cancer, mistrust in the medical system, present orientation, religious identity, and religious behaviors were assessed through the survey. Cancer fatalism was measured using a revised version of the Powe Fatalism Inventory. Multiple regression was used to analyze survey data. Results Regression analyses on 131 surveys with complete responses showed that age, income, possessing health insurance, having a present orientation, and engaging in prayer were significant predictors of fatalistic cancer beliefs (R2= 0.26, p<0.05). Discussion The results support some previously established influences on cancer fatalism; however, other influences, specifically medical mistrust, religious identification, and church attendance did not predict cancer fatalism. Cancer fatalism is not directly related to religion but may be indirectly associated with religious practices that indicate a high external locus of control. Examining the contributors of cancer-related beliefs may yield valuable information that can enhance culturally appropriate cancer communication and programming.

Citation Format: Deeonna E. Farr, Heather M. Brandt, Daniela B. Friedman, Cheryl A. Armstead, Sue P. Heiney, Swann A. Adams, Wanda Green, James R. Hébert. Influence of culture and religion on fatalistic cancer beliefs. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr A79.
Abstract B09: Multivariable Models for Predicting Likely Metastatic Sites for Triple Negative Breast Cancers
Authors: Klimov Sergey , Green Andrew , Aleskandarany Mohammed , Rakha Emad , Ellis Ian , Reid Michelle , Padmashree Rida C. G. , Aneja Ritu
Published: March 2017

Background: Unique organ microenvironment may preferentially support growth of specific tumor clones because of which different breast cancer subtypes show distinct tropisms for sites of metastasis. While a few gene expressionbased signatures are known to predict sitespecific metastasis of breast cancer, little work has focused on identification of clinically facile immunohistochemical predictors of metastasis to specific sites, especially for triple negative breast cancers (TNBCs).

Methods: Primary tumor samples from 322 TNBC patients were stained for 133 biomarkers and assessed by immunohistochemistry. Differences in average levels of these biomarkers were compared between patients with or without metastasis to specific sites (brain, bone, lungs, liver, lymph nodes). Significantly different biomarkers were then analyzed within a Cox regression model to evaluate their prognostic value when patients with metastasis to the site of interest were compared to patients with no metastasis. Ideal thresholds, based on maximizing model fit, stratified cohorts that show high and low expression of each biomarker. A combination of a biomarker found high for each site, low for each site, and the Nottingham Prognostic Index (NPI) was used to stratify patients.

Results: Our analysis uncovered several biomarkers whose expression levels in primary tumors can predict the site of future metastasis in TNBCs. Our models for brain (PARP1 & BRCA2), bone (MTA1 &Tumor-Adjacent CD8), liver (TFF1 & N-Cadherin), and lung (ROR) were able to identify patients who had at least a 500% risk of site specific distant metastasis.

Conclusion: Relatively simple and inexpensive immunohistochemical analyses of biomarkers, combined with logical model building, in primary tumors of TNBCs may allow prediction of the site of future metastasis. Highrisk patients may benefit from increased surveillance of such sites.

Citation Format: Sergey Klimov, Andrew Green, Mohammed Aleskandarany, Emad Rakha, Ian Ellis, Michelle Reid, Rida C. G. Padmashree, Ritu Aneja. Multivariable Models for Predicting Likely Metastatic Sites for Triple Negative Breast Cancers. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr B09.
Abstract B53: BRCA1 and BRCA2 mutations spectrum in Puerto Rican Hispanics
Authors: Pérez-Mayoral Julyann , Cora-Morges Adrian , Gonzalez-Rosa Krystel , Hernandez Jessica , Castillo Danielle , Herzog Josef , Weitzel Jeffrey , Cruz-Correa Marcia
Published: March 2017

Introduction: Hereditary breast cancer accounts for up to 10% of breast cancer cases. These hereditary breast cases have been shown to be associated with mutations in the BRCA1 and BRCA2 genes. The prevalence and types of mutations in these genes varies depending on the population and ethnicity under study. Identification of such specific mutations allows for site specific testing. In the absence of knowledge of specific mutation information, entire gene sequencing is necessary in order to identify the putative mutations involved in the predisposition to increased risk.

