bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract PO-092: Development of an organoid assay for studying racial disparity in pancreatic acinar ductal metaplasia
Authors: Gosling Alyssa , Jiang Jinmai , Perkins Corey M. , Yao Yingwei , Schmittgen Thomas D.
Published: December 2020

Blacks have higher rates of incidence and mortality of pancreatic cancer compared to Whites and non-White Hispanics. In an effort to identify a biological basis for this disparity, we propose examining the early events in the development of pancreatic cancer. The process by which pancreatic acini transdifferentiate into ductal epithelial cells (i.e. acinar ductal metaplasia or ADM) is one of the earliest events in the development of pancreatic ductal adenocarcinoma. We adapted the classic in vitro ADM assay, by which primary mouse pancreatic acini undergo ADM once plated onto the extracellular matrix matrigel, to an assay to culture and transdifferentiate human pancreatic organoids. We have received normal, human pancreatic acini from pancreatic islet transplantation centers from Black (n=8), White (n=19) and Hispanic (n=16) donors. The gender distribution was 29 males and 14 females. The acinar cells were cultured on matrigel and allowed to undergo ADM over a 5 to 6 day period. The number of ductal epithelial cells were microscopically counted and the rate of transdifferentiation was determined by kinetic modeling of the data. We have successfully cultured and transdifferentiated 40 of 43 human pancreatic acinar cells. Data from our study suggests that females undergo ADM at a faster rate than males and among the different races, the rate of acinar transdifferentiation decreases in the following order Blacks > Whites > non-White Hispanics. In summary, we demonstrate that women and Blacks have the highest rate of pancreatic transdifferentiation. Future studies include sequencing of the RNA isolated from the tissues to identify molecular drivers of acinar transdifferentiation and their impact on health disparities of pancreatic cancer.

Citation Format: Alyssa Gosling, Jinmai Jiang, Corey M. Perkins, Yingwei Yao, Thomas D. Schmittgen. Development of an organoid assay for studying racial disparity in pancreatic acinar ductal metaplasia [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-092.
Abstract PO-093: Circulating tumor DNA (ctDNA) from peripheral blood is detectable among Ghanaian breast cancer patients
Authors: Ahuno Samuel T. , Edusei Lawrence , Titiloye Nicolas , Adjei Ernest , Clegg-Lamptey Joe-Nat , Yarney Joel , Wiafe-Addai Beatrice , Awuah Baffour , Vanderpuye Verne , Duggan Maire , Wiafe Seth , Nyarko Kofi , Aitpillah Francis , Ansong Daniel , Ahearn Thomas , Kwarteng Alexander , Abubakar Mustapha , Garcia-Closas Montserrat , Ha Gavin , Figueroa Jonine D. , Polak Paz
Published: December 2020

Cancer incidence is rising and mortality rates are high in Africa, where access to molecular pathology is limited. Analysis of cancer-related mutations in circulating tumor DNA (ctDNA) from cell-free DNA (cfDNA) that is shed into the bloodstream by tumor cells could be transformative to the African continent and provide new molecular insights. Using samples collected from the Ghana Breast Health Study we tested whether whole-genome sequencing (WGS) of cfDNA could detect ctDNA and identify somatic alterations that drive breast cancer. We selected 15 breast cancer patients (median age 49.5 years) with duplicated plasma samples. Pathologic grade, age, and immunohistochemical (IHC) stains for estrogen receptor (ER), progesterone receptor (PR) and HER2 were available for the majority of patients (>80%). cfDNA extraction and WGS at 30x and 0.1x was performed. ichorCNA software was used on Next Generation Sequencing (NGS) read counts to estimate the ctDNA fraction and predict copy number alteration profiles. High depth 30x cfDNA-WGS analysis showed that all 15 breast cancer patients had 1% ctDNA or greater (median[IQR] 3.96%[2.22%-8.13%]). There was high concordance between estimated ctDNA fraction using 0.1x and 30x WGS (Pearson r = 0.9). Copy number profiling showed extensive amplification and deletion of multiple chromosomal regions containing important cancer genes (such as MYC, PIK3CA, TERT, and GATA3). Of the four patients classified as HER2 positive based on IHC, two had increased ERBB2 copy number (50 and 3 copies, respectively). Our data provide evidence that ctDNA-based genomic studies are possible and ctDNA analysis could be a tool for future molecular oncology studies in Africa for cancer etiology, surveillance and clinical trials.

