bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract A038: What about me? A content analysis of triple-negative breast cancer clinical trial inclusion eligibility criteria
Authors: Ridley-Merriweather Katherine E
Published: September 2020

Triple negative breast cancer (TNBC) is noticeably more prevalent in Black women than White, while women from these two groups exhibit similar incidence rates for breast cancers (BCs) that test positive for overexpression of the HER2 receptor (HER2+BC). This content analysis explores whether the available evidence and general knowledge among BC researchers of the significantly higher TNBC incidence rates by African American women than Caucasian women is reflected in the eligibility criteria inclusion language of TNBC clinical trials. Data gathered from clinicaltrials.gov was used in a comprehensive analysis on the text of the trial description and eligibility criteria inclusion language of all eligible clinical trials. Three themes resulted: 1) Similarities in TNBC/HER2+BC eligibility criteria inclusion language; 2) differences in TNBC/HER2+BC eligibility criteria inclusion language; and 3) recruitment language oversights. Four characteristics of the data sets (age requirements, prerequisite of invasive BC, previous treatment for BC, determined life expectancy period) were determined to be similar, and two characteristics (breast surgery restrictions, metastases) were identified as demonstrating a level of difference. Despite well-demonstrated evidence that TNBC measurably, significantly, and disproportionately affects women of African descent, young (particularly Latina) women, and women testing positive for BRCA mutation, there is strong evidence that these risk factors are not at all addressed in the formal inclusion language of BC CTs posted on clinicaltrials.gov. The implications of this work suggest further research to ascertain whether there are efforts to recruit any of these populations independently of the site’s formal listings.

Citation Format: Katherine E Ridley-Merriweather. What about me? A content analysis of triple-negative breast cancer clinical trial inclusion eligibility criteria [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr A038.
Abstract A041: Community engagement in the development of an m-health app utilizing a black male virtual health assistant (VHA) to promote colon cancer screening: An iterative study of credibility and likeability
Authors: Wilson-Howard Danyell , Vilaro Melissa , Griffin Lauren , Travassoli Fatemeh , Zalake Mohan , Lok Benjamin , Modave Francois , Carek Peter , George Thomas , Krieger Janice
Published: September 2020

Traditionally, promotion of colorectal cancer (CRC) screening among minority and rural populations including African American men was delivered by Community Health Workers (CHW), Patient Navigators, and decision aids (printed text or video media) at clinics. A novel approach to increase CRC screening of black men includes developing and utilizing a patient-centered, tailored message delivered via mobile-health (m-health) technology. In this study, a Community Based Participatory Research (CBPR) approach provided feedback on a Virtual Health Assistant (VHA) designed to deliver precision and personalized messages promoting the Fecal Immunochemical Test (FIT) for CRC screening. Focus groups of Black men were recruited to understand and employ their perceptions of a Black-male VHA. Specifically, these men identified source characteristics that would enhance the credibility of the VHA and likeability of an m-health app. The MAIN Model which examines how an interface features affect the user’s psychology through four Affordances: Modality, Agency, Interactivity, and Navigability was used to assess the presumed credibility of the VHA and likability of the app from the focus group transcripts. Each affordance triggers heuristic cues that stimulate a positive or negative perception of trustworthiness, believability, and understandability thereby increasing source credibility and likability. Data collected in the focus group included feedback on the different content modalities, both text and visual: size and font of the text, VHA appearance, voice, movement, diction, the environment as well as perceptions of the trustworthiness and expertise of the interface. Data related to interactivity and ease of navigation through the app was also collected and analyzed. All in all, 25 Black men from the community contributed to the development of three iterations of a Black male VHA over an eighteen-month time span. The final version of the Black male-VHA, ALEX is now part of an intervention to increase CRC screening among minority and rural populations.