Objective: The objective of this project is to identify and annotate the mutations in BRCA1 and BRCA2 genes encountered in the Puerto Rican population which will allow for accessible genetic testing services to be offered.

Methods: From January 2014 to May 2016, we recruited 46 women that met the National Comprehensive Cancer Network guidelines for breast cancer genetic testing. Among recruited participants, 18 were diagnosed with breast cancer, 8 with ovarian cancer, 1 with both breast and ovarian cancer and 19 had family history of breast or ovarian cancer suggestive of hereditary cancer. The recruited individuals were submitted to genetic testing, first by the Hispanel breast cancer mutation panel, developed at City of Hope Division of Clinical Cancer Genetics. If negative on the Hispanel, Sanger sequencing was performed to evaluate the whole genes and confirm results.

Results: Our results showed 38 negative genetic testing for BRCA1/BRCA2, 4 variants of uncertain significance and 4 pathogenic mutations in the population under study. One pathogenic mutation was found in BRCA1 (BRCA1 exon15-16del) and 3 pathogenic mutations were found in BRCA2 (BRCA2 2022del5; BRCA2 4150G>T (E1308X); BRCA2 6027del4).

Conclusion: The prevalence of mutations in this preliminary study is consistent with previous reports of BRCA mutations in Puerto Rico, which describe as BRCA2 as the most commonly mutated gene in the island. Additional studies are needed to fully elucidate the BRCA1/BRCA2 mutation spectrum in Puerto Rico for allowing the implementation of cost-effective and affordable genetic testing strategies for women in need.

Citation Format: Julyann Pérez-Mayoral, Adrian Cora-Morges, Krystel Gonzalez-Rosa, Jessica Hernandez, Danielle Castillo, Josef Herzog, Jeffrey Weitzel, Marcia Cruz-Correa. BRCA1 and BRCA2 mutations spectrum in Puerto Rican Hispanics. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr B53.
Abstract B60: Inflammatory-based diagnostic markers of lung cancer in African Americans
Authors: Meaney Claire L. , Mitchell Khadijah A. , Zingone Adriana , Brown Derek , Tang Wei , Yu Yunkai , Cao Liang , Ryan Brid M.
Published: March 2017

Background:

African Americans have a higher risk of developing lung cancer compared with all other ethnic groups in the USA. Previous studies based on a small panel of markers suggested that certain circulating cytokines were associated with lung cancer. Given the complexity of the immune response in lung cancer and the multitude of cell types involved, we reasoned that examining a broad panel of inflammatory markers — including cytokines, chemokines, angiogenic and other pro-inflammatory factors — might identify a diagnostic signature of lung cancer for African American patients.

Methods:

Differences in 30 inflammatory marker serum levels, were measured in 308 African-American cases and 501 African American controls from the National Cancer Institute-Maryland (NCI-MD) case-control study using a Mesoscale multiplex platform (MSD). The panel of 30 serum inflammatory markers, included chemokines, cytokines and other inflammatory related proteins (Mesoscale VPLEX assay). Associations of the serum cytokine levels with lung cancer were analyzed using Stata statistical software (StataCorp, TX)

Results:

Fifteen inflammatory markers (CRP, IFN-gamma, IL-10, IL-15, IL-17A, IL-1beta, IL-6, IL-7, IL-8, IP-10, MCP-4, MIP-1alpha, TARC, TNF-alpha and VEGF) were significantly different among African American cases compared with African American controls. In agreement with our previous observations, levels of IL-10, IL-1beta, IL-6, IL-8, and TNF-alpha were associated with lung cancer risk. In addition, we found that CRP, IFN-gamma, IL-15, IL-7, IP-10, MCP-4, MIP-1alpha, TARC, and VEGF were associated with lung cancer in African Americans. The associations between CRP, IFN-gamma, IL-10, IL-15, IL-1beta, IL-6, IL-7, IL-8, IP-10 and MCP-4 levels and lung cancer among African Americans were significant after adjustment for additional potential confounding factors.

