bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract B014: Differences in the impact of marital status on risk of suicide among cancer survivors based on cancer sites
Authors: Osazuwa-Peters Nosayaba , Simpson Matthew C. , Boakye Eric Adjei
Published: August 2020

Introduction: Suicide is a threat to cancer survivorship, and a known non-cancer competing cause of death among cancer survivors. In fact, the risk of suicide among cancer survivors is more than double that of the general population, depending on the cancer site. While several factors like age, gender, race, and cancer site are associated with suicide, studies on the potential impact of marriage, a marker for social support, on the risk of suicide among cancer survivors have been inconclusive. This study aimed to examine the impact of marital status on the risk of suicide, and to determine whether there are differences in the effect of marital status on suicide risk based on cancer sites.

Methods: Patients with head and neck (n=162,701), pancreatic (n=127,831), stomach (n=80,839), and lung/bronchus cancer (n=605,274) from the Surveillance, Epidemiology, and End Results (SEER) 18 database diagnosed from 2007-2015 were included (total n=976,645). These cancer sites were selected as they have the highest suicide rates of all cancers. Competing risks proportional hazards models estimated the association between marital status and death from suicide for each of the four cancer sites while controlling for sociodemographic and clinical covariates. These models yielded adjusted hazard ratios (aHR) and 95% confidence intervals (CI).

Results: The patient cohort was mostly male (57%), non-Hispanic white (74%), married/partnered (51%), and had a mean age of 67 years. For stomach cancer, marital status was not associated with death from suicide. For pancreatic, lung, and HNC, divorced/separated patients were more likely to commit suicide than married/partnered patients (aHR range 1.59-2.92). For lung (aHR=1.47, 95% CI 1.14, 1.92) and HNC (aHR=1.31, 95% CI 1.01, 1.70), never-married patients were more likely to commit suicide than married/partnered patients.

Conclusions: Being married was protective against suicide among the cancer survivors in our study, except for stomach cancer survivors. However, the effect of marital status on suicide risk was greater among head and neck cancer survivors than lung, pancreatic, and stomach cancer survivors. It is critical that survivors receive as much support as possible to mitigate suicide risks.

Citation Format: Nosayaba Osazuwa-Peters, Matthew C. Simpson, Eric Adjei Boakye. Differences in the impact of marital status on risk of suicide among cancer survivors based on cancer sites [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr B014.
Abstract B031: Mediating factors for perceived impact of prostate cancer survivors
Authors: Davis Kimberly E. , Richards Antoine , Gooden Reginald
Published: August 2020

Purpose: An estimated 29,530 new cases of prostate cancer (PCa) are expected in 2018. It is estimated that 1 in 5 African-American men will be diagnosed with PCa in their lifetime. The overall 5-year relative survival rate for PCa among African Americans is 96%, compared to nearly 100% among whites. PCa patients are living longer and are confronted with increasingly complex therapeutic decisions. Frequently, patients are not fully prepared to appraise their PCa diagnosis and treatment consequences for perceived impact.

Design Methods: The Center for Cancer Research and Therapeutic Development (CCRTD) at Clark Atlanta University (CAU) registered over 468 survivors to the Prostate Cancer Registry (www.pcregistry.cau.edu), an online registry designed to capture the epidemiologic profile, clinical disease information, and data regarding the experiences of PCa survivors throughout the PCa continuum.

Results/Expected Results: General: Participants (n=468) median age was 66 years; 100% male; 63% Caucasian, and 30% African American. 78% reported they were married and 36% attended college. Total annual income: 19% <$25K; 19% <$50K; 18% <$75K and 35% <$100K. 93% were insured when diagnosed. Mediating factors: Based on the Cognitive Health Appraisal Scale, most survivors reported that prostate cancer is not a challenge, they can beat cancer, and expected positive outcomes. Most men disagreed that PCa has damaged their life, identifying a relatively positive mindset to overcoming PCa. Neutral areas, where men tended to not favor or disfavor, were related to stress, functional limitation, and assessing physical harm associated with PCa.

Discussion/Conclusion: Stress and the loss of functionality are areas of cognitive health concern for PCa survivors. Throughout the assessment, there were no “strongly agree” or “strongly disagree” consensuses, which could denote that men do not feel absolution about their cognitive choices. This could be contributed to a multitude of factors that affect cognitive processes throughout the PCa continuum.