Citation Format: Samuel T. Ahuno, Lawrence Edusei, Nicolas Titiloye, Ernest Adjei, Joe-Nat Clegg-Lamptey, Joel Yarney, Beatrice Wiafe-Addai, Baffour Awuah, Verne Vanderpuye, Maire Duggan, Seth Wiafe, Kofi Nyarko, Francis Aitpillah, Daniel Ansong, Thomas Ahearn, Alexander Kwarteng, Mustapha Abubakar, Montserrat Garcia-Closas, Gavin Ha, Jonine D. Figueroa, Paz Polak, on behalf of the Ghana Breast Health Study Team. Circulating tumor DNA (ctDNA) from peripheral blood is detectable among Ghanaian breast cancer patients [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-093.
Abstract PO-112: Survey on purview, composition and logistical issues concerning provision of home care services among providers affiliated to a non-governmental organization
Authors: Arora Rahul D.
Published: December 2020

Background This survey, which was conceptualized and completed during a month long posting with an NGO specializing in provision of "specialist home care", was born out of a felt need to understand the structure and nature of medical care being provided, under the aforementioned umbrella designation. Methods A questionnaire was administered to doctors, nurses, social workers and volunteers during the monthly audit. Results 43/45 considered Home care services to be a part of generalist palliative care. All respondents agreed that dispensing essential drugs was an integral component of home care. 31/45 agreed upon the need to obtain a local physician liaison in the management of important medical issues. 32/45 expressed agreement that Pediatric palliative care required specialist input. 43/45 agreed on the need to carry a stethoscope, sphygmomanometer and pulse oximeter at the time of each visit. 43/45 agreed that subcutaneous injection and therapeutic paracentesis can be performed safely at home. 42/45 agreed that prescription stamped by a registered medical practitioner should be provided to all patients prescribed essential narcotic drugs. 34/45 preferred the presence of a doctor during the visit.

37/45 agreed that the presence of a doctor was essential towards ensuring effectiveness of the services provided. 25/45 agreed that measurement of vitals is an important component of a home care visit. 36/44 agreed that the average duration of a home care visit should be 30-45 minutes. 9/44 respondents agreed that the maximum time spent at the patient's place should be 15 minutes. 21/45 agreed with the statement that Travel can constitute upto 50 percent of the time during a single day. 20/43 agreed that Travel should not constitute more than 25 percent of the total time allotted for a particular day. 12/45 agreed that the frequency of visits should be kept at a maximum of two times per month. Conclusions Guidelines, governing home care are need to address the dual issues of maximum time that can be spent during travel and the limit of time permissible at a patients home. There should be a clear directive on the frequency of visits, in order to provide a more professional slant to these services.

Citation Format: Rahul D. Arora. Survey on purview, composition and logistical issues concerning provision of home care services among providers affiliated to a non-governmental organization [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-112.
Abstract PO-113: Survey aimed at understanding caregiver attitudes towards components of an effective home care service
Authors: Arora Rahul D.
Published: December 2020

Background Home care teams ensure that essential palliative medicine services are available at the Patient's doorstep. The complexities accompanying the duties of a caregiver in provision of holistic palliative and end of life care in these circumstances are underlined by the existence of psychological issues such as caregiver burden and distress, unique to this population. Re-dressal of these psychological constructs, which have the potential to impact the family's perception of effectiveness of services is an important responsibility of the home care service provider. Methods A questionnaire based upon themes of purview, scope and composition of Home care services was administered during a visit undertaken as part of month long posting in a Non-governmental organization. Caregiver opinion on issues such as frequency, timing and duration of visits and preferences in addition to important domains of patient care were sought. Results A total of 9 caregivers provided their consent for the interview. There was a reasonable degree of resonance with the idea that the Home care team should stock essential drugs, general agreement that the services being rendered were essential to the patient and their caregivers, acceptance that the frequency of visits remain once a week, due acknowledgement of the central role of the accompanying doctor and importance of a social worker during the visit. Majority (8/9) of those interviewed, agreed that the Home care team should be lead by a doctor, while, a similar number concurred that affilation to an NGO provided a more human face to the endeavour. However, there was a lack of consensus on the appropriateness of weekend visits, optimum time spent per visit (limiting the total duration of interaction with the patient and family to a maximum of 15 minutes had only 3 takers), acceptability of maintaining a drug diary and need for the same doctor to accompany the team on consecutive visits. Conclusions Guidelines are yet to address the duties and responsibilities of the Physician providing Home care services. Outreach programmes, which provide an opportunity to impart quality caregiver education, cater to a well defined population and involve the close participation of the Local health functionaries could help build momentum in the right direction.

Citation Format: Rahul D. Arora. Survey aimed at understanding caregiver attitudes towards components of an effective home care service [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-113.
Abstract PO-114: Initiation and adherence to adjuvant endocrine therapy among urban, insured American Indian/Alaskan Native breast cancer survivors
Authors: Emerson Marc A. , Achacoso Ninah , Benefield Halei C. , Troester Melissa A. , Habel Laurel A.
Published: December 2020