Conclusions:

Serum cytokine levels vary by race and might contribute to lung cancer differently between African Americans and European Americans. The findings presented here build upon recent work that identified associations between elevated levels of IL-10, IL-1beta, IL-6, IL-8, TNF-alpha and lung cancer among African Americans. Furthermore, by analyzing a broader spectrum of inflammation, we have identified additional markers of lung cancer for African American patients.

Citation Format: Claire L. Meaney, Khadijah A. Mitchell, Adriana Zingone, Derek Brown, Wei Tang, Yunkai Yu, Liang Cao, Brid M. Ryan. Inflammatory-based diagnostic markers of lung cancer in African Americans. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr B60.
Abstract B74: DISPARITIES IN SURVIVAL AMONG HISPANIC CHILDREN WITH CANCER: THE TEXAS EXPERIENCE
Authors: Bertiery Erika Lopez , Xuan Lei , Pruitt Sandi
Published: March 2017

INTRODUCTION

In 2014, 15,780 incident cancers occurred among US children and adolescents, 15% of whom were Hispanic. Hispanic children with cancer have shown an increased mortality compared to Whites, however, existing studies are small and limited to a few cancer types. We evaluated the association of Hispanic ethnicity with mortality among children with all cancer types.

METHODS

Using Texas Cancer Registry data, we examined differences in all-cause mortality between Hispanics and Non-Hispanic Whites 0-19 years old diagnosed with a primary malignancy, 1995-2013. Differences in survival were estimated using unadjusted Kaplan-Meier curves and multivariable Cox proportional hazard models (adjusted for age, sex, year of diagnosis, cancer type, stage). Analyses were conducted for all cancer types and separately by type (leukemia, lymphoma, solid tumors).

RESULTS

Of 18,687 patients (8,659 Hispanic, 10,028 Non-Hispanic White), 27% had leukemia, 59% a solid tumor, and 13% had lymphoma. In unadjusted Kaplan-Meier analyses, Hispanics with leukemia (p<.001) and solid tumors (p<.001), but not lymphoma (p=.245) had higher mortality, compared to Whites. In adjusted Cox proportional hazard models, Hispanics had higher mortality for all cancer types combined (adjusted hazard ratio [aHR]: 1.30; 95% CI: 1.22-1.37), leukemia (aHR: 1.34; 95% CI: 1.19-1.51), and solid tumors (aHR: 1.26; 95% CI: 1.17-1.36), but not lymphoma (aHR: 1.13; 95% CI: 0.93-1.38).

CONCLUSION

Hispanic children with leukemia or solid tumors in Texas have higher risk of death, compared to Whites. Future research should seek to understand reasons underlying this disparity and to develop interventions designed to improve survival among Hispanic children with cancer.

Citation Format: Erika Lopez Bertiery, Lei Xuan, Sandi Pruitt. DISPARITIES IN SURVIVAL AMONG HISPANIC CHILDREN WITH CANCER: THE TEXAS EXPERIENCE. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr B74.
Abstract C01: Understanding supportive care factors among African American breast cancer survivors
Authors: Davis Claudia M.
Published: March 2017

Introduction: Comprehensive breast cancer care includes not only diagnosis, staging and treatment for cancer, but also assessment and management of the physical, psychological, social, spiritual, and informational needs-collectively known as supportive care. This time frame, largely acknowledged until recently, is commonly referred to as the supportive phase. Several studies have documented the importance of addressing supportive care factors among breast cancer survivors. However, there appears to be a paucity of research concerning African American breast cancer survivors.

Purpose: The purpose of this study was to investigate and understand the patient-centered supportive care factors among community-dwelling African American breast cancer survivors.