Citation Format: Kimberly E. Davis, Antoine Richards, Reginald Gooden. Mediating factors for perceived impact of prostate cancer survivors [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr B031.
Abstract B050: Identification of differentially expressed and spliced genes between breast, colon, lung, and prostate cancer from African American and white patients
Authors: Abo Muthana Al , George Daniel J. , Freedman Jennifer A. , Patierno Steven R.
Published: August 2020

Racial/ethnic disparity in cancer refers to the disproportionate incidence of and/or mortality from various cancers among population groups. In addition to differences in social, lifestyle and structural determinants of health, there is accumulating evidence for a biologic contribution to racial/ethnic disparity in cancer. To understand further the biologic mechanisms underlying racial/ethnic disparity in cancer, the analysis of differential aggregate gene expression and mutation among cancer patients of different population groups is important. Our recently published work reported differential RNA splicing as a critical mechanism underlying prostate cancer aggressiveness and drug response in African American (AA) patients. Here, we use R to analyze the Genomic Data Commons for differential aggregate gene expression (2-fold mean change, p < 0.001, Wilcoxon rank sum test) and TCGASpliceSeq to analyze TCGA for differential RNA splicing (20% median change, percent spliced in) between breast (BRCA, 183 AA and 761 white), colon (COAD, 56 AA and 194 white), squamous and adenocarcinoma lung (LUSC and LUAD, 34 and 57 AA and 392 and 444 white, respectively), and prostate (PRAD, 49 AA and 307 white) cancer specimens from AA and white patients. Our analysis identified 698 differentially expressed genes (DEGs) and 114 alternative RNA splicing events (ARSs) in BRCA, 107 DEGs and 57 ARSs in COAD, 25 and 117 DEGs and 115 and 53 ARSs in LUSC and LUAD, respectively, and 25 DEGs and 71 ARSs in PRAD from AA and white patients. Notably, comparing the lists of DEGs or ARSs from each cancer type with each of the other cancer types yields a minority of overlapping DEGs or ARSs among cancer types, indicating that race-related DEGs and ARSs are largely specific to cancer type. Pathway analysis of DEGs and ARSs reveals that the majority of these genes function in pathways relevant to cancer development and progression, such as programmed cell death, DNA repair, signal transduction, gene expression and metabolism. These analyses increase understanding of molecular mechanisms underlying racial/ethnic disparity in cancer. Upon further study of the function of these variants, such DEGs and ARSs have the potential to become candidates for development of new precision medicine interventions.

Citation Format: Muthana Al Abo, Daniel J. George, Jennifer A. Freedman, Steven R. Patierno. Identification of differentially expressed and spliced genes between breast, colon, lung, and prostate cancer from African American and white patients [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr B050.
Abstract B066: SCUBE3 inhibition improves doxorubicin response in breast cancer
Authors: Onyeagucha Benjamin C. , Dhillon Kashish , Rajamanickam Subapriya , Panneerdoss Subbarayalu , Eedunuuri Vijay K. , Mohammad Tabrez A. , Timilsina Santosh , Chen Yidong , Rao Manjeet K.
Published: August 2020

The development of novel targeted therapies is urgently required for improving the outcome of breast cancer patients. Chemotherapy is the common treatment option for malignant breast cancer. However, resistance and toxicity remain the major obstacles hindering the effectiveness of chemotherapeutic agents in cancer patients. Therefore, identifying genes/factors that sensitize breast cancer cells to chemotherapeutic agents could improve treatment outcome in patients. Using an unbiased high-throughput screen, we identified Signal peptide CUB domain EGF-like 3 (SCUBE3) genes as a novel therapeutic adjuvant that can improve the efficacy of doxorubicin, a chemotherapeutic agent commonly used in treating breast cancer patients. Our findings demonstrated that SCUBE3 promotes breast cancer cells' progression as knockdown of SCUBE3 inhibited the ability of breast cancer cells to form colony, migrate, and invade, while overexpression of SCUBE3 promoted tumor growth in preclinical mouse models. Our results revealed that SCUBE3 mediates its protumor effects by regulating genes involved in growth and survival in the MAPK pathway, DNA damage surveillance pathway including RAD51 and FOXM1, and apoptotic pathway including Mcl-1. Using interaction studies, we demonstrated that EGFR is a true receptor of SCUBE3 as EGFR and SCUBE3 interact and this interaction mediated progrowth signaling of SCUBE3. These findings underline the importance of SCUBE3 as a potent therapeutic target for treating breast cancer patients.

