bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract PO-086: Social vulnerability related to rural disparities in colorectal cancer mortality in Florida
Authors: Rodriguez Alejandro Arroyo , Odahowski Cassie Lewis
Published: January 2022

Introduction: The multiple rural and urban counties in the state of Florida exhibit different socioeconomic characteristics and access to healthcare. These differences in living conditions potentially impact incidence and mortality rates of diseases, particularly cancer. We examined rural differences in county-level colorectal cancer incidence and mortality and county social vulnerability characteristics related to rural disparities in colorectal mortality for all 67 counties in Florida. Methods: We examined colorectal cancer incidence and mortality data provided by the National Cancer Institute (NCI) State Cancer Profiles in conjunction with the United States Census Bureau definition for rurality: counties that have more than 50% of their population within a rural area would be classified as rural. We used a t-test for unequal variances to examine the difference in the mean colorectal incidence and mortality for rural counties compared to urban counties. We then used a linear regression to examine county social vulnerability (SoVI) metrics, poverty, and Medically Underserved Areas (MUA) related to colorectal cancer mortality. Preliminary Results: Of the 67 counties in Florida, 25 were designated as rural and 42 were designated as urban. The mean rural age-adjusted incidence of colorectal cancer was 40.93 per 100,000 compared to 36.82 per 100,000 for urban incidence (p=0.16). The rural mortality per 100,000 for colorectal cancer was significantly higher than urban colorectal morality per 100,000 (18.22 vs 13.12, p=<0.01). Our pending regression analysis will pinpoint county SoVI factors (such as poverty and MUA) specifically related to the observed disparity in rural colorectal cancer mortality. Conclusion: While risk of colorectal cancer was not significantly higher for rural counties in Florida, the rural colorectal death rate was significantly higher in rural than urban counties. These results add to the understanding of socioeconomic characteristics related to rural disparities in cancer mortality. Further work is needed to address strategies for eliminating rural disparities so that there is a greater chance of surviving diseases such as colorectal cancer.

Citation Format: Alejandro Arroyo Rodriguez, Cassie Lewis Odahowski. Social vulnerability related to rural disparities in colorectal cancer mortality in Florida [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-086.
Abstract PO-091: Access to healthcare and preventive services use by limited English proficiency (LEP) adults: Trends from the US Medical Expenditure Panel Survey, 2014–2018
Authors: Ramirez Natalia , Nogueira Leticia , Yabroff Robin , Han Xuesong , Fedewa Stacey
Published: January 2022

Background: The number of Limited English proficiency (LEP) adults has been increasing in the United States and LEP is adversely associated with measures of access to care. This study will further examine the association between LEP and access to healthcare and preventive services use by providing more up to date information from a United States representative sample. Methods: Adults with and without LEP aged ≥18 years were identified from the 2014–2018 Medical Expenditure Panel Survey. The association between LEP and access to healthcare and preventive services was evaluated with multivariate logistic regression models, stratified by age group (18–64 years and ≥65 years), controlling for age, gender, education, marital status, geographic region, and survey year. Data were analyzed in 2021. Results: Adults with LEP were more likely to not have a usual source of care in both age groups [18–64 years = (adjusted Odds Ratios [aOR]=2.86; 95% Confidence Interval =2.57-3.18); ≥65 years = (aOR=1.67; 95% CI=1.31-2.12)] and be uninsured [18-64 years = (aOR=7.25; 95% CI=6.43-8.16); ≥65 years (aOR=22.22; 95% CI=11.38-43.41)] compared to adults without LEP. Adults aged 18-64 years with LEP we also significantly less likely to utilize preventive services including blood pressure check (aOR=2.20; CI=1.94-2.49), cholesterol check (aOR=1.31; CI=1.10-1.56), any colorectal screening (aOR=1.71; 95% CI=1.44-2.03) and receipt of the flu vaccine (aOR=1.28; 95% CI=1.16-1.42) than adults without LEP. Elderly adults with LEP were also less likely to use preventive services, with a similar magnitude of association. Conclusion: Adults of all ages with LEP continue to have lower access to care and preventive services that similar adults without LEP. Healthcare systems could adopt interventions such as providing language assistance services to patients and the training of providers in cultural competence to eliminate barriers to care and improve access to preventive services.

Citation Format: Natalia Ramirez, Leticia Nogueira, Robin Yabroff, Xuesong Han, Stacey Fedewa. Access to healthcare and preventive services use by limited English proficiency (LEP) adults: Trends from the US Medical Expenditure Panel Survey, 2014–2018 [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-091.
Abstract PO-110: Plant isolate dibenzyl trisulfide induces caspase-independent death in triple negative breast cancer cells derived from patients of West African descent
Authors: Wooten Jonathan , Wooten Shaniece , Araújo Cristina , Aja Joyce , Mavingire Nicole , Delgoda Rupika , Brantley Eileen
Published: January 2022