Design/Methods: Via recruitment flyers, supportive groups and word of mouth, 169 women were recruited and screened from breast cancer support groups and community dwellers. One hundred and sixty women were eligible and 155 participated. The inclusion criteria were women who self-identified as African/Black American, age 25 years and older, diagnosed with breast cancer and at least 1 year post-active treatment. As part of a larger study, and using a qualitative descriptive approach, an open-ended questionnaire explored supportive care factors that were utilized by n = 155 African American breast cancer survivors in southern and northern California.

Results: The results revealed that the breast cancer survivors age at diagnosis ranged from 31-77 (M = 51.7), and years of survivorship ranged from 1-27 (M = 9.7). Among these women, the four (4) supportive care factors that were considered to be the most helpful and primary during their survivorship trajectory were their faith, supportive structures, being optimistic and having adequate access to information.

Conclusion: An understanding of these factors as reported by African American breast cancer survivors might facilitate discussion among members of the oncology care team and this shared dialogue could pave the way for a responsive healthcare model (e.g. survivorship care plans) and targeted intervention of psychosocial resources. The resultant effect could also inform and promote the delivery of culturally specific healthcare to address the supportive care needs among African American breast cancer survivors.

Citation Format: Claudia M. Davis. Understanding supportive care factors among African American breast cancer survivors. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr C01.
Abstract C06: Implementation of Universal Colorectal Cancer Screening for Lynch Syndrome: A Population-Based Study
Authors: Sierra Isabel , Diaz-Algorri Yaritza , Maldonado Valerie , Alicea Kimberly , Rosado Kathia , Cruz-Correa Marcia
Published: March 2017

Introduction: Colorectal cancer (CRC) is the leading cause of cancer death in Puerto Rico and the third one among US Hispanics. Up to 2-4% of colorectal cancer cases are caused by germline mutation in at least one of these four DNA mismatch repair (MMR) genes: MLH1, MSH2, MSH6, and PMS2. Mutations in these genes cause Lynch Syndrome (LS), the most common hereditary form of CRC. Immunohistochemistry (IHC) tests for the presence of MMR proteins and microsatellite instability (MSI) analysis is often performed on the tumor of CRC cases to screen for LS and as markers for prognosis. Universal screening of CRC for LS has been recommended by the National Comprehensive Cancer Network (NCCN) since 2014.

Objective: The purpose of this study was to determine the prevalence of positive LS-screening test as determined by absence of MMR proteins in CRC since the implementation of universal tumor screening for LS in the largest private pathology laboratory in Puerto Rico.

Methods: We collected the data from all CRC cases performed at Hato Rey Pathology Laboratories from September 2014 to December 2015. Pathologies performed where collected from 11 hospitals that cover the island of Puerto Rico. The data collected included results of IHC and MSI analysis as well as tumor location, gender, age, date reported and hospital.

Results: A total of 317 CRC tumors were evaluated for LS-screening; with a mean age of 66 years, and 54.3% were males. IHC analysis was performed in 288 cases and of these, 11.1% demonstrated absence of one or more of the MMR proteins, compatible with a positive screening test for LS. There were 21 cases that had only MSI analysis performed and they were all reported as microsatellite stable.

Conclusion: This is the first evaluation of a systematic program for Universal CRC screening for LS in Puerto Rico. Our data is consistent with results from other studies of US-Hispanics where approximately 10% of individuals of Hispanic origin with CRC have MSI. The observed prevalence of absence of MMR-proteins in our study supports universal screening of LS among Hispanics in accordance with NCCN guidelines.