Citation Format: Benjamin C. Onyeagucha, Kashish Dhillon, Subapriya Rajamanickam, Subbarayalu Panneerdoss, Vijay K. Eedunuuri, Tabrez A. Mohammad, Santosh Timilsina, Yidong Chen, Manjeet K. Rao. SCUBE3 inhibition improves doxorubicin response in breast cancer [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr B066.
Abstract B097: Knowledge of cervical cancer risk factors and screening among sub-Saharan African immigrant women
Authors: Adegboyega Adebola , Aroh Adaeze , Hatcher Jennifer
Published: August 2020

Background: Globally, cervical cancer is one of the most common cancers among women. The risk of invasive cervical cancer remains high among sub-Saharan African immigrant (SSAI) women in the US despite being a preventable cancer. Women's knowledge about cervical cancer risk factors and preventive behaviors has been found to be related to the uptake of Pap screening and engagement in other healthy behaviors. Given the high prevalence of human papillomavirus (HPV) infection and other cervical cancer risks among SSAI women, it is critical that SSAI women be well informed and knowledgeable regarding their cervical cancer risk and prevention. The purpose of this study is to assess SSAI women's knowledge of cervical cancer risk factors, HPV, and cervical cancer screening.

Methods: This study was a quantitative analysis of cross-sectional survey of 108 English-speaking SSAI women aged 21 and above recruited from Lexington and Frankfort, Kentucky, between October and December 2016. Information on demographics, screening behavior, and cervical cancer knowledge was collected. A knowledge scale including 14 questions about facts and common myths related to cervical cancer and HPV was used. Total knowledge scores were calculated for participants. Analysis was conducted to identify factors associated with knowledge scores.

Results: Participants' mean age was 34 ± 9 years, 56% had a college degree, 65% reported that their income was adequate, and 54% had lived in the U.S for more than 5 years. The composite knowledge score was 7.8 ±3.6 with a maximum score of 14. In bivariate analysis, length of residence in the U.S (P= 0 .001), ever had Pap screening (P < 0.001), health insurance (P < 0.001), having primary provider (P = 0.020), and health provider recommendation for cervical cancer screening (P = 0.006) were associated with knowledge. In multiple regression analysis, longer length of residence in the U.S (P = 0.044) and ever having a Pap screening (P = 0.007) remained significantly associated with cervical cancer knowledge.

Conclusions: Findings show a limited knowledge of cervical cancer risk factors and the role of HPV in cervical cancer. Future research should further explore and understand how length of residence in the US and having had a Pap screening are related to cervical cancer risks knowledge. The gaps in women's knowledge points to the need for targeted educational interventions to address knowledge needs of SSAI women to encourage cervical cancer screening prevention and timely detection.

Citation Format: Adebola Adegboyega, Adaeze Aroh, Jennifer Hatcher. Knowledge of cervical cancer risk factors and screening among sub-Saharan African immigrant women [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr B097.
Abstract B104: [Advocate Abstract] Evaluating the impact of strategic partnerships
Authors: Brent Beaulah
Published: August 2020

Despite progress in reducing racial disparities in breast cancer mortality, black women in Chicago are still more than twice as likely to die from the disease than white women. For sixteen years, Sisters Working It Out (SWIO), a 501c3 nonprofit, has utilized peer education and patient navigation as evidence-based methods to increase breast cancer knowledge and access to and utilization of quality breast health care for underserved women across the city. Strategic partnerships have been an invaluable resource for the organization. The aim of this study is to evaluate the programmatic impact of an academic-nonprofit partnership in improving breast health knowledge for women on Chicago's Southside.

Citation Format: Beaulah Brent. [Advocate Abstract] Evaluating the impact of strategic partnerships [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr B104.
Abstract B117: Analysis of luminal breast cancer tumor microenvironment using seqFISH
Authors: Polonsky Michal , Round Krista , Seewaldt Victoria , Cai Long
Published: August 2020

Women with luminal breast cancers generally have a good prognosis (92% five-year survival). However, Latina/Hispanic women with luminal breast cancer are 30% more likely to present with advanced luminal breast cancer and twice as likely to die. Disparities persist even when accounting for socioeconomic factors. Whether this is due to a more aggressive biologic subtype remains unclear. Here, we aim to identify the signaling networks and intercellular interactions that drive poor prognosis in luminal breast cancer patients and use this data to tailor therapeutic interventions to improve survival. The tumor microenvironment, which is highly heterogeneous, plays an essential role in cancer progression. An additional layer of information lies in the spatial organization of the tissue, with cells coming in close proximity in order to exchange signals over short distances. Thus, to understand the network of interactions and signaling between cells, there is a need for single-cell measurements of multiple cellular features in the intact tissue. Sequential Fluorescence in Situ Hybridization (seqFISH), developed in the lab of Dr. Long Cai, enables precise quantification of several hundreds to several thousands of mRNA transcripts in single cells, preserving the structure of the tissue. In this methodology, fluorescently labeled probes are hybridized onto the fixed tissue, giving rise to a fluorescent signal whenever the corresponding mRNA is present. The tissue is sequentially imaged, washed and re-hybridized, resulting in a unique barcode for each mRNA. seqFISH has been demonstrated both on cell cultures and on whole organs and has been shown to be highly accurate and repetitive. We will use this methodology and combine it with multiplex antibody staining to line mRNA expression with protein localization and modifications. Combining these experimental methodologies with advanced image analysis tools developed by the Long lab will allow an in-depth investigating of the cellular stated and signaling pathways within malignant tissues. Correlating findings between patients, as well as between samples from the same patient taken over time, could potentially provide a deep understanding of the factors leading to poor prognosis, which can in turn improve diagnostics of luminal breast cancer.