Citation Format: Danyell Wilson-Howard, Melissa Vilaro, Lauren Griffin, Fatemeh Travassoli, Mohan Zalake, Benjamin Lok, Francois Modave, Peter Carek, Thomas George, Janice Krieger. Community engagement in the development of an m-health app utilizing a black male virtual health assistant (VHA) to promote colon cancer screening: An iterative study of credibility and likeability [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr A041.
Abstract A053: Association between socioeconomic status and access to specialized cancer consultation and treatment among advanced gastrointestinal cancers
Authors: Davis Laura E , Coburn Natalie G , Hallet Julie , Earle Craig C , Myrehaug Sten , Li Ying , Mahar Alyson L
Published: September 2020

Introduction: Gastrointestinal (GI) cancers of the pancreas, esophagus, stomach, colon and rectum often present at an incurable stage. Treatments such as chemotherapy and radiotherapy can improve quality and quantity of life for patients with these advanced gastrointestinal (GI) cancers. However, many patients fail to receive such treatments or even consult with a cancer specialist to determine if treatment is an option. Socioeconomic status (SES) is associated with cancer outcomes, but the mechanisms as to why, such as access to specialized care, are not clearly established. This study examined the association between SES and receipt of specialized cancer consult and treatment in Ontario, Canada. Methods: This was a population-based retrospective cohort study of advanced GI cancer patients diagnosed between 2007 and 2017 using linked administrative databases. The exposure of SES was defined using the deprivation item in the Ontario Marginalization Index. The outcome of oncology consult was defined as a consultation with either a radiation oncologist or a medical oncologist and the outcome of treatment was defined as receipt of chemotherapy or radiotherapy. Both were measured in the year following diagnosis. Multivariable Cox-proportional hazards regression models were used to determine association of deprivation with oncology consult and treatment. Confounders identified a priori include age, sex, comorbidities and cancer site. Results: 29,297 patients had a diagnosis of advanced GI cancer and were included in the study. 27.4% of the cohort did not have an oncology consult and 53.7% did not receive treatment in the year following diagnosis. The most deprived quintile compared to the least deprived quintile was associated with decreased consult (HR 0.89 (0.85-0.93)) and decreased treatment (HR 0.81 (0.77-0.86)) after adjusting for confounders. Conclusion: This study found that even in a single-payer universal healthcare system, SES is associated with access to specialized cancer care. Future research should examine mechanisms through which policy might help low SES patients access specialized cancer care.

Citation Format: Laura E Davis, Natalie G Coburn, Julie Hallet, Craig C Earle, Sten Myrehaug, Ying Li, Alyson L Mahar. Association between socioeconomic status and access to specialized cancer consultation and treatment among advanced gastrointestinal cancers [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr A053.
Abstract A057: Influence of race and economic deprivation on metastatic breast cancer outcomes
Authors: Heckman Rachel , Senthil Keerthana , Rosenzweig Margaret Quinnl , Ann Welch Hilda
Published: September 2020

Background: Metastatic or Stage 4 breast cancer (MBC) is a heterogeneric, life ending illness with a treatment course of multiple sequential therapies. There are documented racial disparities in breast cancer outcomes and treatment equity, but little is known about the racial or socio-economic differences during MBC and end of life (EOL) care. Aim1: Describe a cohort of patients deceased from MBC - patient, tumor, treatment, symptoms and end of life care characteristics. Aim 2 – Compare patient, symptoms and end of life care characteristics according to race and neighborhood deprivation. Methods: Cohort of deceased patients from large, breast cancer program from October 2016 until June 2019. Protocolized, retrospective chart review for patient (age, race, neighborhood deprivation score,derived from zip code), tumor (ER, PR, Her 2, subtype), symptoms (25 symptoms + overall wellbeing rated 0-10 at last visit before death; generalized anxiety, screening depression and overall distress), end of life care (palliative care consult, hospice, length of time in hospice, place of death, ICU admission prior to death, goals of care discussion documented). Results: Cohort of N=130. Black - N=17 (13%); White - N=112 (86.2%). Dichotomized according to median (69) NDI, N=58 (49.2%) in more deprived neighborhoods. Triple negative breast cancer subtype N= 7(41%) Black and N=34 (30%) white. Survival: Survival overall was 1175 days. Black survival was less than half of white. Black – 501 days (SD – 339); White – 1242 days (SD 1363), p=.031.No survival differences according to neighborhood. Of the 25 symptoms measured during breast cancer treatment cough,nausea, hot flashes, headaches, and overall health were significantly (p <.05) worse for black vs. white patients with no differences noted for other symptoms. Dizziness, nausea, vomiting, anxiety, depression, overall distress and overall health were significantly (P<.05) worse for patients from more deprived neighborhoods. Among the 130 deceased MBC patients N=108 (81.8%) had palliative care services, N=65 (50%) had no advance directives, N=52 (40%) did not use hospice services, and N=16 (12%) died in the ICU. No difference between Black and White patients or patients from more vs. less deprived neighborhoods for these outcomes. Conclusion: There is racial and economic disparity in MBC survival and symptoms prior to death. Overall end of life planning is not well addressed in this population.