Patients with triple negative breast cancer (TNBC) possess tumors that lack estrogen receptor, progesterone receptor, and human epidermal growth receptor expression. While these patients traditionally receive chemotherapy to combat this aggressive breast cancer subtype, others use natural remedies. Dibenzyl trisulfide (DTS) is derived from Petiveria alliacea, a perennial shrub that grows in tropical regions of the world. Many TNBC patients residing in the tropics are of West African descent. Therefore, we evaluated the anticancer actions of DTS in TNBC cells, including those derived from patients of West African descent. We found that DTS inhibited TNBC cell viability, migration and proliferation in a dose-dependent manner. Interestingly, DTS blocked the propensity of pro-carcinogen benzo-A-pyrene to induce proliferation of immortalized breast epithelial cells. Moreover, we found that DTS induced early apoptosis in TNBC cells, which was only partially attenuated following pretreatment with pan-caspase inhibitor zVAD-fmk. Though DTS induced pro-apoptotic gene and protein expression along with PARP cleavage, it failed to produce appreciable caspase 3 cleavage and promote significant apoptotic body formation. This suggests that this plant isolate induces caspase-independent and non-apoptotic death of TNBC cells. Furthermore, DTS promoted lysosomal membrane destabilization and cathepsin B release in TNBC cells. Taken together, DTS exhibits promising chemotherapeutic and chemopreventive ability by inducing non-apoptotic TNBC cell death and thwarting TNBC progression, supporting its evaluation in clinical trials as an agent to combat TNBC among patients of West African descent.

Citation Format: Jonathan Wooten, Shaniece Wooten, Cristina Araújo, Joyce Aja, Nicole Mavingire, Rupika Delgoda, Eileen Brantley. Plant isolate dibenzyl trisulfide induces caspase-independent death in triple negative breast cancer cells derived from patients of West African descent [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-110.
Abstract PO-127: Proteome profiling of pancreatic Ductal Adenocarcinoma (PDAC) primary tumors in Caucasian, African Americans and Latinx patients
Authors: Law Henry C.-H. , Riner Andrea N. , Trevino Jose G. , Woods Nicholas T.
Published: January 2022

The clinical management of pancreatic ductal adenocarcinoma (PDAC) faces difficult challenges due to its aggressive metastatic potential, complex microenvironment, and lack of targeted therapies. Health disparities also exacerbate these challenges. For instance, Black and African American (AA) patients have higher incidence rates and worse clinical outcomes than White patients even when socioeconomic and tumor stages are controlled. To advance the understanding of the biological differences across the racial groups, PDAC primary tumors collected from 30 Caucasian, 12 African American (AA) and 3 Latinx patients were analyzed by quantitative proteomics. In collaboration with the IDeA National Resource for Quantitative Proteomics, 5820 proteins were identified and quantified using data-independent acquisition (DIA) in the tumor proteome. Comparing the Latinx and the Caucasian tumor proteome, 120 and 95 proteins were found up- and down-regulated in the Latinx proteome, respectively. Proteins involved in the fatty acid metabolism, urea cycle, bile acid and bile salt metabolism were found enriched among the upregulated proteins. 108 and 75 proteins were found up- and down-regulated in African American tumor proteome over the Caucasians, respectively. The 108 upregulated proteins were submitted for Reactome Pathway Analysis. Pathways such as the complement cascade, extracellular matrix (ECM) organization and ECM proteoglycans were found enriched. Haptoglobin-related protein (HPR) was one of the 108 upregulated proteins in the AA tumor proteome, which is also observed at the transcript level in the The Cancer Genome Atlas data. The HPR is known for its trypanolytic function and gene amplifications are observed in those of African descent. HPR works with haptoglobin to clear the free hemoglobin in blood to prevent oxidative damage. We believe that the proteins overexpressed, and the biological processes activated are contributing to the PDAC disparities observed in the African descendants. Therefore, the characterization of the PDAC proteome is a valuable method to delineate the underlying molecular signatures that may contribute to the health disparities.

Citation Format: Henry C.-H. Law, Andrea N. Riner, Jose G. Trevino, Nicholas T. Woods. Proteome profiling of pancreatic Ductal Adenocarcinoma (PDAC) primary tumors in Caucasian, African Americans and Latinx patients [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-127.
Abstract PO-129: Influence of triple-negative versus Luminal A breast cancer subtype on choice of autologous versus implant based delayed-immediate breast reconstruction
Authors: Amaya Joshua , Dickey Ryan M. , Jones Kaitlin , Teotia Sumeet S. , Haddock Nicholas T.
Published: January 2022