Background: Disparities in adjuvant endocrine therapy (AET) initiation and adherence have been shown by race/ethnicity, however the relationship among American Indian/Alaskan Natives (AIAN) is poorly understood, particularly among the 73% of urban residing AIAN. We evaluated whether AET-initiation and adherence were lower among AIAN than other races/ethnicities enrolled in Kaiser Permanente of Northern California (KPNC) health system. Methods: We identified 23,680 AET- eligible (first primary, stage I-III, hormone receptor-positive breast cancers) patients from 1997 to 2014 and used KPNC’s pharmacy records to identify AET-prescriptions and refill dates. We assessed AET-initiation (≥1 filled prescription within 1-year of diagnosis) and AET-adherence (proportion of days covered [PDC] ≥80%) every year up to 5-years post AET-initiation. Results: At the end of the 5-year period, 83% were AET-initiators and 58% were AET-adherent. Compared to all other races/ethnicities, AIAN women had the second lowest AET-initiation (Black=78.0%, AIAN=78.6%, Hispanic=83.0%, non-Hispanic white [NHW]=82.5%, Asian=84.7%), the lowest AET- adherence by the end of the 1-year and 5-year period (70.3% and 50.8% vs. NHW=76.4% and 58.8%, respectively), and the greatest AET-discontinuation in year period 4 to 5 (13.8% AET-adherence decrease, 64.6% to 50.8%), after AET-initiation. In the multivariable models adjusting for age, socioeconomic and clinical factors, AIAN, Hispanic, and Black women were less likely than NHW women to be AET- adherent although the number of AIAN was small leading to imprecise estimates. At the end of the 5-year period, total underutilization (combining initiation and adherence) in AET-eligible was greatest among AIAN (70.6%), followed by Black (69.6%), Hispanic (63.2%), NHW (58.7%), and Asian (52.3%), underscoring the AET- treatment gap. Conclusion: Our results suggest that AET-initiation and adherence are particularly low for insured AIAN women. Results suggest that interventions are needed, even for urban, insured AIAN women who tend to have greater geographic access and fewer financial issues than their rural counterparts.

Citation Format: Marc A. Emerson, Ninah Achacoso, Halei C. Benefield, Melissa A. Troester, Laurel A. Habel. Initiation and adherence to adjuvant endocrine therapy among urban, insured American Indian/Alaskan Native breast cancer survivors [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-114.
Abstract PO-129: High expression of MKK3 correlates with poor clinical outcomes in African American breast cancer patients
Authors: Yang Xuan , Amgad Mohamed , Cooper Lee A.D. , Du Yuhong , Fu Haian , Ivanov Andrey A.
Published: December 2020

African American women experience a 2-fold higher incidence of triple-negative breast cancer (TNBC) and are 40% more likely to die from breast cancer than women of other ethnicities. Previous studies have revealed a higher frequency of inactivating mutations in multiple tumor suppressor genes in African American breast cancer patients as compared to White patients. However, the molecular bases for the survival disparity in breast cancer remain unclear, and no race-specific therapeutically actionable targets have been proposed. To address this clinical need, we took the computational systems biology approach to uncover new potentially druggable genes that contribute in poor clinical outcomes of African American breast cancer patients. Through a comprehensive analysis of gene expression and survival data determined for The Cancer Genome Atlas (TCGA) breast cancer patient cohort, we found that more than 30% of all protein-coding genes are differentially expressed in White and African American breast cancer patients. The cluster analysis of co- regulated genes combined with the pathway enrichment analysis revealed a strong association of genes upregulated in African American patients with major oncogenic processes including cell cycle regulation, immunodeficiency, and oxidative phosphorylation. We have further identified more than 30 genes whose overexpression correlates with worsened clinical outcomes of African American breast cancer patients but not White patients. Among those genes, the overexpression of mitogen-activated protein kinase kinase 3 (MKK3) has one of the most dramatic and race-specific impacts on the survival of African American TNBC patients. We found that MKK3 can promote the TNBC tumorigenesis in African American patients in part by activating the master regulator MYC through protein- protein interaction. Together, this study uncovered new genetic features and molecular mechanisms of breast cancer tumorigenesis. As one example, we discovered new functional connectivity between poor clinical outcomes of African American TNBC patients and activation of the MYC transcriptional program through MKK3 signaling. These findings may open new opportunities for clinical investigations to reduce the survival disparity in breast cancer.

Citation Format: Xuan Yang, Mohamed Amgad, Lee A.D. Cooper, Yuhong Du, Haian Fu, Andrey A. Ivanov. High expression of MKK3 correlates with poor clinical outcomes in African American breast cancer patients [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-129.
Abstract PO-130: Molecular profiling of tumor mutations in PR Hispanics with cancer: Moving towards oncology precision medicine
Authors: Hernandez Aida M. Rodriguez , Rodriguez Sariemma Mendez , Torres Gabriela Torres , Correa Marcia Cruz
Published: December 2020

Background: Molecular profiling techniques such as next-generation sequencing to identify somatic mutations in tumors from oncologic patients allows physicians to have a better understanding of the tumor carcinogenic pathway and thus design therapeutic treatment strategies. The objective of our study was to provide data on the results of a sample of Puerto Rican patients with solid tumors and identify the prevalence of genetic mutations. Methods: We conducted a single-institution clinical study based on results of molecular tumor profiling of 592 known mutations using next-generation sequencing testing (CARIS Life Sciences). Mutations in actionable genes were highlighted as they have current or developing molecular therapies for oncology patients. Results: Tumors from a sample population of 50 Puerto Rican patients were evaluated using CARIS Life Science testing. The median age of our study population was 55 (range 21-84) with 54% (27) males and 46% (23) females.