Citation Format: Rachel Heckman, Keerthana Senthil, Margaret Quinnl Rosenzweig, Welch Hilda Ann. Influence of race and economic deprivation on metastatic breast cancer outcomes [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr A057.
Abstract A063: Social context and cancer: Stress and quality of life in rural-dwelling Latina cancer survivors
Authors: Ceballos Rachel M , Ibarra Genoveva , Escareno Monica , Gonzalez Nora , Marchello Nathan
Published: September 2020

Introduction: Latina breast and gynecologic cancer survivors (LCS) experience higher levels of distress and lower quality of life compared to non-Latinos. This randomized control trial examined the effect of a promotora-led 10-week Spanish language support program on levels of stress and cancer-related quality of life (QOL) in LCS. Methods: Fifty-nine LCS were randomized to receive the 10-week intervention (n=30) or to a delayed-intervention control (n=29) group. Measures were assessed at baseline (T1) and upon completion of the intervention period (T2) and included the: short Hispanic Stress Inventory (HSI) [subscales: extra-familial and intra-familial stress]-version 2, the Functional Assessment of Cancer Therapy (FACT-G) QOL scale [subscales: physical (P-QOL), functional (F-QOL), emotional (E-QOL), social (S-QOL)], the FACT-Fatigue QOL scale, and a demographic survey. RESULTS: No statistically significant differences were observed between the intervention and control groups for any of the outcome variables. Perceived stress scale [t(57)=0. 37, p=0. 72], Hispanic Stress Inventory extrafamilial subroup [t(57)=1. 8, p=0. 09], and Hispanic Stress Inventory intrafamilial subgroups [t(57)=1. 5, p=0. 18]. Results for quality of life subscales were physical [t(57)=-1. 66, p=0. 10], social [t(47)=-0. 32, p=0. 75], emotional [t(57)=-0. 41, p=0. 97], and functional [t(57)=1. 38, p=0. 17] well-being. Exploratory analyses a mediating effect of extrafamilial stress on a significant relationship between Spanish-only language and lower EQOL. Conclusions: The effect of the promotora-led intervention was not significant. However, an exploratory mediation analyses identified a significant role of extrafamilial (ethnic-based) stress among Spanish-only speakers with EQOL. A detailed presentation of study findings, including a critique of the intervention design and implications for the effect of social context on cancer-related outcomes will be discussed.