Background: Triple-negative and luminal A breast cancer molecular subtypes have divergent clinical and prognostic characteristics for breast cancer patients. Our study aims to compare the reconstructive choice of these two groups from the time they receive a tissue expander to the time they complete autologous or implant-based breast reconstruction. Methods: 255 patients who underwent delayed-immediate breast reconstruction with tissue expander placement from 2013 to 2017 diagnosed with either TN (n = 73) or luminal A (n = 182) invasive breast cancer subtype seen by two surgeons at a single institution were identified. Preference of autologous and implant- based reconstruction was analyzed, along with tissue expander (TE) complications, race, age, BMI, smoking, adjuvant therapy, and comorbidities. Results: There was a significant difference in the choice of implant- or autologous-based reconstruction among these two groups (p < 0.05). A greater proportion of luminal A patients underwent implant-based reconstruction (63.47%) and a greater proportion of TN patients underwent autologous-based reconstruction (53.13%). With regard to TE outcomes, there was no significant difference between the two groups with regard to duration of TE placement by reconstructive type, or TE surgical complications. Significantly more TN patients underwent radiation therapy (p < 0.01) and neoadjuvant chemotherapy (p < 0.0001) than luminal A patients. BMI, comorbidities, radiation therapy and overall TE complications were identified as predictive factors of patients electing for autologous reconstruction over implants. Conclusion: TN breast cancer patients mostly chose autologous-based reconstruction, while luminal A patients chose implant-based reconstruction. Both patient groups carried their tissue expanders for similar duration with similar complication profile. Radiation therapy is likely a major factor in the decision for the type of delayed-immediate reconstruction among this population.

Citation Format: Joshua Amaya, Ryan M. Dickey, Kaitlin Jones, Sumeet S. Teotia, Nicholas T. Haddock. Influence of triple-negative versus Luminal A breast cancer subtype on choice of autologous versus implant based delayed-immediate breast reconstruction [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-129.
Abstract PO-134: Differential effects of CXCR1 and CXCR2 receptors on prostate tumorigenesis
Authors: Adekoya Timothy O. , Smith Nikia , Kothari Parag , Richardson Ricardo M.
Published: January 2022

Chemokines and their receptors are important proteins that promote growth of various malignant tumors. In prostate cancer, some members of the CXC chemokine receptor have been shown to enhance angiogenesis, proliferation and metastasis. In this study we assess the roles of the interleukin-8 (IL-8/CXCL8) receptors CXCR1 and CXCR2 in prostate cancer development, using the African American MDA PCa 2b cell line. Our results show that overexpression of CXCR2 enhanced in-vitro cell proliferation, soft agar growth and in-vivo tumor xenograft in nude mice, whereas overexpression of CXCR1 inhibited cell proliferation and tumor growth, relative to control cells. Interestingly, cells overexpressing CXCR1 exhibited a more mesenchymal phenotype, characterized by reduced E-Cadherin but increased N-Cadherin and vimentin protein expression. CXCR1 overexpression also blocked AKT activation and signal transduction. CXCR2 overexpression, however, resulted in a neuroendocrine phenotype, characterized by reduced androgen (AR) receptor expression and altered chromogranin A expression. In conclusion, these results indicate that CXCR1 and CXCR2 overexpression may play alternate roles on prostate tumorigenesis.

Citation Format: Timothy O. Adekoya, Nikia Smith, Parag Kothari, Ricardo M. Richardson. Differential effects of CXCR1 and CXCR2 receptors on prostate tumorigenesis [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-134.
Abstract PO-142: Analysis of the genomic landscapes of Barbadian and Nigerian women with triple negative breast cancer
Authors: Hercules Shawn M. , Liu Xiyu , Bassey-Archibong Blessing I. , Skeete Desiree H.A. , Connell Suzanne Smith , Daramola Adetola , Banjo Adekunbiola A.F. , Ebughe Godwin , Agan Thomas , Ekanem Ima-Obong , Udosen Joe E. , Obiorah Christopher , Ojule Aaron C. , Misauno Michael A. , Dauda Ayuba M. , Egbujo Ejike C. , Hercules Jevon C. , Ansari Amna , Brain Ian , MacColl Christine , Xu Yili , Jin Yuxin , Chang Sharon , Carpten John D. , Bédard André , Pond Gregory R. , Blenman Kim R.M. , Manojlovic Zarko , Daniel Juliet M.
Published: January 2022

Women of African ancestry (WAA) are disproportionately affected by the aggressive triple negative breast cancer (TNBC) subtype that is often associated with high recurrence rates and metastasis. Although there is a high prevalence of TNBC across West Africa and in women of the African diaspora, there has been no comprehensive genomics study to investigate the mutational profile of ancestrally related women across the Caribbean and West Africa. To shed more light on this phenomenon, whole exome sequencing (WES) was performed on 31 formalin-fixed paraffin-embedded TNBC tissues from ancestrally related Barbadian and Nigerian women. We compared these genomics profiles with data from The Cancer Genome Atlas (TCGA) for African American (TCGA-AA), European American (TCGA-EA) women with TNBC. With an average coverage of 382x for tumour samples (n= 31) and 4335x for pooled germline (n=22) non-tumor samples, the most mutated genes in our cohorts include NBPF12, PLIN4, TP53 and BRCA1. For TCGA TNBC cases, these genes had a lower mutation rate, except for TP53 (32% in our cohort; 63% in TCGA-AA; 67% in TCGA-EA). For all altered genes, there were no differences in frequency of mutations between WAA TNBC groups including the TCGA-AA cohort. Additionally, we observed a high frequency of copy number variant alterations in PIK3CA, TP53, FGFR2 and HIF1AN genes. This study provides in-depth insights into the underlying genomic alterations in WAA-TNBC samples and shines light on the importance of inclusion of non-European populations in cancer genomics and biomarker studies.