The primary tumor sites found among the population were in colorectal (n=24), gastric (n=5), breast (n=4), lung (n=3), unknown (n=3) bladder (n=1), bile duct (n=1), pancreas (n=1), endometrial (n=1), ovarian (n=1), Hypopharynx (n=1) kidney (n=1), ovarian (n=1), pancreas (n=1), prostate (n=1), spine (n=1), tongue (n=1), and Tonsillar Pillar (n=1). Mutations were found in multiple signaling pathways: Cell cycle control, Chromatin Remodeling/DNA Methylation, DNA Damage and Repair, G Protein Signaling, MAPK Signaling, PI3K/Akt Signaling, RNA Splicing, and Wnt / β-Catenin Signaling. Discussion: Molecular profiling techniques such as next-generation sequencing has allowed for massive parallel sequencing of the human genome to further study the cancer genome. From this sample population of Puerto Rican patients with cancer, we have found a high prevalence of TP53, APC, and KRAS mutations, with less predominance of EGFR and HRD pathway mutations. Novel therapies targeting specific pathways require understanding the somatic mutation profile to establish precision medicine and improve therapeutic responses.

Acknowledgments: Pan American Center for Oncology Trials

Citation Format: Aida M. Rodriguez Hernandez, Sariemma Mendez Rodriguez, Gabriela Torres Torres, Marcia Cruz Correa. Molecular profiling of tumor mutations in PR Hispanics with cancer: Moving towards oncology precision medicine [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-130.
Abstract PO-132: Rosmarinic acid-induced apoptosis and cell cycle arrest in triple-negative breast cancer cells
Authors: Soliman Karam F.A. , Messeha Samia S. , Zarmouh Najla O. , Asiri Abrar
Published: December 2020

Rosmarinic acid (RA) is a polyphenolic compound with various pharmacological properties, including anti-inflammatory, immunomodulatory, anti-mutagenic, antioxidant, and anticancer activities. This study evaluated the effects of RA in two racially different triple-negative breast cancer (TNBC) cell lines. One cell line was derived from Caucasian origin (MDA-MB-231), and another one was derived from an African American origin (MDA-MB-468). The apoptotic effect of RA was performed using An Annexin V-FITC Apoptosis Detection Kit, while the Propidium Iodide Flow Cytometry Kit was used to detect the cell cycle distribution. Gene expression profiling was established using Human Apoptosis PCR array. The results obtained show that RA significantly caused cytotoxic and antiproliferative effects in both cell lines in a dose- and time-dependent manner. It was noted that RA induced cell cycle arrest-related apoptosis and altered the expression of many apoptosis-involved genes differently. In MDA-MB-231 cells, RA arrested the cells in the G0/G1 phase. In contrast, RA causes S-phase arrest in MDA-MB-468 cells, leading to a 2-fold increase in the apoptotic effect compared to MDA-MB-231 cells. Furthermore, in MDA-MB- 231 cells, RA significantly upregulated the mRNA expression of three genes: Harakiri (HRK), tumor necrosis factor receptor superfamily 25 (TNFRSF25), and BCL-2 interacting protein 3 (BNIP3). In contrast, in the MDA-MB-468 cell line, RA induced a significant transcription activation in three genes, including TNF, growth arrest, and DNA damage-inducible 45 alpha (GADD45A), and BNIP3. Furthermore, RA repressed the expression of TNF receptor superfamily 11B (TNFRSF11B) in MDA-MB-231 cells in comparison to the ligand TNF superfamily member 10 (TNFSF10) and baculoviral IAP repeat-containing 5 (BIRC5) in MDA-MB-468 cells. In conclusion, the data suggest that the polyphenol RA may have a potential role in TNBC therapies, particularly in African American cells.