Note: This abstract was not presented at the conference.

Citation Format: Michal Polonsky, Krista Round, Victoria Seewaldt, Long Cai. Analysis of luminal breast cancer tumor microenvironment using seqFISH [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr B117.
Abstract B122: Racial and ethnic disparities and reverse disparities in HPV vaccination: A meta-analysis
Authors: Spencer Jennifer C. , Calo William , Brewer Noel T.
Published: August 2020

Importance: Studies disagree about whether human papillomavirus (HPV) vaccination uptake differs meaningfully among racial and ethnic groups, an important issue given large disparities in some HPV-associated cancers.

Objective: To comprehensively characterize racial and ethnic differences in HPV vaccine initiation and follow-through.

Data Sources: We systematically searched PubMed, CINAHL, Embase, and Web of Science to identify US studies from 2006 through mid-2017 reporting the association of race and ethnicity with HPV vaccination. We identified 118 studies (n=3,095,486) that met inclusion criteria.

Study Selection: Included studies were published in English and reported HPV vaccine initiation or follow-through in the US with at least one comparison by race or ethnicity.

Data Extraction and Synthesis: We synthesized effect sizes using random effects meta-analysis for Blacks, Hispanics, and Asians as well as for all minority groups combined. We stratified results by source of vaccination data (self-reported or provider-verified). We used meta-regression to identify study characteristics associated with the size and direction of racial/ethnic differences in vaccination.

Main Outcomes and Measures: The effect size was the risk difference, the percentage point difference between White and one or more racial or ethnic minority groups in HPV vaccine initiation and in follow-through.

Results: HPV vaccine initiation showed no racial or ethnic differences overall. However, among studies of provider-verified vaccination, minorities were 6.1% [3.3%-8.8%] more likely than Whites to initiate HPV vaccination. This reverse disparity was larger for Hispanics, males, and younger samples (age <18). In contrast, minorities were 8.6% (5.6%, 11.7%) less likely than Whites to follow-through with the full HPV vaccine series, a disparity present across all participant and study characteristics.

Conclusions and Relevance: Racial and ethnic minorities are more likely to initiate but less likely to follow through with HPV vaccination, a clear finding that self-report studies have obscured. Efforts to promote HPV vaccination should be broad, as uptake remains low across all racial and ethnic groups. Nevertheless, higher initiation among minorities offers potential for future reductions in HPV cancer disparities and may provide insights for reducing disparities in uptake of other preventive services.

Citation Format: Jennifer C. Spencer, William Calo, Noel T. Brewer. Racial and ethnic disparities and reverse disparities in HPV vaccination: A meta-analysis [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr B122.
Abstract C003: A machine learning-based approach to identify biomarkers of environmental toxicant exposures relevant to liver cancer disparities in rural Illinois
Authors: Smith Brandi Patrice , Madak-Erdogan Zeynep
Published: August 2020

Although there have been nationwide reductions in cancer death recently, liver cancer mortality remains a problem in rural Illinois. Research scientists anticipate that exposure to environmental toxicants in rural Illinois may be possible causes of increased liver cancer mortality in females. The purpose of our study is to identify potential biomarkers that are related to early liver toxicity through machine learning. We accessed gene expression data from the open source Toxicogenomics Project-Genomics Assisted Toxicity Evaluation System (TG-GATES) database from rats that had been exposed to over 170 toxicants relevant to liver cancer. We performed a differential gene expression analysis to identify significant features or genes that are related to hepatotoxicity endpoints (e.g., necrosis, centrilobular hypertrophy, and hepatocellular hypertrophy). Then we performed a feature selection method to decrease the dimensionality of the gene set. We then used classification modeling to identify specific genes related to our hepatotoxicity endpoints. Lastly, we built a predictive model by random splitting of the complete gene set by one of the endpoints and used the complete differentially expressed gene set to predict this particular endpoint. Our model predicted specific genes that were highly related to liver toxicant exposure. In the next phase of our studies, we will use these biomarkers to associate geospatial toxicant exposures with health effects in wild mice caught from areas with high liver cancer incidence in the state of Illinois. Our approach identifies biomarkers of potential environmental exposures from wildlife liver gene expression data and associates presence of such compounds in environment soil and water sources in counties with high liver cancer incidence.