Citation Format: Shawn M. Hercules, Xiyu Liu, Blessing I. Bassey-Archibong, Desiree H.A. Skeete, Suzanne Smith Connell, Adetola Daramola, Adekunbiola A.F. Banjo, Godwin Ebughe, Thomas Agan, Ima-Obong Ekanem, Joe E. Udosen, Christopher Obiorah, Aaron C. Ojule, Michael A. Misauno, Ayuba M. Dauda, Ejike C. Egbujo, Jevon C. Hercules, Amna Ansari, Ian Brain, Christine MacColl, Yili Xu, Yuxin Jin, Sharon Chang, John D. Carpten, André Bédard, Gregory R. Pond, Kim R.M. Blenman, Zarko Manojlovic, Juliet M. Daniel. Analysis of the genomic landscapes of Barbadian and Nigerian women with triple negative breast cancer [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-142.
Abstract PO-145: Contribution of the GR-LEDGF/p75 axis to prostate cancer chemoresistance
Authors: Sanchez-Hernandez Evelyn S , Ortiz-Hernandez Greisha L. , Ochoa Pedro T. , Gomez Christian R , Casiano Carlos A
Published: January 2022

Prostate cancer (PCa) is the second leading cause of cancer deaths in the U.S., disproportionally affecting African American (AA) men. Glucocorticoids (GCs) are administered to PCa patients and have been implicated in therapy resistance. This may be critical to AA men with PCa since they have elevated endogenous GCs levels compared to Caucasian American (CA) men. GCs bind to the glucocorticoid receptor (GR) to exert their actions. The mechanisms of GR-mediated chemoresistance, and its possible contribution to PCa mortality disparities are unknown. We demonstrated that GCs upregulate the chemoresistance-associated protein and transcription co-activator LEDGF/p75 in PCa cells and identified consensus GR binding sites in the promoter region of this protein. Given that both GR and LEDGF/p75 are components of the RNA polymerase II transcription complex, we hypothesized that GR transcriptionally upregulates LEDGF/p75 and then interacts with it to enhance taxane resistance in PCa cells. Pharmacological and genetic inhibition of GR in a panel of docetaxel (DTX)-sensitive and -resistant PCa cells decreased the expression of LEDGF/p75, confirming its status as a candidate GR target gene. However, silencing of LEDGF/p75 had no effects on GR expression. Immunoprecipitation studies revealed that GR and LEDGF/p75 interact in DTX-sensitive and -resistant PCa cells. This interaction was confirmed by confocal microscopy. Immunohistochemical analysis of GR and LEDGF/p75 expression in normal and tumor prostate tissues was performed and the results are currently being analyzed. Our studies use a mechanistic approach to evaluate the potential contribution of the GR-LEDGF/p75 axis to PCa chemoresistance. Evaluating the co-expression of these proteins in racially diverse PCa tissues may also reveal race-related differential expression, providing insights into the potential contribution of this axis to PCa chemoresistance and mortality disparities.

Citation Format: Evelyn S Sanchez-Hernandez, Greisha L. Ortiz-Hernandez, Pedro T. Ochoa, Christian R Gomez, Carlos A Casiano. Contribution of the GR-LEDGF/p75 axis to prostate cancer chemoresistance [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-145.
Abstract PO-147: Targeting Notch signaling in cancer stem-like cells of triple-negative breast cancer
Authors: Murphy Adrienne M. , Ucar Ayse D. , Miele Lucio
Published: January 2022

Triple-Negative Breast Cancer (TNBC) is an aggressive form of breast cancer. This particular type expresses no Estrogen (ER) and Progesterone (PR) hormone receptors or Human epidermal growth factor receptor-2 amplifications. African American women are more frequently affected at a younger age by this aggressive breast cancer than any other ethnicity. Furthermore, heterogeneity of cells within a tumor challenges to identify specific targets to develop new drugs. Specifically, a subpopulation of cells within a tumor, called cancer stem-like cells (CSC) are known to grow slower, resist treatments, and be responsible for the relapse and metastasis of a tumor. Notch signaling pathway, which is one of the key regulatory signaling pathways in normal and cancer stem cells. We hypothesize that Notch1 signaling is a crucial signaling pathway for TNBC and worthwhile to target. To be able to identify and test Notch-specific targeted drugs, it is crucial to establish a cell line that overexpresses and knocks down the target gene. Therefore, in this project, we establish Notch1 modified stable TNBC cell lines and checked their morphological and physiological changes. Using MDA-MB-231 TNBC cell line, for the Notch1 knockout, we used crisper/cas9 gene-editing method and clonal selection of knockout cells. For the overexpression of NOTCH1 intracellular domain, we constructed and used pBABE-puro lentivirus system. Our results showed the Notch1 KO cells become more epithelial-like in appearance, with reduced expression of CD44+/CD24lo CSC markers, and reduced capacity to form mammospheres. On the other hand, overexpression of Notch1 the CSC become more mesenchymal and increase the expression of CSC markers. Also, we observed reduced metabolic activity of our Notch1KO cells while the overexpression of Notch1 increased the metabolic activity of the TNBC cells. Our preliminary results show that targeting Notch signaling is a promising approach to cure TNBC patients suffering from this aggressive cancer.