Citation Format: Isabel Sierra, Yaritza Diaz-Algorri, Valerie Maldonado, Kimberly Alicea, Kathia Rosado, Marcia Cruz-Correa. Implementation of Universal Colorectal Cancer Screening for Lynch Syndrome: A Population-Based Study. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr C06.
Abstract C17: Unequal Financial Burdens Highlight Racial Disparities of Colon Cancer Patients in New York
Authors: Oveson Brian C. , Parikh Purvi , Telem Dana , Williams Jennifer , Bergamaschi Roberto , Sasson Aaron , Talamini Mark , Kim Joseph
Published: March 2017

Background: We have previously investigated racial disparities in colorectal cancer outcomes and discovered outcomes differences according to racial group. In our ongoing studies we sought to determine whether these disparities in survival resulted in unequal financial burdens between black and white patients. The purpose of this study was to identify whether financial disparities exist between the black and Caucasian colorectal cancer patients within New York State, with the ultimate goal of eliminating any differences.

Research Design: The Statewide Planning and Research Cooperative System (SPARCS) database of New York State (NYS) was used to compare costs of colon cancer surgery hospitalizations of the black and Caucasian patient populations between 2009-2013. Student t-tests were performed for comparison of inpatient hospital discharge, ambulatory surgery, and emergency department admission within the SPARCS database. Facility costs were calculated using hospital discharge data and Institutional Cost Reports. Logistic regression analysis examined race as the dependent variable to identify the etiology of cost disparity.

Results: Overall, 26,477 patients (white, n= 21,606; and black, n=4,871) underwent colon cancer treatment. Treatment costs in the black population were higher compared to the white population (mean, $64,747 vs $58,127; median, $44,951 vs $41, 285) (p<0.001). Emergent operations were more frequent in the black population (52% vs 37%)(p<0.001), as well as the median length of stay in the hospital (7 days vs 6 days) (p<0.001). After these data were normalized with respect to length of stay and percentage of emergent operations, the costs for blacks were lower than the costs for Caucasians.

Conclusion: This study revealed that the black colon cancer population had higher costs than the Caucasian colon cancer population. We identified emergent operations and longer hospitalization as the primary etiologies for this disparity. Sufficient colon cancer screening for the black population might reduce the number of emergent operations and reduce length of hospitalization if the cancer is detected at an earlier stage.

Note: This abstract was not presented at the conference.

Citation Format: Brian C. Oveson, Purvi Parikh, Dana Telem, Jennifer Williams, Roberto Bergamaschi, Aaron Sasson, Mark Talamini, Joseph Kim. Unequal Financial Burdens Highlight Racial Disparities of Colon Cancer Patients in New York. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr C17.
Abstract C60: [Advocate Abstract:] Cancer Screening Guidelines and the Impact of the Minority Community
Authors: Aldrich Dawn
Published: March 2017

As of today, minority women are still leading the death toll in breast cancer. In addition, the under-served are confused with what we have worked so hard to promote in educating them about cancer screening, Some women were dismissive as they would tell us they don't have to get screened- not because they were not 40 or over but because they saw it on television. Interestingly, they were those who were concerned as they knew of people who were much younger or had no family history that were diagnosed or died of cancer. There is a concern of the minority and under-served community who are on the losing side of mist cancers, the questions are now coming in fast and furious and communication is extremely important. The poster will address the concerns, the statistics on diagnosis, stage and mortality rates.

Citation Format: Dawn Aldrich. [Advocate Abstract:] Cancer Screening Guidelines and the Impact of the Minority Community. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr C60.
Abstract C72: Social norms, family communication, and hepatitis B screening among Asian Americans
Authors: Juon Hee-Soon , Rimal Rajiv , Lee Sunmin
Published: March 2017

Background: Although social norms are thought to play an important role in hepatitis B screening behaviors, limited theoretical or empirical guidance exists on how the underlying process works. Using the theory of normative social behavior (TNSB), we examined the role played by injunctive norms and interpersonal discussion in the relationship between descriptive norms and hepatitis B screening behavior among Asian Americans.

Methods: Chinese, Korean, and Vietnamese Americans in the Washington D.C.-Baltimore metropolitan area (N=877) were recruited from community-based organizations. Self-administered baseline surveys collected information on their demographic, social norms (e.g., descriptive and injunctive norms), interpersonal communication, and HBV screening behavior.