Citation Format: Karam F.A. Soliman, Samia S. Messeha, Najla O. Zarmouh, Abrar Asiri. Rosmarinic acid-induced apoptosis and cell cycle arrest in triple-negative breast cancer cells [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-132.
Abstract PO-136: MicroRNA-1205 directly binds to FRYL and suppresses aggressive prostate cancer
Authors: Graña-Amat Xavier , Ogunwobi Olorunseun , Naidoo Michelle K. , Levine Fayola
Published: December 2020

High mortality rates of prostate cancer (PCa) are associated with metastatic castration-resistant prostate cancer (mCRPC) due to the maintenance of androgen receptor (AR) signaling despite androgen deprivation therapies (ADTs). Resistance to second generation ADTs leads to the progression to AR-independent neuroendocrine PCa (NEPC), which is observed in nearly 1 in 5 men with mCRPC and is associated with very poor outcome. PCa neuroendocrine differentiation (PCND) is observed in treatment-related NEPC, however, this mechanism is poorly understood. The 8q24 chromosomal locus is an important prostate cancer (PCa) susceptibility region containing genetic variants associated with increased PCa incidence and aggressiveness. PVT1 is a gene located within this region that encodes microRNA- 1205 (miR-1205), whose function is largely unknown. We have previously reported that miR-1205 is underexpressed in a cohort of histologically confirmed PCa tissue, when compared to normal tissue and is also underexpressed in vitro in CRPC cells, when compared to non-CRPC cells. We also demonstrated that exogenous miR-1205 significantly inhibited tumor volume in CRPC-derived xenograft male NOD/SCID gamma mice, suggesting that miR-1205 is a tumor suppressor. To understand the molecular mechanism of miR-1205, we demonstrated that miR-1205 directly targets Fry-like (FRYL) by performing an RNA pulldown assay. FRYL is predicted to regulate dendritic branching leading to the hypothesis that FRYL plays a role in PCND. To examine miR-1205 regulation of FRYL in PCND in vitro, LNCaP cells were cultured under androgen deprivation conditions for fourteen days. We observed FRYL mRNA overexpression and a significant reduction of miR-1205 expression in LNCaP-PCND cells when compared to undifferentiated LNCaP cells. To further determine whether this mechanism drives PCND, miR-1205 was inhibited in RWPE-1 and LNCaP androgen-sensitive cells. As a result, FRYL protein expression was increased along with neuroendocrine marker expression when compared to cells transfected with a negative control. To determine whether PCND is driven directly through FRYL activity, FRYL was silenced using an siRNA in PC-3 cells (model of NEPC). Interestingly, knockdown of FRYL did not reveal a decrease of neuroendocrine markers, suggesting that miR-1205 may induce PCND independently of FRYL. Further understanding this molecular mechanism may provide novel insights into overcoming ADT resistance in aggressive PCa.

Citation Format: Xavier Graña-Amat, Olorunseun Ogunwobi, Michelle K. Naidoo, Fayola Levine. MicroRNA-1205 directly binds to FRYL and suppresses aggressive prostate cancer [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-136.
Abstract PO-150: Epidemiology of endometrial cancer as a second primary malignancy in Florida
Authors: Medina Heidy N. , Schlumbrecht Matthew P. , Pinheiro Paulo S.
Published: December 2020

Background: According to cancer registry data, nearly 20% of Endometrial Cancer (EC) cases in the US are second or higher-order primary cancers. Little is known in regard to the epidemiology of EC as a Second Primary (ECSP) cancer. Purpose: To compare ECSPs and EC as a first primary in relation to histological types and cause- specific survival; examine survival of ECSP according to original primary site, and treatment received for the first primary. Methods: All cases of EC diagnosed from 2005-2016 were obtained from the Florida Cancer Data System. Chi-square tests, Kaplan-Meier methods and Cox Regression were used in the analysis. Results: Of 9,002 initial ECSPs, 73% were not “clinically independent”, i.e. without treatment distinctions between first and second cancers. These included ECSPs of different histologies from a first EC, and ECSPs following ovarian and cervical cancers (<1 year). After excluding these, there were 2,401 ECSPs and 37,128 ECs as a first primary; 1,260 ECSPs followed breast cancer (BC), 299 followed colorectal cancer (CRC), and other sites(n=842). The 5-year, age-standardized cause-specific survival was 72.2% (95%CI: 71.8-72.7) for first ECs and 60.7% for ECSPs (95%CI: 58.5-63.0).

However, after adjusting for age, race/ethnicity, histology, and stage there was no significant difference between ECSP and first EC (HR 0.92, 95%CI: 0.83-1.03). Post- colorectal ECSPs had lower 5-year survival (55.3%, 95%CI: 48.9-61.7) than post- breast cancer ECSPs (64.8%, 95%CI: 61.8-67.9), and significantly higher risk of EC- specific death (HR 1.78, 95%CI:1.23-2.58) in multivariable analysis. Lastly, women who had chemotherapy for both ECSP and a preceding BC did not have a higher EC- specific risk of death (HR 0.79, 95% CI: 0.46-1.36) compared to those who only received chemotherapy for EC as a first primary. Conclusions: ECSP survival is similar to that of EC as a first primary. However, ECs post-CRC may constitute a population of interest with much worse survival than those post-BC. There was no information to separately assess Lynch syndrome cases or those receiving tamoxifen as part of BC treatment. Lastly, chemotherapy for a previous BC does not seem to affect the effectiveness of chemotherapy for ECSPs. Further research is needed in the epidemiology of second cancers.