Citation Format: Adrienne M. Murphy, Ayse D. Ucar, Lucio Miele. Targeting Notch signaling in cancer stem-like cells of triple-negative breast cancer [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-147.
Abstract PO-148: The role of annexin A6 in triple-negative breast cancer metabolism and disease progression
Authors: Williams Stephen D. , Widatalla Sarrah E. , Sakwe Amos M.
Published: January 2022

Triple-negative breast cancer (TNBC), which accounts for up to 17% of all breast cancer cases in the Unites States, disproportionately affects premenopausal African American and Hispanic women. Here, we report the synergistic function of the tumor suppressor annexin-A6 (AnxA6) and Lapatinib-resistance (Lap-R) in the context of cellular bioenergetics. Metabolic profiling of TNBC cell lines show extensive diversity amongst basal-like (BSL) vs mesenchymal-like (MSL) molecular subtypes. Down regulation of AnxA6 in AnxA6- expressing and Lap-R cell lines attenuated mitochondrial respiration, glycolytic function, and cellular ATP production capacity, decreasing the overall metabolic plasticity of the cell. Additionally, AnxA6-depletion altered lipid metabolism by enhancing the mitochondrial uptake of cytosolic fatty acids for β-oxidation. NMR-based metabolomics revealed that AnxA6 depleted and/or Lap-R TNBC cells have a greater dependency on gluconeogenic precursors including glycine, alanine, lactic acid, and oxaloacetic acid as survival mechanisms. Taken together, this study proposes that altered expression of AnxA6 is accompanied by significant bioenergetic adaptations and hence provide novel insights into the failure of EGFR-targeted therapies as therapeutic options and disease progression in patients with triple-negative breast cancer.

Citation Format: Stephen D. Williams, Sarrah E. Widatalla, Amos M. Sakwe. The role of annexin A6 in triple-negative breast cancer metabolism and disease progression [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-148.
Abstract PO-181: Race, educational attainment and pancreatic cancer mortality among Latinos
Authors: Correa Tulio L. , Guelli Mariana S.T.C.
Published: January 2022

Background: Socioeconomic status, race, and educational attainment are known to impact outcomes of various cancers. Pancreatic cancer is one of the most aggressive types of cancer and accounts for a high number of deaths worldwide. This study aims to describe the mortality for pancreatic cancer by sex, race/skin color, and educational attainment in Brazil in the past decade. Methods: Descriptive ecological study, which evaluated the mortality rate for pancreatic cancer in the Brazilian National Health System from 2010-2019. The mortality rate was evaluated by sex, race/skin color, and educational attainment using the national database (DATASUS – Department of Informatics of the Unified Health System). The official classification of race/skin color in Brazil is composed of five categories: White, Brown [Pardo], Black, Yellow, and Indigenous. Results: During this time period, there was a total of 94024 deaths from pancreatic cancer in the Brazilian National Health System, of which 47295 (50.3%) were female. Regarding race/skin color; 58802 (62.5%) considered themselves white, 24845 (26.4%) brown, 5883 (6.3%) black, 954 (1%) others, and 3540 (3.8%) did not answer the question. Regarding educational attainment (n=76343); 9658 (12.7%) never had formal education, 41157 (53.9%) had >0 to 7 years, 15632 (20.4%) had 8 to 11 years, and 9896 (13%) had >12 years of educational attainment. Conclusions: The majority of patients who died from pancreatic cancer in our study were female, white, and had >0 to 7 years of educational attainment. However, these associations are still little analyzed worldwide and need more attention.

Citation Format: Tulio L. Correa, Mariana S.T.C. Guelli. Race, educational attainment and pancreatic cancer mortality among Latinos [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-181.
Abstract PO-207: Impact of Medicaid expansion on stage at diagnosis for US adults with pancreatic cancer: A population-based study
Authors: Mobley Erin M. , Guerrier Christina , Tfirn Ian , Gutter Michael S. , Vigal Kimberly , Pather Keouna , Baskovich Brett , Awad Ziad , Parker Alexander S
Published: January 2022