Citation Format: Brandi Patrice Smith, Zeynep Madak-Erdogan. A machine learning-based approach to identify biomarkers of environmental toxicant exposures relevant to liver cancer disparities in rural Illinois [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr C003.
Abstract C015: Social network analysis with respondent driven sampling data: A study of ethnic and geographic integration on Guam and Hawaii
Authors: Badowski Grazyna , Dulana Louis , Somera Lilnabeth P. , Cassel Kevin , Lee Hye-ryeon , Roman Janessa , Morales Jayson
Published: August 2020

US Pacific Islanders are one of the fastest-growing population groups in the US, and serious disparities in health outcomes exist in this group, with cancer being the leading cause of death. Limited knowledge about the cancer communication practices and risk behaviors of US Pacific Islanders, as well as their social network structure and integration, makes effective cancer prevention interventions difficult, and contributes to disparities. In 2017, we conducted a survey on health communication on Guam and Hawaii using the respondent-driven sampling method (RDS) to recruit participants (N=733 for Hawaii, and N=533 for Guam). RDS is a network-based sampling technique where initial seed respondents recruit others from their social networks. The recruiting process repeats iteratively, thereby forming long referral chains. RDS provides a viable data for making inferences about the underlying network structure. During the sampling process two pieces of information are gathered. First, each recruiter-recruit dyad is documented. Second, respondents are asked how many other members of the target population they know and interact with. In this study, we used this information to create recruitment chains and test the quantity and quality of cross-gender, cross-ethnicity, cross-generation ties. We also analyzed the geographic distribution and spatial clustering of the samples. Self-reported network size (degree) was used to estimate of a homophily, a measure of the strength of association to one's own group beyond random mixing. In general, strong homophily was found for different ethnic groups (with values ranging from 0.7 to 0.8), whereas gender and age had weak homophily. Even though the participants tended to recruit spatially proximal peers, both samples in Guam and Hawaii eventually covered the whole catchment area.

Citation Format: Grazyna Badowski, Louis Dulana, Lilnabeth P. Somera, Kevin Cassel, Hye-ryeon Lee, Janessa Roman, Jayson Morales. Social network analysis with respondent driven sampling data: A study of ethnic and geographic integration on Guam and Hawaii [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr C015.
Abstract C064: Hormone-related risk factors and breast cancer subtype in African American women
Authors: Davis Jennifer , Jimenez Cecilia , Clinton Chrystina , Fadden Mary Kay , Lipworth Loren , Sanderson Maureen
Published: August 2020

Purpose: To investigate the association between hormone-related risk factors and breast cancer subtype in African American women. We hypothesized that African American women with triple-negative breast cancer (TNBC) would have a lower prevalence of hormone-related risk factors than women with other breast cancer subtypes (1) hormone receptor [HR +/-] and human epidermal growth factor receptor 2 [HER2-] or (2) HR +/- and HER2+.

Methods: African American women ages 25-75 years diagnosed with primary invasive breast cancer in 2009-2013 in Tennessee, South Carolina, and Georgia were eligible for the study. A total of 629 women (premenopausal n=175; postmenopausal n=454) provided information on hormone-related risk factors in a telephone interview and consented to review of tumor tissue; breast cancer subtype was obtained from pathology reports.

Results: Although not significantly different, pre- and postmenopausal women with TNBC were more likely to have early age at menarche than women with other subtypes. Obesity was higher among pre- and postmenopausal women with HR+/- HER2+ disease and intermediate among women with TNBC relative to women with HR+/- HER2- disease. Oral contraceptive use was less likely among women with TNBC, significantly so for postmenopausal women (odds ratio=0.70, 95% confidence interval=0.53-0.91) than women with other subtypes.

Conclusions: Histologic subtyping is currently being performed on collected tissue to confirm the reported breast cancer subtypes in the pathology reports. The large number of African American women participating in our study can further our understanding of hormone-related risk factors and their relationship with breast cancer subtypes in this population.

Citation Format: Jennifer Davis, Cecilia Jimenez, Chrystina Clinton, Mary Kay Fadden, Loren Lipworth, Maureen Sanderson. Hormone-related risk factors and breast cancer subtype in African American women [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr C064.
Abstract C074: Areca (betel) nut chewing and metabolic conditions
Authors: Paulino Yvette C. , Yamanaka Alisha N. , Sotto Patrick F.P. , Badowski Grazyna , Wilkens Lynne R. , Hernandez Brenda Y.
Published: August 2020