Citation Format: Rachel M Ceballos, Genoveva Ibarra, Monica Escareno, Nora Gonzalez, Nathan Marchello. Social context and cancer: Stress and quality of life in rural-dwelling Latina cancer survivors [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr A063.
Abstract A067: Oncotype DX assay has similar predictive accuracy for adverse pathology at radical prostatectomy in African American and European American men
Authors: Carbunaru Samuel , Marcias Virgilia , Gann Peter , Sharifi Roohollah , Yang Ximing , Dixon Michael , Gorbein Chase , Jovanovic Borko , Kajdacsy-Balla Andre , Murphy Adam B.
Published: September 2020

Objective: To validate the 17-gene Oncotype DX Genomic Prostate Score (GPS) biopsy-based gene expression assay as a predictor of adverse pathology (AP: Pathologic Gleason score ≥4+3, presence of any Gleason 5, and/or ≥pT3) in African American (AA) men. Methods: Between February 2009 and September 2014, AA and European American (EA) men with very low, low, and intermediate risk prostate cancer (PCa) enrolled in a multi-institutional prospective study of vitamin D impacts of biopsy outcomes. The subset who proceeded to immediate radical prostatectomy (RP) after biopsy with available biopsy tumor blocks was included in a comparative effectiveness analysis of GPS on biopsy and its association with surgical AP on RP using logistic regression and receiver operating characteristic curves. Multiplicative interactions tested for differential prediction of GPS accuracy by race (AA vs. EA). Results: Overall, 102 AA and 76 EA men elected RP, out of which 51 (47.2%) had AP. GPS result was a significant predictor of AP (odds ratio per 20 GPS units [OR/20 units] in AA: 4.78; 95% CI 1.8-12.5, P =0.001; and EA: 4.41; 95% CI 1.6-11.9, P =0.003) in univariable analysis. On multivariate analysis, there was a significant interaction between GPS and race (P=0.01). On race stratified binary logistic regression, AP remained significant after adjustment for NCCN risk group in both AA and EA men (OR/20 units in AA: 3.29; 95% CI 1.2-9.1, P =0.02; and EA: 4.24; 95% CI 1.4-12.6, P =0.01). Area under the curves for AP using GPS/20 units was 0.719 for AAs vs. 0.745 for EAs (P=0.39). Conclusion: In this AA validation study, the Oncotype Dx PCa assay was confirmed as an independent predictor of AP at prostatectomy in AA and EA men with similar predictive accuracy, though there was evidence of effect modification by race.

Citation Format: Samuel Carbunaru, Virgilia Marcias, Peter Gann, Roohollah Sharifi, Ximing Yang, Michael Dixon, Chase Gorbein, Borko Jovanovic, Andre Kajdacsy-Balla, Adam B. Murphy. Oncotype DX assay has similar predictive accuracy for adverse pathology at radical prostatectomy in African American and European American men [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr A067.
Abstract A069: TRPV6 as a putative genomic susceptibility locus influencing racial disparities in cancer
Authors: Francis-Lyon Patricia , Malik Fahreen , Cheng Xiaoyun , Ghezavati Alireza , Xin Feihan , Cai Rafiki
Published: September 2020

It is well established that African Americans exhibit higher incidence, higher mortality, and more aggressive forms of some cancers, including those of breast, prostate, colon, stomach, and cervix. Here we examine the ancestral haplotype of the TRPV6 calcium channel as a putative genomic factor in this racial divide. The minor (ancestral) allele frequency is 60% in those of African Ancestry, but between 1 and 11% in all other 1000 Genomes populations. Recent research on TRPV6 structure/function, its association with specific cancers, and the evolutionary-ecological conditions which impacted selection at its locus are synthesized to provide evidence for the TRPV6 haplotype as a germline susceptibility locus in cancer. Examination of a recently-proposed model for TRPV6 Ca2+-dependent inactivation, as it relates to the haplotype SNP identified as the target of selection, is proposed here as an explanatory mechanism for hypothesized failure to inactivate the channel at high Ca2+ concentrations in those who have the ancestral haplotype. This could result in an over-abundance of cellular Ca2+, which has been implicated in cancer, for those in settings where calcium dietary and supplemental intake is far higher than in their ancestral environment. This synthesis of recent research makes a case for investigation into the TRPV6 haplotype as a genomic factor in cancer disparity. If TRPV6 is found to be implicated, future research would be warranted to improve risk assessment and examine interventions with the aim of improving cancer outcomes for people of African descent.