Introduction: We evaluated whether expansion of state Medicaid programs is associated with earlier-stage at diagnosis for pancreatic cancer among those under the age of 65, before and after Medicaid expansion considering key demographic, clinical, and geographic covariates. Methods: We obtained Surveillance, Epidemiology, and End-Results (SEER-18) data on individuals under 65 years of age diagnosed with pancreatic cancer from 2007-2016, including Urban Influence Code (UIC) and Social Deprivation Index (SDI) data. We defined early stage as either local or regional disease (versus advanced disease). To estimate the effect of Medicaid expansion on stage at diagnosis, we used a Difference-in-Differences (DD) model, at the individual level, comparing those from early-adopting states in 2014 to non-early-adopting states. We utilized cluster-robust standard errors and explored the role of covariates including demographic factors (race, sex, insurance coverage at diagnosis), clinical indicators (disease located in the head of the pancreas), and county characteristics (UIC and SDI). Results: The probability of early-stage disease at diagnosis increased by 3.9 percentage points (ppt) for those from Medicaid expansion states post-expansion (n=36,609). After adjustment for key covariates, the ppt was attenuated to 2.7. Of note, we observed evidence of interactions with sex and race. Indeed, the beneficial effect of living in an expansion state on stage at diagnosis was less pronounced for men (increase in the probability of early stage at diagnosis by 2.1ppt) than women (3.6ppt) and non-existent for blacks (-3.1ppt) compared to whites (4.9ppt) and other races (4.8ppt). Redefining early stage to only local stage attenuated the beneficial effect for all groups and increased the negative effect for blacks. Conclusion: Medicaid expansion is associated with earlier stage at diagnosis for pancreatic cancer; however, this beneficial effect is not uniform across sex and race. This underscores the need to investigate the impact of policy changes and implementation strategies on disparities in pancreatic cancer survival.

Citation Format: Erin M. Mobley, Christina Guerrier, Ian Tfirn, Michael S. Gutter, Kimberly Vigal, Keouna Pather, Brett Baskovich, Ziad Awad, Alexander S Parker. Impact of Medicaid expansion on stage at diagnosis for US adults with pancreatic cancer: A population-based study [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-207.
Abstract PO-213: Financial implication of prostate cancer hypofractionated radiotherapy
Authors: Acharya Suryakanta
Published: January 2022

Background- Prostate cancer is the 2nd most common cancer in males, worldwide & not far behind lung cancer incidence. Radiation holds the potential to cure non-metastatic disease (T1b-T3a), however the old 8-week long conventional radiation treatment is too lengthy & costly for patients. Non-inferiority CHHiP trial established 4 week long hypofractionated radiation which provided a big relief to patients saving substantial cost & time. Method- From January 2020 to December 2020, I had adopted the shorter 4-week radiation regimen for all eligible prostate cancer patients (T1b-T3a N0 M0) needing radiation & the expenditure, both direct as well as indirect, was calculated. Direct cost includes cost of radiation, treatment planning & was obtained from hospital bills. Drug cost was excluded as the amount was too small & insignificant. Indirect cost includes the cost of staying in the city, food & the cost of commuting (local patients) which were obtained from each patient. Total cost during radiation was compared for both 8 week & 4-week regimen. 10 patients participated in the study. Result- Direct cost had reduced from 1750 USD to 1100 USD favoring the shorter 4-week regimen. This translates to 37% cost reduction. Indirect cost was reduced by 50% as the duration of stay reduced from 51 days (8 weeks RT) to 26 days (4 weeks RT) for patients who are from other cities. Those from local place had informed similar figure of commuting cost reduction. Overall, the total cost (direct & indirect) of radiation treatment was reduced by 40%. Conclusion- All patients were glad to know the reduced duration of radiation treatment & 40% cost saving. The time factor has not been taken into account, few patients on job were able join their workplace 4 weeks earlier.

Citation Format: Suryakanta Acharya. Financial implication of prostate cancer hypofractionated radiotherapy [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-213.
Abstract PO-217: Race and metastatic behavior of breast cancer subtypes
Authors: Han Yunan , Colditz Graham A. , Lian Min , Liu Ying
Published: January 2022

Introduction: Racial/ethnic differences exist in early-stage breast cancer, but less is known about whether there are racial differences in metastatic sites of breast cancer. Thus, we examined racial/ethnic differences in metastatic behavior of de novo metastatic breast cancer (MBC). Methods: We identified 28,072 adult women (63.9% non-Hispanic White [NHW], 16.6% non-Hispanic Black [NHB], 7.7% non-Hispanic Asian or Pacific Islander [API], 11.8% Hispanic) diagnosed with de novo MBC in the Surveillance, Epidemiology and End Results between 2010 and 2018. Sites of distant metastasis included bone, lung, liver, and brain. Age-standardized incidence rates and incidence rate ratios (IRRs) were calculated. Logistic regressions were used to estimate the multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Results: NHBs had the highest incidence of MBC (13.2 per 100,000). Bone is the most common site of distant metastasis (63.1%). The risks of developing distant metastases to different sites varied by race/ethnicity. Compared with NHW women, NHB women had higher risks of bone (IRR=1.37, 95% CI 1.32-1.43), lung (IRR=1.91, 95% CI 1.80-2.03), liver (IRR=1.62, 95% CI 1.52-1.73), and brain (IRR=1.72, 95% CI 1.51-1.94) metastases. API and Hispanic women had lower risks of bone, lung, and liver metastases than NHW women, and API women also had a lower risk of brain metastasis. In women with hormone receptor-positive and HER2-negative MBC, NHBs, Hispanics, and APIs had a higher risk of lung metastasis and a lower risk of bone metastasis than NHWs after adjusting for age, year of diagnosis, marital status, tumor histology and grade. In women with hormone receptor-positive and HER2-positive MBC, NHB race was related to a higher risk of lung metastasis, and API race to a lower risk of bone metastasis. Hispanics with triple-negative MBC had a lower risk of liver metastasis than their NHW counterparts. A lower risk of liver metastasis was also observed in APIs and Hispanics with hormone receptor-negative and HER2-positive MBC than their NHW counterparts. Conclusions: The association of race and ethnicity with the risk of MBC differed by metastatic sites and tumor subtypes. Propensity to lung metastasis in NHB women with hormone receptor-positive MBC, Hispanics and APIs with hormone receptor-positive and HER2-negative MBC suggests the importance of preventive efforts targeting lung metastasis in these vulnerable patients.