Oral cancer is the most widely studied health outcome linked to areca (betel) nut chewing, or mastication of the Areca catechu fruit or seed often combined with slaked lime, tobacco, and the Piper betle (leaf). A growing area of research is the influence of betel nut chewing on metabolic conditions. To investigate betel nut chewing and metabolic conditions, including obesity and related health characteristics, a cross-sectional study of 122 adults was conducted in Guam between July 2013 and October 2014. Information on demographics, medical history, dietary intake and betel nut use was collected. Height and weight measurements were collected to calculate body mass index or BMI (weight in kg/height in m2) as an indicator of weight status. Waist was also measured to calculate waist-to-height ratio as an indicator of health risk status. Health characteristics were compared across the three chewing groups: 64 current betel nut chewers, 37 former betel nut chewers, and 21 non-betel nut chewers. Strong evidence of differences by betel nut exposure were seen by ethnicity (predominantly Chamorros across all chewing groups), BMI (predominantly obese among former betel nut chewers), waist-to-height ratio (predominantly high risk among current and former betel nut chewers), history of self-reported stroke (predominant among former betel nut chewers), and alcohol consumption (highest number of drinks among current betel nut chewers). The evidence of poor metabolic conditions seen among current betel nut chewers supports the need for a comprehensive approach to betel nut prevention strategies, to include the prevention of oral cancer and metabolic conditions. The evidence of poor metabolic conditions seen among former betel nut chewers warrants additional advanced study designs to rule out temporal ambiguity, and to further investigate any health implications of betel nut cessation.

Citation Format: Yvette C. Paulino, Alisha N. Yamanaka, Patrick F.P. Sotto, Grazyna Badowski, Lynne R. Wilkens, Brenda Y. Hernandez. Areca (betel) nut chewing and metabolic conditions [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr C074.
Abstract C100: Identification and functional characterization of a novel GLI1 splice variant in breast cancer
Authors: Dixon Maria S. , Chdid Lhoucine , Lamson David R. , Tarpley Michael T. , Oladapo Helen O. , Fleming Jodie M. , Freedman Jennifer A. , Devi Gayathri R. , Williams Kevin P.
Published: August 2020

The purpose of this study is to investigate the biologic significance of novel GLI1 splice variants in breast cancer. African American (AA) women suffer a disproportionately high burden of basal-like breast cancer, an aggressive subtype that has no targeted therapy (1). About 15-20% of breast cancers are triple-negative/basal-like, are associated with poor clinical outcomes and show disproportionately higher prevalence in younger women of African descent (2-4). The Hedgehog (Hh)/GLI1 developmental pathway has emerged as a therapeutic target in many cancers, including breast cancer studies from our lab (5, 6). Overexpression of the main Hh transcriptional mediator GLI1, correlates with poor patient prognosis and relapse. The human GLI1 transcript undergoes alternative splicing producing two shorter isoforms, an N-terminal deletion variant (GLI1ΔN) (7) and a truncated GLI1 (tGLI1) (8), which have been reported to have different patterns of tissue expression and function. tGLI1 has been identified as being highly expressed in several cancers, including in breast cancer (9). We performed in silico analysis of the NCBI database for evidence of additional human GLI1 transcripts and identified a novel GLI1 splice variant, GLI1-X2, that has an in-frame deletion of the entire exon 10-zinc finger 5 domain of the GLI1 gene. Our preliminary data show that GLI1-X2 is expressed in basal-like breast cancers at substantially higher levels than GLI1, tGLI1, or GLI1ΔN. To our knowledge, we are the first to demonstrate expression of GLI1-X2 in any model and our findings expand the GLI1 family of zinc finger transcription factors. Our objectives are to examine the expression differences of the GLI1 splice variants in basal-like and luminal breast cancer cell models, AA and White patient samples and to investigate the biologic function of GLI1-X2 in breast cancer. Previous studies report that GLI1ΔN and tGLI1 proteins retain intact functional zinc finger domains. Thus, we hypothesize that the loss of zinc-finger 5 is critical for GLI1-X2's functional role and regulation of downstream target genes in breast cancer. As the biologic significance of GLI1-X2 in normal and cancer biology is unknown, this proposed work is the first to characterize its function and potential role in cancer.

Citation Format: Maria S. Dixon, Lhoucine Chdid, David R. Lamson, Michael T. Tarpley, Helen O. Oladapo, Jodie M. Fleming, Jennifer A. Freedman, Gayathri R. Devi, Kevin P. Williams. Identification and functional characterization of a novel GLI1 splice variant in breast cancer [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr C100.
Abstract C109: Modulation of HDAC activity in subtypes of triple-negative breast cancer: Effects of vorinostat on HDAC 7 expression and cancer stem cells progression
Authors: Emamzadeh Fatemeh Nouri , Hawkins Anfernee , Miranda-Carboni Gustavo , Moore Rhonda , Word Beverly , Lyn-Cook Beverly
Published: August 2020