Citation Format: Heidy N. Medina, Matthew P. Schlumbrecht, Paulo S. Pinheiro. Epidemiology of endometrial cancer as a second primary malignancy in Florida [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-150.
Abstract PO-160: Association between variants in acinar-to-ductal metaplasia genes and pancreatic cancer incidence in racially diverse populations
Authors: Bogumil David , Schmittgen Thomas , Perkins Corey , Lee Eun-Sook , Stern Mariana , Carpten John , Setiawan Veronica Wendy
Published: December 2020

Background: Pancreatic cancer is one of the deadliest cancers with increasing incidence and mortality. Racial/ethnic disparities in incidence have been observed in the United States with African Americans exhibited the highest incidence. In the Multiethnic Cohort Study (MEC), we found elevated risk among African Americans, Japanese Americans and Native Hawaiians. Acinar-to-ductal metaplasia (ADM) is considered the main origin of pancreatic pre-neoplastic lesions that eventually develop into pancreatic ductal adenocarcinoma (PDAC). In our preliminary in-vitro study, we found differences in the rate of ADM across racial/ethnic groups with Blacks undergoing ADM greater than whites followed by Hispanics. We hypothesize that genetic variants in genes involved in the ADM process are associated with PDAC risk. Methods: We examined the associations of single nucleotide polymorphisms (SNP) in KRT19, PTF1A and SOX9 with risk of PDAC in two prospective cohorts: the MEC and the Southern Community Cohort Study (SCCS). Nested case-control samples with 691 incident PDAC cases and 13,778 controls from African-American, Japanese- American, Latino, Native Hawaiian, and white participants were included in this analysis. SNP and PDAC associations were examined using logistic regression, adjusting for age, sex, study, body mass index, diabetes, and population stratification using principal components. Results: In racial/ethnic groups combined, no association was observed between SNPs in KRT19, PTF1A and SOX9 and PDAC risk.

However, in ethnic-stratified analyses, we found significant associations between PTF1A and PDAC in whites; rs1886763 (G/A) OR=1.72 (95% CI: 1.22, 2.42). We also found significant associations between 7 SNPs in KRT19 and PDAC among Japanese Americans. All these 7 SNPs were in high linkage disequilibrium, with the strongest of these associations was observed for rs56051972 (G/C) OR=1.77 (95% CI 1.17, 2.66).

Conclusions: In this racially diverse populations, we found associations between key ADM genes and PDAC risk in certain racial/ethnic groups. Our findings suggest potential role of ADM in influencing PDAC risk.

Citation Format: David Bogumil, Thomas Schmittgen, Corey Perkins, Eun-Sook Lee, Mariana Stern, John Carpten, Veronica Wendy Setiawan. Association between variants in acinar-to-ductal metaplasia genes and pancreatic cancer incidence in racially diverse populations [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-160.
Abstract PO-162: Helicobacter pylori in Native Americans in Northern Arizona
Authors: Monroy Fernando P. , Brown Heidi E. , Sanderson Priscilla , Jarrin Gregory , Mbegbu Mimi , Kyman Shari , Chief Camenlita , Harris Robin B.
Published: December 2020

Background. Helicobacter pylori, one of the most common bacterial infections worldwide. Chronic infections are associated with gastritis, peptic ulcer, and gastric cancer. While H. pylori infections and gastric cancer are going down in the US, certain populations continue to experience high H. pylori prevalence of infection and a significant burden from stomach cancer. For example, in Arizona H. pylori prevalence of infection among the Navajo is 60% and gastric cancer is 3-4 times higher that of the white population. Objective: The aim of this work was to survey the presence of virulence factors (cagA and vacA) in H. pylori in the Navajo reservation and their association with gastric disease. Methods: The presence of the virulence genes, cagA and vacA in H. pylori was investigated in gastric biopsies from 97 patients attending the gastroenterology clinic in Winslow, AZ. Biopsies were collected from the antrum and fundus and used for histological examination and for molecular characterization. Molecular characterization was performed by looking at type and number of EPIYA motifs in cagA and presence of different alleles in the signal (s) and medium (m) regions of the vacA gene. Results: The infection rate in the biopsy samples was 22.9%. The cagA gene amplified in 76.9% of the cases and analysis of the 3′ region of cagA showed the predominant presence of the “Western CagA” type with the EPIYA-ABC motif (70.0%) the most prevalent. The vacA allele s1bm1 was the most prevalent (76.9%) followed by s2m2 (11.5%). CagA negative isolates were associated with gastritis or normal findings while EPIYA motifs ABCC were present in severe gastric disease. vacA s2m2 were associated with normal findings. Conclusions: In this population, we have found H. pylori genotypes with predominant cagA Western-type and ABC EPIYA motifs. The vacA s1m1 genotype was the most prevalent and seemed to be associated with gastritis. American Indian/Native American populations are at higher risk for gastric cancer than the general US population. It is important to better establish and quantify genotypes of H. pylori to identify bacterial factors involved in the high prevalence of H. pylori and associated disease among the Navajo population.