Citation Format: Yunan Han, Graham A. Colditz, Min Lian, Ying Liu. Race and metastatic behavior of breast cancer subtypes [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-217.
Abstract PO-233: Effect of Lactobacillus on tumor growth and radiosensitivity
Authors: Reguero-Cadilla Laura P. , Klopp Ann
Published: January 2022

Cervical cancer is the most common HPV-associated cancer as it is diagnosed in more than half a million women a year. It specially affects low and middle-income countries. In terms of treatment options, microbiome may be a key element in achieving the desired effect of radiation treatment in cervical cancer. The objective here is to evaluate the effect of Lactobacillus iners on tumor growth and cell response to radiation therapy. A previous test cohort identified that poor responders had an abundance of the Lactobacillus genus in their microbiome, while early/exceptional responders had other microorganisms such as Porphyromonas augmented. Moreover, whole genome shot gun sequencing (WGS) demonstrated that Lactobacillus iners is the most common species of Lactobacillus in cervical samples of poor responders and is absent in exceptional responders. Based on these findings, we propose that Lactobacillus iners creates a microenvironment which supports tumor growth and facilitates resistance to radiation therapy. A clonogenics assay using SiHa, HeLa and CaSki cell lines with three bacterial supernatants at different radiation doses was performed. While another facet of our research was comparing tumor growth in C57 mice receiving Lactobacillus iners suspension and those not receiving it. In terms of the clonogenics assay: L. crispatus and L. iners supernatants may increase radiosensitivity of SiHa, HeLa, and CaSki cell lines. Cell survival may also be affected by nutrients in bacterial broths. In terms of the mice's tumors analyzed: no significant differences in tumor growth were found between the control and treatment groups. L. crispatus cohort showed tumor regression, which correlates with higher populations of innate immune cells. Further clonogenic and in vivo experiments are supported to obtain more precise results that could eventually be applied in radiation oncology treatments.

Citation Format: Laura P. Reguero-Cadilla, Ann Klopp. Effect of Lactobacillus on tumor growth and radiosensitivity [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-233.
Abstract PO-239: Patient and provider experiences with an incidentally diagnosed cancer precursor: A qualitative study
Authors: Castaneda-Avila Maira A. , Mazor Kathleen M. , Lapane Kate , Epstein Mara M.
Published: January 2022

Background: Monoclonal gammopathy of undetermined significance (MGUS) is a prevalent, yet incidentally diagnosed precursor to multiple myeloma. We sought to gather foundational knowledge about the experiences of patients and healthcare providers during the process of diagnosing MGUS. Methods: We conducted semi-structured qualitative interviews. We recruited 14 patients using ResearchMatch and Facebook, and eight local healthcare providers. Interviews were analyzed using thematic analysis. Results: We identified three themes focused on the process of receiving or giving an MGUS diagnosis, relating to: (1) providers' explanations, (2) patients' understanding, and (3) the response to diagnosis. Providers reported that they explained MGUS using similar language for all patients, regardless of literacy level or other factors. Providers also indicated the challenges of explaining MGUS to non-English speaking patients using an interpreter. Although all patients were able to offer some description of MGUS in their own words, several patients reported they really did not understand what this diagnosis means. Providers acknowledged that an MGUS diagnosis may lead some patients to experience anxiety. Providers also reported that the referral to a hematologist-oncologist could be inherently stressful for some patients and make them worried about having cancer. Patients reported varied responses to receiving an MGUS diagnosis ranging from relief to anxiety about MGUS progression to multiple myeloma. Conclusion: We observed that providers tend to use consistent language when explaining an MGUS diagnosis to patients. Patients diagnosed with MGUS have a basic understanding of their condition, yet some patients feel anxiety around the diagnosis, which may affect other aspects of their lives. For underserved populations, providers may need to use interpreters to ensure all patients understand their condition. These findings are an important first step in understanding patients' experiences as they are diagnosed with MGUS.