Results: Social norms and family communication emerged as key factors in HBV screening. For Vietnamese Americans, family communication moderated the influence of descriptive norms on behavior. Injunctive norm moderated the influence of descriptive norms on behavior among Korean Americans. However, there was no significant interaction for Chinese Americans.

Discussion: Family communication and social Snorms are integral in enabling Asian Americans to have HBV screening and warrant sensitivity in the design of liver cancer prevention program in this high risk group of Asian Americans.

Citation Format: Hee-Soon Juon, Rajiv Rimal, Sunmin Lee. Social norms, family communication, and hepatitis B screening among Asian Americans. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr C72.
Abstract C92: [Advocate Abstract:] The Disparity of Human Papillomavirus Vaccination Knowledge, Attitudes and Practices in College-Age Women 18-26 years old
Authors: Weaks Francesca
Published: March 2017

Background: In 2006, two vaccinations with guidelines were released to prevent against the Human Papillomavirus (HPV), and was recommended for all females' ages 11-12. Updated guidelines target females ages 11-12, and encourage catch up vaccinations for ages 13-26. The original recommendations by the CDC and other medical professionals did not address females ages 14-26. In 2006, females ages 14-26 were not recommended to receive the vaccination but were and still are the highest risk population for contracting HPV. During the ages of 14-26 years old, most females begin sexual intercourse and become vulnerable to sexually transmitted diseases Objective: To investigate the key factors that contributes to college-aged students initiating and completing the HPV vaccination. Participants: College students ages 18-26 attending Towson University enrolled in selected Health Science Classes during Summer Session 2012. Methods: Data were collected during the summer session of 2012 from students enrolled in Health Science classes at Towson University Department of Health Science. Classes were selected from the available summer classes that were offered and had approval from the professor .Students completed a survey regarding their Knowledge, Attitudes, and Practices of HPV either during an in-class session or via Blackboard. Statistical analysis was conducted using chi-square, independent t-test, and logistic regression.

Citation Format: Francesca Weaks. [Advocate Abstract:] The Disparity of Human Papillomavirus Vaccination Knowledge, Attitudes and Practices in College-Age Women 18-26 years old. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr C92.
Abstract IA02: A global perspective on clinical cancer genomics
Authors: Weitzel Jeffrey
Published: March 2017

Access to genomic cancer risk assessment (GCRA) is standard of care in most developed countries, but is not readily available in Latin America. Following needs assessment, a dissemination and implementation intervention, including clinical training and application of in expensive genomic tools, was used to develop a model for vertical integration of GCRA among underserved populations in Latin America. A roundtable forum with 15 Latin American physicians representing Brazil, Colombia, Mexico, Puerto Rico and Peru was conducted to assess the state of GCRA services and barriers to implementation in these countries. The roundtable was conducted in Spanish, moderated by bilingual cancer genetics clinicians, recorded, transcribed, translated and thematically analyzed. Roundtable findings indicated a need for a multi-level approach with GCRA training, cost-effective genomic testing, and an evidence-based foundation to support the development of policy, infrastructure and resources to implement and sustain GCRA services in Latin America. The City of Hope Intensive Course and Clinical Cancer Genomics Community of Practice (CCGCoP), an NCI R25-E multi-modal training and practice support program, was piloted to address in part the need for clinicians with GCRA skills as part of infrastructure development. A common prospective registry protocol was implemented via the Cancer Genomics Community Research Network (CCGCRN), and disruptive technologies (next generation sequencing and other rapidly evolving genomic tools) enabled inexpensive BRCA testing tools to be introduced to support GCRA services. Site assessments and clinical proctoring demonstrated successful initiation of GCRA services and has revealed barriers to follow up care. Thus, innovative pairing of disruptive technologies and multimodal training tools have the potential to accelerate implementation of genomic cancer risk assessment and prevention for underserved populations.