Citation Format: Fernando P. Monroy, Heidi E. Brown, Priscilla Sanderson, Gregory Jarrin, Mimi Mbegbu, Shari Kyman, Camenlita Chief, Robin B. Harris. Helicobacter pylori in Native Americans in Northern Arizona [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-162.
Abstract PO-166: The effects of neighborhood ethnic density and psychosocial factors on colorectal cancer screening behavior among Asian American adults
Authors: Bhimla Aisha , Yeh Ming-Chin , Mann-Barnes Tyrell , Do Phuong , Kim Chul , Park Hemi , Ma Grace X.
Published: December 2020

Introduction: This study examined how neighborhood ethnic composition influences colorectal cancer (CRC) screening behavior in Asian Americans and explored whether the associations between psychosocial predictors including knowledge, self-efficacy, and barriers with CRC screening behavior varied by the level of neighborhood ethnic composition. Methods: A total of 1,057 Filipino, Korean, and Vietnamese Americans aged 50 and older were included in the study. Psychosocial factors associated with CRC screening, CRC screening behavior, and socio-demographics were extracted from participants’ survey data. Neighborhood ethnic composition was characterized as the census-tract level percentage of Asian residents. Participant’s addresses were geocoded to the census tract level to determine whether they resided in an ethnically dense neighborhood. Results: The mixed-effects logistic regression model 1 illustrated that residing in an ethnically dense neighborhood was associated with lower odds of CRC screening (OR=0.65, 95% CI=0.49, 0.77; p=0.019) after controlling for age, gender, education, and ethnic group. Furthermore, greater perceived barriers to CRC screening (OR= 0.62; 95% CI=0.55, 0.90; p<0.001) resulted in a lower odds of obtaining a CRC screening, while higher self-efficacy (OR=1.17, 95% CI=1.11, 1.23, p<0.001) was associated with greater odds of CRC screening. In model 2, among those residing in a high ethnically dense neighborhood, greater barriers to screening was associated with lower odds of having obtained a CRC screening (OR=0.51; 95% CI=0.28, 0.93; p=0.028). Conclusion: The study findings revealed that residing in an ethnically dense neighborhood led to a lower likelihood of having obtained a CRC screening. Future studies should examine disparities in built environment, socioeconomic, and cultural factors that are characteristic of ethnically dense neighborhoods and their impact on CRC screening participation.

Citation Format: Aisha Bhimla, Ming-Chin Yeh, Tyrell Mann-Barnes, Phuong Do, Chul Kim, Hemi Park, Grace X. Ma. The effects of neighborhood ethnic density and psychosocial factors on colorectal cancer screening behavior among Asian American adults [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-166.
Abstract PO-167: Area-level social deprivation and stage at diagnosis among breast cancer patients in South Carolina
Authors: Lawson Andrew B. , Hughes-Halbert Chanita , Babatunde Oluwole A. , Zahnd Whitney E. , Eberth Jan M.
Published: December 2020

Background: Cancer incidence, staging and mortality rates differ across geographic areas; however, there is a need for a better understanding of how neighborhood level socioeconomic and access to care factors impact cancer burden to tailor cancer control interventions in ways that appropriately target geographic determinants of cancer health disparities. The purpose of this study was to characterize the distribution of neighborhood deprivation in a cohort of breast cancer patients and examine the effect of social deprivation, healthcare professional shortage Area (HPSA) designation, and individual-level characteristics on breast cancer staging.

Methods: We established a retrospective cohort of breast cancer patients diagnosed from 1996 to 2015 using the South Carolina Central Cancer Registry.

Sociodemographic (e.g., race, age) and clinical variables were abstracted from the registry. We linked registry data to county-level variables to determine levels of social deprivation and residence in a health care professional shortage area using the Robert Graham Center’s Social Deprivation Index (SDI) and the Health Resources and Services Administration primary care HPSA designation. Bivariate analyses and multivariate regression analyses were used to examine associations. Results: The sample included 54,501 female breast cancer patients. Overall, the mean for SDI was 54.2 (+18.1) and the range was 76 (19-95). Approximately 44.4% of women lived in areas with high levels of social deprivation (e.g., SDI score of 52 to 95). In the logistic regression model, living in a geographic area with high social deprivation was significantly associated with African American race (OR=2.3, 95% C.I. 2.2-2.4), being unmarried (OR=1.2, 95% C.I. 1.1-1.3), and HPSA designation (OR=14.0, 95% C.I. 13.5- 14.6). Higher tumor grade (OR=1.2; 95% CI.1.2-1.3) and later stage (OR=1.1, 95% C.I. 1.1-1.2) were also significantly associated with neighborhood deprivation. Conclusion: This study shows that SDI differs by race and clinical characteristics among breast cancer patients. The SDI could be integrated into tumor registries and cancer research to understand the effects of neighborhood level variables on cancer health disparities to improve the precision of cancer control interventions that are developed to address geographic determinants.