Citation Format: Patricia Francis-Lyon, Fahreen Malik, Xiaoyun Cheng, Alireza Ghezavati, Feihan Xin, Rafiki Cai. TRPV6 as a putative genomic susceptibility locus influencing racial disparities in cancer [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr A069.
Abstract A083: Detection of personalized oncogenic risk after genotoxic exposures
Authors: Okunieff Paul , Zhang Steven B , Zhang Zhenhuan , Swarts Steven G , Lockney Natalie A , Casey-Sawicki Katherine , Vidyasagar Sadasivan
Published: September 2020

Purpose: Despite reduced sensitivity to sun exposure, many Black patients treated with ionizing radiation appear to experience increased skin toxicity as compared to White patients. The cause is unknown, yet some studies have suggested that DNA repair is reduced in these patients. Therefore, we developed a technology to examine organ-specific differences in mutation rate after irradiation. In this study, we demonstrate the feasibility of personalized quantitative measurements of single base errors in DNA using a saline skin swab after irradiation. We believe this technology will have the potential to identify patients at higher risk for skin toxicity and, therefore, for whom preventative measures are most important. Methods/Results: We have developed a method for quantification of point mutations using xeno-DNA clamps. This method exceeds the theoretical limit for quantitation of base errors using standard deep-gene sequencing by several orders of magnitude. It can be performed on an organ-specific basis with less than 1 ng of DNA (≈100 cells). We have developed both a mouse and a human clamp set. Measurements of mouse organs, including the liver, brain, skin, spleen, and small bowel, were performed before and at various times after irradiation (0.5 to 10 Gy). Human cell culture studies parallel the mouse studies, and human clinical trials are underway using cotton swabs of skin and oral mucosa. The brain is highly efficient at damage repair, whereas mature lymphocytes repair poorly; epithelial cells (GI and skin) have intermediate accumulation of mutations after irradiation. Mutation accumulation can be higher at a low dose and does not monotonically increase with dose. Conclusions: Our xeno-DNA clamp methodology can easily, inexpensively, and quantitatively measure incremental point changes in the non-coding silent DNA that makes up 98.5% of the human genome. The test is ready for clinical application and a clinical trial is beginning in Black and White patients with head and neck cancers. Preliminary data will be presented.

Citation Format: Paul Okunieff, Steven B Zhang, Zhenhuan Zhang, Steven G Swarts, Natalie A Lockney, Katherine Casey-Sawicki, Sadasivan Vidyasagar. Detection of personalized oncogenic risk after genotoxic exposures [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr A083.
Abstract A084: Personalized prediction of radiation sensitivity
Authors: Lockney Natalie , Swarts Steven G , Li Jennifer , Morris Christopher , Henderson Randal , Zhang Steven B , Zhang Zhenhuan , Vidyasagar Sadasivan , Gupta Reshu , Casey-Sawicki Katherine , Zlotecki Robert , Okunieff Paul
Published: September 2020

Purpose/Objective: Patients of different races with similar cancers are often treated with radiation according to safety criteria largely collected from patients of European origin. However, even among those patients, toxicities are not predictable. Patients of African origin appear to have more severe skin radiation reactions, particularly Black women with breast cancer, than other populations. We have developed a technique using circulating cell-free DNA (cfDNA) that appears to predict toxicity in patients with otherwise similar radiation dosimetry, allowing for early intervention to prevent side effects (marketed as RadToxTM, DiaCarta, Inc.). Methods: Pre-clinical studies were performed in mice with white (BALB/c), brown (C3H/HeJ), or black (C57BL/6) fur. Radiation was delivered to the hind limb, and the skin reaction was evaluated. Blood was collected to evaluate changes in cfDNA as compared to severity of cutaneous toxicity. A phase I/II clinical study (n=54) was also performed to determine if plasma cfDNA measured early in a radiotherapy course can predict the subset of patients who experience grade 2 or higher radiotoxicity. Results: The most severe toxicity was seen in the C57BL/6 mice, and at similar doses the increase in cfDNA was higher than in the other two strains. Fifty-four patients were evaluable for the clinical study. Radiation significantly increased cfDNA on all days following the first radiation session. Acute maximum GI toxicity score, but not acute GU toxicity, was significantly correlated with cfDNA levels obtained on days 1, 2, 3, 4, and 5 of radiotherapy (p<0.005). Conclusions: Plasma cfDNA levels predicted the mouse strain that experienced more severe toxicity, and in a small study detected acute bowel toxicity. A larger study is needed to confirm the results and the value of the test for identifying patients who need special interventions to reduce toxicity. Further testing of this hypothesis is under evaluation in an NCI-funded multi-institutional study.