Citation Format: Jeffrey Weitzel. A global perspective on clinical cancer genomics. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr IA02.
Abstract IA10: Cancer: A Hispanic historical perspective
Authors: Ramirez Amelie G.
Published: March 2017

US Hispanics/Latinos are an extremely diverse population. This diversity stems from Spanish settlements in the US in the 1400s to late 1700s, and also major immigration patterns into the US from the early 1800s to present. This means US Hispanics/Latinos differ greatly in regards to their genetic ancestry, creating variability in genetic make-up, cultural values, degree of assimilation to U.S. lifestyle, and socio-demographics. Due to the cancer health disparities that affect US Hispanics/Latinos in diverse ways, there is a tremendous need to conduct cancer research that considers US Hispanics/Latinos as a highly heterogenous population with as much diversity within, as across other ethnic groups. Certain cancer health disparities affect certain US Hispanics/Latinos ethno-regional groups differently, such as Puerto Ricans, Cubans, Mexicans, South Americans, and Central Americans. This presentation will briefly introduce data and statistics on the diversity among the US Hispanics/Latinos population and how they vary in cancer rates and cancer knowledge and attitudes, as well as emerging research.

Citation Format: Amelie G. Ramirez. Cancer: A Hispanic historical perspective. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr IA10.
Abstract IA12: Variation in genetic ancestry proportions among Latinos and its impact on cancer risk, prediction, and outcomes
Authors: Fejerman Laura
Published: March 2017

Latinos are a heterogeneous group, encompassing individuals with diverse genetic and sociocultural backgrounds. Reports on U.S. cancer incidence rates and cancer mortality in Latinos have only recently started to provide information by national origin, which has unveiled disparities that were not apparent in analyses that grouped all Latinos together. Genetic ancestry is another important factor in the characterization of Latin American populations. Mainly composed of European, Indigenous American and African ancestral influences, it can reflect socioeconomic/sociocultural differences as well as genetic ones. There have been studies testing the association between genetic ancestry and cancer risk, and genetic ancestry and cancer survival. However, there is a lack of published investigations assessing the performance of cancer risk prediction models in Latinos with different ancestry proportions. In this presentation, I will provide an overview of what we know about cancer risk and mortality in Latinos with different ancestry proportions and present preliminary results of an ongoing study of breast cancer risk prediction in U.S. Latinas.

Citation Format: Laura Fejerman. Variation in genetic ancestry proportions among Latinos and its impact on cancer risk, prediction, and outcomes. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr IA12.
Abstract IA32: Policy and Environmental Strategies to Reduce Cancer Risk Factors in Tribal Nations: Challenges and Opportunities
Authors: Jernigan Valarie Blue Bird
Published: March 2017

Cancer is a pressing public health and economic concern in Native American Tribal Nations. The Institute of Medicine has identified policy and environmental interventions (e.g., calorie labeling, smoking bans) as critical to reducing and controlling cancer risk factors, particularly obesity and tobacco use. Because of their sovereign status, Tribal Nations are uniquely positioned to implement such interventions, yet few have been reported upon in the scientific literature, hindering the scale-up and dissemination of effective interventions and even worsening disparities. This presentation will identify the current status and impact of policy and environmental interventions to address and control obesity and smoking in Native American Nations, identify and discuss barriers, what is gaining momentum, and what can be done to move toward action.

Citation Format: Valarie Blue Bird Jernigan. Policy and Environmental Strategies to Reduce Cancer Risk Factors in Tribal Nations: Challenges and Opportunities. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr IA32.
Abstract IA36: Caught in the middle: Viewing adolescent/young adult oncology patients as the medically underserved
Authors: McEachron Troy A.
Published: March 2017