Citation Format: Andrew B. Lawson, Chanita Hughes-Halbert, Oluwole A. Babatunde, Whitney E. Zahnd, Jan M. Eberth. Area-level social deprivation and stage at diagnosis among breast cancer patients in South Carolina [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-167.
Abstract PO-171: Unique stroke disparity and cancer risk in Asian Americans
Authors: Xia Helen Y. , Lu Wenyue
Published: December 2020

Background: Stroke is the fifth-leading cause of death in the US. Previous studies have found that the prevalence of precancerous lesions in patients with ischemic stroke is higher than that in the general population. Studies show that Asian-Americans are more likely to experience a severe ischemic stroke in comparison with other racial groups. Although predisposing risk factors for stroke and stroke epidemiology have been studied extensively, racial-ethnic disparities in stroke incidence and prevalence are well documented but less understood. Methods: This study uses a sample of 18889 adults who self-reported suffering stroke in the Behavioral Risk Factor Surveillance System (BRFSS-2018), which includes five racial and ethnic groups (White, Black, American Indian, Hispanic, and Asian American populations). Factors associated with stroke are used in data analysis. Results: Compared with other racial groups (White/Black/American Indian/Hispanic) in the United States, Asians are at an elevated risk of suffering a stroke. Asians reported a significantly higher rate of stroke in younger age group: in groups aged 18-34, Asians reported the highest rate of having stroke (15.4% vs. White, 1.9%; Black, 2.7%; American Indian, 4.7%; and Hispanic, 10.5%; p<0.001). In addition, among respondents with normal/under-weight, doing exercise, and no smoking, Asians also reported significant higher stroke rates. Specifically, among people being normal- or under-weight; 50.2% of Asians reported having stroke in comparing with White, 29.7%; American Indian, 29.5%; Hispanic, 26.3% and Black, 25.4% (p<0.001). Among people reported doing exercise, Asians (67.0%) reported the highest rate of stroke followed by Hispanic (59.5%), White (58.6%), Black (55.2%) and American Indian (53.3%) (p<0.001). Similarly, among people reported no smoking, Asians (75.6%) also reported a significant higher rate of stroke in comparing with White (66.6%), Hispanic (60.5%), Black (55.7%), and American Indian (44.8%) (p<0.001). More logistic regression results will be reported at presentation. Conclusion: Stroke incidence and prevalence are not uniform. Asian-Americans face unique disparities compared to their racial counterparts’ risk factors for stroke. Elucidating these underlying risk factors and identifying intervention strategies to address the stroke disparities experienced by Asian-Americans will improve both stroke and cancer prevention.

Citation Format: Helen Y. Xia, Wenyue Lu. Unique stroke disparity and cancer risk in Asian Americans [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-171.
Abstract PO-173: Racial/ethnic differences and underlying behavioral mechanisms in the association between metabolic syndrome and cancer
Authors: Zhu Lin , Ma Grace X.
Published: December 2020

Introduction: Recent epidemiological studies have suggested a trend of increasing prevalence of metabolic syndrome (MetS) and certain types of cancer among adults under the age of 50. How is MetS associated with cancer in adults under the age of 50? How does the association vary by racial/ethnic groups? What are the potential lifestyle behavioral mechanisms? This study attempts to gain insights into these questions. Methods: We used data from the 2011–2016 National Health and Nutrition Examination Survey (NHANES) to define a case-control sample to examine the racial/ethnic disparities in the association of MetS and cancer of any type. We used chi-square test and binary logistic regression to examine the MetS and cancer association. All analyses were conducted in Stata 14. Results: From a total sample of 17,969 cases, we identified 15,463 no-cancer cases, and 1,584 cancer cases. We found that MetS was significantly associated with cancer risk in the total sample (odds ratio = 1.50, p = .005). This association was only found in the Asian subsample with marginal significance (odds ratio = 3.68, p = .06). Smoking was a significant mediator to the MetS-cancer association in the total sample; sleep duration was a marginally significant mediator in the African American subsample. Conclusion: To summarize, we found that the association between MetS and cancer vary by race/ethnicity for adults under the age of 50. The etiological and epidemiological mechanisms of such racial/ethnic disparities warrant future research. Our findings of racial/ethnic disparities between MetS and cancer contribute to the growing body of the literature and provide implications for future research and public health interventions. The next steps of our research are to: (1) conduct analysis in larger samples such as the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database; (2) explore the etiological and epidemiological mechanisms of MetS-cancer association with sufficient power within each racial/ethnic group; and 3) design and implement integrative behavioral interventions among high-risk groups to reduce cardiometabolic and cancer risks.

Citation Format: Lin Zhu, Grace X. Ma. Racial/ethnic differences and underlying behavioral mechanisms in the association between metabolic syndrome and cancer [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-173.