Citation Format: Natalie Lockney, Steven G Swarts, Jennifer Li, Christopher Morris, Randal Henderson, Steven B Zhang, Zhenhuan Zhang, Sadasivan Vidyasagar, Reshu Gupta, Katherine Casey-Sawicki, Robert Zlotecki, Paul Okunieff. Personalized prediction of radiation sensitivity [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr A084.
Abstract A102: Association of lymphoid malignancies and area-based socioeconomic status with survival in the United States
Authors: Castaneda-Avila Maira A , Jesdale Bill , Epstein Mara
Published: September 2020

Background: Over 114,000 new cases of lymphoid malignancies (LM), including Hodgkin lymphoma (HL), Non-Hodgkin lymphoma (NHL) and multiple myeloma (MM), are diagnosed annually. However, little is known about the influence of socioeconomic status (SES) on LM survival among Hispanics, who comprise 18% of the US population. This study evaluates the association between area-based SES and survival of Hispanic LM patients compared with non-Hispanic whites and non-Hispanics blacks. Methods: All LM reported to the NCI Surveillance, Epidemiology, and End Results Program (SEER-18) diagnosed between 2000-2015 were included. Census tract-level socioeconomic status (SES) was assessed in tertiles. Cox proportional hazards models estimated hazard ratios (aHR) to evaluate SES with cause-specific survival, adjusted for sex, stage at diagnosis, radiation, surgery and chemotherapy. All analyses were stratified by race/ethnicity. Results: Hispanics with low SES diagnosed with MM were 30% (aHR:1.3, 95% CI: 1.0-1.6) more likely to die from MM than those Hispanics with high SES. Whites and blacks with low SES diagnosed with MM were 20% (95% CIwhites: 1.1-1.3; 95% CIblacks: 1.0-1.4) more likely to die from MM than those with high SES. An association of low SES and death from NHL also found among Hispanics (aHR: 1.2; 95% IC: 1.1-1.5), whites (aHR: 1.3; 95% IC: 1.2-1.4) and blacks (aHR: 1.3; 95% IC: 1.0-1.7) compared to high SES groups. No association was found for HL. Conclusion: Low SES was associated with worse LM survival among different races/ethnicities. These results suggest SES is an important factor in determining long-term outcomes of patients diagnosed with LM.

Citation Format: Maira A Castaneda-Avila, Bill Jesdale, Mara Epstein. Association of lymphoid malignancies and area-based socioeconomic status with survival in the United States [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr A102.
Abstract A123: Legislation by states and its impact on factors causing divergence in HPV vaccination coverage: Analysis of 2013-2017 National Immunization Survey - Teens (NIS-TEENS)
Authors: Ranganathan Radhika , Hung Peyin , Adams Swann Arp , Hair Nicole L , Bailey Shiba Simon
Published: September 2020