Epigenetic drugs, such as histone deacetylase inhibitors (HDACi), are continuing to emerge as promising therapies for various cancers. These drugs, including FDA-approved vorinostat, are capable of multiple actions and considered to be multifunctional. Histone deacetylases (HDAC) are chromatin-modifying enzymes that are involved in various cellular events, such as tissue differentiation, autophagy, apoptosis, migration, mitosis and angiogenesis. High levels of HDACs have been detected in several cancers. Early studies in our laboratory showed different effects by vorinostat on global HDAC activity in several triple-negative breast cancer (TNBC) subtypes. This study focused on HDAC 7, which has been associated with increases in cancer stem cells and poor prognosis. Cancer stem cells play an important role in cancer resistance to therapy. Histone deacetylase inhibitors are emerging as therapy for triple-negative breast cancer, which is currently an unmet need in women's health due to the lack of targeted therapies. This study investigated the effects of vorinostat on apoptosis and the modulation of HDAC 7 expression in two subtypes of triple-negative breast cancers, MB231(MSL) and HCC70 (BL-2). Using caspase 3/7 assays vorinostat induced apoptosis. Additionally, flow cytometry and immunostaining were conducted to determine vorinostat's effects on expression of two cancer stem cell (CSC) markers, CD44 and CD24. Western blot and real-time PCR showed a significant decrease (10-fold) in the expression of HDAC 7 by vorinostat in HCC70 cells. A modest decrease (3-fold) was also observed in MB231 cells. CD44 expression was deceased by vorinostat in MB231 cells. This study demonstrated that vorinostat exerts its anticancer effects through several mechanisms, such as inducing apoptosis, downregulating HDAC 7 and decreasing cancer stem cells. This therapy could be beneficial for subtypes of TNBC, such as HCC70, an aggressive basal-like 2 cell line from an African American.

Citation Format: Fatemeh Nouri Emamzadeh, Anfernee Hawkins, Gustavo Miranda-Carboni, Rhonda Moore, Beverly Word, Beverly Lyn-Cook. Modulation of HDAC activity in subtypes of triple-negative breast cancer: Effects of vorinostat on HDAC 7 expression and cancer stem cells progression [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr C109.
Abstract C112: [Advocate Abstract] Male breast cancer education program
Authors: Dornan Wayne
Published: August 2020

The results of a breast cancer education program directed towards men will be presented. The result indicate that men before the education program were unaware than breast cancer can be diagnosed in men. Furthermore, before the education program, men who were surveyed were unlikely to seek medical attention if they found a lump in the breast. The post-education survey results will be presented at the conference.

Citation Format: Wayne Dornan. [Advocate Abstract] Male breast cancer education program [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr C112.
Abstract C114: Lymph circulating tumor cells are phenotypically different from tumor cells circulating in the blood
Authors: Torres-Luquis Odalys J. , Mohammed Sulma I.
Published: August 2020

Breast cancer is the most common cancer in women. However, metastasis is the leading cause of death. When the tumor cell migrates from the primary tumor, it can disseminate into the blood circulation or lymphatic system. It has been proven that 80% of malignant carcinoma choose the lymphatic system over the vascular system. Despite the importance of sentinel lymph node (SLN) metastasis as a staging marker, lymphatically disseminated tumor cells (LCTCs) in transit from the primary tumor to the SLN have never been captured, characterized and compared to blood-borne tumor cells (BCTCs) in the same host. Here we use a microsurgical technique to collect draining lymph in situ from a growing tumor prior to its entry in SLN in syngeneic animals and patients with breast cancer. Unlike BCTC, LCTCs are found in clusters that exhibit a hybrid epithelial-mesenchymal phenotype, display a cancer stem cell CD44hi, CD24hi, ALDHA1hi signature, grow as mammospheres and are highly tumorigenic. We also showed that the lymph is enriched in tumor-derived exosome proteins and EGF growth factor. Characterization of LCTCs vs. BCTCs and the compilation of tumor-derived factors en route to the SLN can provide insights into the metastatic process and has relevance to cancer immunotherapy.

Citation Format: Odalys J. Torres-Luquis, Sulma I. Mohammed. Lymph circulating tumor cells are phenotypically different from tumor cells circulating in the blood [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr C114.
Abstract IA03: The All of Us Research Program and precision engagement
Authors: Richardson-Heron Dara
Published: August 2020

Precision medicine is a revolutionary approach to disease prevention and treatment that takes into account individual differences in lifestyle, environment, and biology. Precision medicine will give clinicians tools to better understand the complex mechanisms underlying a person's health, disease, or condition, and to better predict which treatments and prevention strategies will be most effective. Spearheaded by the National Institutes of Health, the All of Us Research Program seeks to engage one million or more volunteers living in the U.S. to contribute their health data over many years to improve health outcomes, fuel the development of new treatments for disease, and catalyze a new era of evidence-based and more precise preventive care and medical treatment. By taking part, participants will contribute to an effort to advance the health of generations to come. As promising as the concept of precision medicine truly is if we are to truly change the treatment paradigm and ensure that the medicines and prevention strategies people are using actually work for them, those who have traditionally been under-represented in research need to participate. These conversations are not easy and will take purposeful time and effort to build trust toward action—we need precision engagement. This talk will provide an overview of the All of Us Research Program and its goals; outline the All of Us transformational approach to diversity, participation, and data access; and describe the program's approach to precision engagement to address value and build trust.