Traditionally cancer has been thought to arise in two distinct age groups, pediatrics and adults. In the United States, pediatric patients range in age from newborn up to 21 years old while adult patients are considered to be older than 21. Recently a new patient population has begun to emerge, collectively known as the adolescent-young adult (AYA) population. In the United States, AYA patients span the age range from 15-39 years old. Much is known about a variety of “adult” cancers and our understanding of “pediatric” cancers is steadily growing. Despite these advances, there is very little data regarding AYA-specific cancers. Furthermore, the differences in normal human development and/or maturation that are encompassed within the AYA age range is extremely dynamic thus leading to the hypothesis that the molecular and clinical characteristics of malignancies in AYA patients may be inherently different than those which are observed in patients outside of this age range. This talk will highlight some of the unique challenges faced by this medically underserved population as it pertains to cancer care, treatment, and outcome. This talk will also focus on the importance of the AYA oncology population to cancer research and our biological understanding of different malignancies as it pertains to precision medicine and subsequent therapeutic strategies.

Citation Format: Troy A. McEachron. Caught in the middle: Viewing adolescent/young adult oncology patients as the medically underserved. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr IA36.
Abstract IA39: Variations in breast cancer risk by race/ethnicity in the US
Authors: DeSantis Carol
Published: March 2017

The American Cancer Society recommends average-risk women begin annual screening at age 45, with an option for women to begin screening earlier at age 40. This guideline is for all women; however, breast cancer risk varies substantially by race/ethnicity in the US. In this presentation, I will provide an overview of the most current information on breast cancer rates in the US, focusing on differences in risk by race/ethnicity and age, as well as for specific breast cancer subtypes.

Citation Format: Carol DeSantis. Variations in breast cancer risk by race/ethnicity in the US. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr IA39.
Abstract A12: Developing PDeX (Patient Derived Explant) to determine the basis for response to AR-directed therapeutics
Authors: Shafi Ayesha , Schiewer Matthew , Leeuw Renee de , McCue Peter , Birbe Ruth , Gomella Leonard , Lallas Costas , Trabulsi Edouard , Raj Ganesh , Knudsen Karen
Published: March 2017

Prostate cancer (PCa) is the most common non-cutanenous cancer and the second leading cause of cancer-related death in American men. Androgen receptor (AR) is a hormone-activated transcription factor that plays an important role in both the development and progression of PCa. Androgen deprivation therapy is a common first-line therapy. However, many patients become resistant to such therapy and the tumor recurs. Thus, there is a vital need for the development of novel, more effective drugs. One major hurdle in this aspect is the lack of adequate preclinical models. Current models do not effectively recapitulate the heterogeneity and the microenvironment of human PCa tumors hindering the ability to accurately predict therapeutic response. Our lab has generated a method to culture patient tumors ex vivo termed patient derived explant (PDeX). This approach maintains the integrity of the native tumor microenvironment, tumor tissue morphology, and molecular signaling. Intriguingly, our PDEX model can be targeted with various therapeutic agents or lentiviral-based shRNAs to determine specific responses on individual tumor growth. Furthermore, with this model we can quantitatively assess drug efficacy on numerous parameters (i.e. AR levels, Ki67 staining, apoptosis screening). Data to be discussed will assess the variances in response to AR-directed therapeutics and underlying mechanisms of action. In addition, we can potentially identify clinically relevant subpopulations of patients and molecularly profile their cultured tissue to uncover new pathways for therapeutic intervention. Thus, the PDeX model allows for a comprehensive evaluation of individual tumors in their native microenvironment to ultimately develop more effective therapies.

Citation Format: Ayesha Shafi, Matthew Schiewer, Renee de Leeuw, Peter McCue, Ruth Birbe, Leonard Gomella, Costas Lallas, Edouard Trabulsi, Ganesh Raj, Karen Knudsen. Developing PDeX (Patient Derived Explant) to determine the basis for response to AR-directed therapeutics. [abstract]. In: Proceedings of the AACR Special Conference: Patient-Derived Cancer Models: Present and Future Applications from Basic Science to the Clinic; Feb 11-14, 2016; New Orleans, LA. Philadelphia (PA): AACR; Clin Cancer Res 2016;22(16_Suppl):Abstract nr A12.