Background: Human papilloma virus (HPV) is strongly associated with multiple cancer types, affecting women, men and children of all races, ethnicities and backgrounds. HPV causes more than 30,000 cases of cancer every year and more than 70% of U.S population will experience at-least one HPV infection at some point. School-entry mandates and public health education campaigns though being separate entities, have significantly increased vaccine uptake, reduced disease prevalence and decreased racial disparities in disease rates. Furthermore, improvements in immunization against HPV are not equally distributed across gender, age, demographic and socioeconomic divisions within the recommended group of vaccine recipients. Objectives: To analyze and report the association between state-level policies and HPV vaccination uptake. We further explore predictors of HPV vaccination uptake using Aday & Anderson’s behavioral theory of healthcare utilization. Methods: A repeated cross-sectional survey of NIS-Teens data from 2013-2017 was used for the analysis. Bivariable associations and multivariable ordered logistic regression models were statistically performed using STATA 15/IC & SAS v9.4. Results: HPV vaccination completion rates were 17% higher in teens who lived in states with a legislative mandate irrespective of policy enactment. Relative to males, females had 72% higher odds of uptake. Compared to whites, Non-Hispanic blacks had a 21% lower odds of vaccination uptake. Compared to western region of the US, the north-east region reported 1.47 times higher odds of HPV vaccination. Provider recommendation was also significantly associated with HPV vaccination coverage rates. Conclusion: State legislative mandates had a profound impact of vaccination uptake. Additionally, racial minorities were significantly less likely to receive vaccination. Analysis of statewide adaptation of policy related bills and federal funding on VFC (Vaccine For Children) program could further inform those policy initiatives with the greatest uptake of vaccination.

Citation Format: Radhika Ranganathan, Peyin Hung, Swann Arp Adams, Nicole L Hair, Shiba Simon Bailey. Legislation by states and its impact on factors causing divergence in HPV vaccination coverage: Analysis of 2013-2017 National Immunization Survey - Teens (NIS-TEENS) [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr A123.
Abstract B074: The long noncoding RNA from PVT1 exon 9 is overexpressed in prostate cancer in Black males and induces malignant transformation, invasiveness, and castration-resistance in prostate epithelial cells
Authors: Pal Gargi , Huaman Jeannette , Levine Fayola , Orunmuyi Akintunde , Olapade-Olaopa E. Oluwabunmi , Ogunwobi Olorunseun O.
Published: September 2020

Prostate cancer (PCa) is the most common non-skin cancer and the second leading cause of cancer-related death for men in the United States. PCa is the greatest source of cancer-related mortality in males of African ancestry. One of the most important susceptibility loci for cancer is the 8q24 human chromosomal region. The non-protein coding gene locus plasmacytoma variant translocation 1 (PVT1) is located at 8q24 and is dysregulated in different cancers. PVT1 gives rise to several alternatively spliced transcripts and microRNAs. There are at least twelve exons of PVT1, which make separate transcripts, and likely have different functions. The transcript from PVT1 exon 9 is significantly overexpressed in PCa tissues in comparison to normal prostate tissues obtained from Black males. Both transient and stable overexpression of PVT1 exon 9 induce significantly increased prostate epithelial cell proliferation, migration, and proliferating cell nuclear antigen (PCNA) expression. Notably, implantation into mice of a novel subline of a non-tumorigenic prostate epithelial cell line stably overexpressing PVT1 exon 9 results in the formation of malignant tumors with features characteristic of aggressive PCa. Further, PVT1 exon 9 overexpression significantly induces castration-resistance in prostate epithelial cells. Consequently, PVT1 exon 9 expression is important for PCa initiation and progression and may have potential diagnostic and therapeutic applications in PCa in Black males.

Citation Format: Gargi Pal, Jeannette Huaman, Fayola Levine, Akintunde Orunmuyi, E. Oluwabunmi Olapade-Olaopa, Olorunseun O. Ogunwobi. The long noncoding RNA from PVT1 exon 9 is overexpressed in prostate cancer in Black males and induces malignant transformation, invasiveness, and castration-resistance in prostate epithelial cells [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr B074.
Abstract B102: Body mass index, physical activity, and breast cancer subtype in European American, African American, and Sea Island breast cancer survivors
Authors: Ford Marvella E , Bauza Colleen E , Findlay Victoria J , Turner David P , Abraham-Hilaire Latecia M , Moore Leslie A , Magwood Gayenell , Alberg Anthony J , Gaymon Kadeidre , Knight Kendrea D , Hilton Ebony , Malek Angela M , Kramer Rita M , Peterson Lindsay L , Bolick Susan , Hurley Deborah , Mosley Catishia , Hazelton Tonya R , Burshell Dana R , Nogueira Lourdes , Mack Franshawn , Brown Erika T , Salley Judith D , Whitfield Keith E , Cunningham Joan E
Published: September 2020