Citation Format: Dara Richardson-Heron. The All of Us Research Program and precision engagement [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr IA03.
Abstract IA28: Advocate Perspective: Diversity in research: A missing link to eliminate health disparities
Authors: Segarra-Vazquez Barbara
Published: August 2020

The literature shows that whites, mostly males, make up the majority (more than 80%) of the participants in cancer treatment and prevention studies. This is of great concern as the finding of these studies are generalized among different population groups. The federal government began taking action to address diversity in research since 1993 with the National Institute of Health Revitalization Act directed to increase participation of women and minorities in clinical research. Other government initiatives and programs have followed, such as the Minority Health and Health Disparities Research and Education Act, National Center for Minority Health and Health Disparities, and Excellence Center to Eliminate Ethnic and Racial Disparities, among others. Despite the government's efforts to increase diversity in research for more than 25 years, women and racial/ethnic minorities continue to be under-represented. Furthermore, as we keep moving into the era of precision medicine, fast-accumulating evidence suggests that the gap will grow even bigger. Understanding molecular biology in health disparities of cancer across populations and studying the interaction of biologic factors and other factors that contribute to the differences in cancer burden should become even more a research priority. To increase the participation of women and minorities in research, strategies such as having recruitment as a separate criterion in research proposal evaluations could result in a more thorough approach. This could lead to the consideration of cultural as well as other important aspects of the population group of interest. Also, specific strategies to overcome patients' barriers to enrollment in research should be implemented. In order to address under-representation in research, one has to consider tackling diversity from many angles. Diversity goes beyond recruiting diverse populations. Attention should also be given to diversity in researchers, research teams, study sections, research staff, physicians recruiting for clinical trials, and patient advocates. Moreover, journals and their editors play a key role in reducing the gap.

Citation Format: Barbara Segarra-Vazquez. Advocate Perspective: Diversity in research: A missing link to eliminate health disparities [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr IA28.
Abstract IA32: Liver cancer screening—How much progress have we really made?
Authors: Singal Amit G.
Published: August 2020

Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related death worldwide and a leading cause of morbidity and mortality in patients with cirrhosis. Given an aging population of patients with hepatitis C virus (HCV) infection and a growing population of patients with nonalcoholic fatty liver disease (NAFLD), the incidence of HCC is anticipated to continue rising over the next 20 years. HCC disproportionally affects racial/ethnic minority populations in the United States, with higher age-specific rates among non-Hispanic Black, Hispanic white, and Asian persons compared to non-Hispanic whites. Studies have also suggested racial and ethnic disparities in HCC early detection, treatment receipt, and prognosis, with Black and Hispanic patients with HCC having worse overall survival than White and Asian patients. One of the strongest determinants of HCC-related prognosis is tumor burden at the time of diagnosis, with curative options only available for patients diagnosed at an early stage. Patients detected at an early stage can be treated with curative therapies such as liver transplantation or surgical resection, achieving 5-year survival rates exceeding 60%, whereas those detected at more advanced stages are only amenable to palliative therapies, with a median survival of 1-2 years. Therefore, several professional societies recommend HCC screening in at-risk patients (most notably patients with chronic hepatitis B infection or those with cirrhosis from any etiology) with an abdominal ultrasound and a blood test, alpha fetoprotein, every 6 months. HCC screening has been associated with improved early detection, increased curative treatment, and improved survival in several cohort studies. However, HCC screening is underused in clinical practice, with fewer than 20% of at-risk patients receiving consistent semiannual HCC screening. Studies suggest lower HCC screening receipt in racial/ethnic minorities and persons of low socioeconomic status, although no studies have been sufficiently large to evaluate intersectionality of race/ethnicity and socioeconomic status. Survey studies suggest several provider-level and patient-level barriers to HCC screening that likely must be addressed to increase HCC screening, particularly among socioeconomically disadvantaged patients and those being followed outside of tertiary care referral centers. Although few studies have evaluated interventions to increase HCC screening, some have yielded early promising results.

Citation Format: Amit G. Singal. Liver cancer screening—How much progress have we really made? [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr IA32.