Citation Format: Maira A. Castaneda-Avila, Kathleen M. Mazor, Kate Lapane, Mara M. Epstein. Patient and provider experiences with an incidentally diagnosed cancer precursor: A qualitative study [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-239.
Abstract PO-241: Cancer burden in a population of Hispanic cohort of persons living with HIV: 1992-2017
Authors: Menon Pranav , Mayor Angel Mauricio
Published: January 2022

Background: HIV-associated immune suppression has been linked to an increased risk of certain cancers; this risk maybe higher among Hispanics patients living with HIV (PLWH). The purpose of this study is to better understand the burden of cancer in minority PLWH, particularly those residing in Puerto Rico. Methods: Data from the Puerto Rican Retrovirus Research Center Cohort, matched with the Puerto Rican Cancer and Morality Databases were used to evaluate the cancer burden among Hispanic PLWH between January 1992 to December 2019. Fisher and chi square analysis were conducted to test associations of the neoplasm with gender, HIV risk factors, cancer risk factors anti-retroviral therapies (ART), and death, using SAS 9.4. Results: A total of 4,665 PLWH were evaluated with a mean age at enrollment of 38.43 ± 9.63, 71.60% male, 66.92% were 31-50, 69.52% smoked tobacco, 48.47% consumed alcohol, 48.30% were IV drug users, 28.40% reported men sex with men. At enrollment, 37.45% had a CD4 count < 200 cells (immunological AIDS), 46.23% received ART and 29.71% combination ART (cART). A total of 346 (7.42%) were diagnosed with some type of cancer, where 41.82% were AIDS defining malignancies. [Kaposi's sarcoma: 16.72%, Non-Hodgkin's Lymphoma: 15.73%, and Cervical Adenocarcinoma: 9.42%)] and the rest (53.18%) were non-AIDS defining cancers, [prostate (6.69%), lung (4.86%), Hodgkin's Lymphoma (3.94%), Liver (3.34%)]. Cancers were more prevalent in PLWH who are older, with CD4 count < 200, receive CART, and consumed alcohol. Morality in PLWH with cancer (62.4%) was higher than in those without cancer (53.8%). Cancer mortality was more prevalent in cases who were men, who had not received cART at enrollment, those who drink alcohol, or smoked tobacco. Discussion: Gaining an in depth understanding regarding the burden of cancer in minority PLWH is essential in mitigating adverse outcomes. Our findings indicate higher use of cART in PLWH with cancer, in line with the incremental increase of chronic conditions among this population after the availability of ART. There are significant differences in demographic information and risk factors exposure between HIV patients with cancer and those without. We also find that, beside the HIV risk factor, the classical cancer risks are affecting this vulnerable population. Consequently, further studies need to be done to get further information that will help to design tailored prevention strategies directed to PLWH.

Citation Format: Pranav Menon, Angel Mauricio Mayor. Cancer burden in a population of Hispanic cohort of persons living with HIV: 1992-2017 [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-241.
Abstract PO-246: Correlates of HPV test history among African American and Sub-Saharan African immigrant women
Authors: Adegboyega Adebola , Wiggins Amanda , Williams Lovoria B. , Dignan Mark
Published: January 2022

Background: Human Papillomavirus (HPV) is the causative agent in nearly all cases of cervical cancer. Cervical cancer is preventable and treatable if detected early through regular screening. While Pap testing is a traditionally accepted screening option, HPV testing offers improved assurance of low cancer risk and reliable identification of cervical precancer and cancer. However, HPV testing is a relatively new testing option and remains underused. Black women, including Sub-Saharan African immigrants, have higher risk for cervical cancer incidence, mortality rates, and later stage of diagnosis for cervical cancer. The purpose of this study was to examine predictors of ever having had an HPV test among African American and Sub-Saharan African immigrant women. Methods: We conducted a cross-sectional 85-item survey with self-described African American or Sub-Saharan African immigrant women recruited from the community in a medium size city in the Southeastern US. Data included demographics, HPV and HPV testing knowledge, and HPV testing history. Logistic regression evaluated predictors of ever having had an HPV test. Results: The average age of the 91 women was 38.2 years (SD = 12.6) and almost two-thirds (65%) were African immigrants. The majority (84%) had ever had a Pap test and more than one-third (36%) had ever had a HPV test. Women were correct on less than half of the HPV knowledge 16-item scale (M = 7.1, SD = 4.7) and HPV testing knowledge was low, with women answering an average of less than two out of five items correctly (M = 1.8, SD = 1.5). Younger age (p=.004), higher education (p=.015), and higher HPV testing knowledge (p=.007) were significant predictors of having had an HPV test. Every one-year increase in age was associated with a 7% decrease in having had an HPV test (OR=.93, 95% CI = 0.88-0.98), while every one-level increase in education was associated with a 2-fold increase (OR=2.1, 95% CI=1.15-3.69). Every one-item increase in HPV testing knowledge was associated with an over two-fold increase in having had an HPV test (OR=2.1, 95% CI = 1.2-3.6). Conclusions: To ensure prompt diagnosis, follow up, and treatment, health care providers must stay abreast of updated screening guidelines and implement them. Future research should prioritize increasing knowledge and HPV testing among older women and those with lower educational attainment. c

Citation Format: Adebola Adegboyega, Amanda Wiggins, Lovoria B. Williams, Mark Dignan. Correlates of HPV test history among African American and Sub-Saharan African immigrant women [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-246.