BACKGROUND: Breast cancer (BCa) is the second leading cause of cancer death among women in the United States and large racial/ethnic disparities are evident. Higher levels of body mass index (BMI), lower rates of physical activity (PA), and hormone receptor-negative BCa sub-type are associated with poorer BCa treatment outcomes. PURPOSE: To evaluate the prevalence of high BMI, low PA level, and BCa sub-type among three BCa survivor groups: European Americans (EAs), African Americans without Sea Island ancestry (AAs), and AAs with SI ancestry (SIs). METHODS: A state central cancer registry database was used to identify 137 (42 EAs, 66 AAs, and 29 SIs) women diagnosed with BCa between May 2012 and October 2013, who were within 6-21 months of diagnosis at the time of the study. RESULTS: Regardless of racial/ethnic group, most participants (82%) were overweight/obese (p=0.46). BMI was highest in younger AAs (p=0.02). The CDC PA guidelines (≥150 minutes/week) were met by only 28% of participants. In terms of BCa sub-type, among the 86 participants who provided saliva samples, the frequency of triple-negative BCa and estrogen-receptor-negative BCa was lower in EAs and SIs than in AAs (p< 0.05). CONCLUSIONS: This is the first study to identify differences in obesity rates, PA rates, and BCa sub-type in EAs, AAs, and SIs. Future research could explore dietary and PA behavioral interventions to reduce BCa recurrence risk, and could evaluate potential differential immune responses linked to the frequency of triple-negative BCa in AAs.

Citation Format: Marvella E Ford, Colleen E Bauza, Victoria J Findlay, David P Turner, Latecia M Abraham-Hilaire, Leslie A Moore, Gayenell Magwood, Anthony J Alberg, Kadeidre Gaymon, Kendrea D Knight, Ebony Hilton, Angela M Malek, Rita M Kramer, Lindsay L Peterson, Susan Bolick, Deborah Hurley, Catishia Mosley, Tonya R Hazelton, Dana R Burshell, Lourdes Nogueira, Franshawn Mack, Erika T Brown, Judith D Salley, Keith E Whitfield, Joan E Cunningham. Body mass index, physical activity, and breast cancer subtype in European American, African American, and Sea Island breast cancer survivors [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr B102.
Abstract C004: End-of-life care in patients with advanced cancer in an urban safety net hospital
Authors: Nguyen Vina P , Festa Kate , Gowarty Minda , Islam Shabatun , Patts Gregory J , Ko Naomi Y
Published: September 2020

Abstract End-of-life care (EoL) in patients with advanced cancer is uniquely challenging in an urban safety net hospital. Low socioeconomic status, poor health literacy and non-congruent language barriers are only a few of the possible challenges that patients can encounter. The purpose of this study was to understand patterns of EoL care for patients with advanced cancer treated at a racially diverse, urban academic safety net hospital. Experimental Procedures We performed a retrospective analysis of 308 adult patients with advanced cancer who died between 2012 and 2015. A standardized chart abstraction tool included sociodemographic, clincopathologic and health services variables. We defined under-utilization of EoL care as no enrollment in hospice or enrollment for three days or less. Aggressive EoL care was defined as 1) receipt of chemotherapy in the last 14 days of life, 2) admission to the intensive care unit in the last 30 days of life, 3) more than one admission (to the hospital or emergency department) in the last 30 days of life, or 4) dying in an acute care setting. Summary of Data Among 308 abstracted records, 54% were racial minorities, 63% were not born in the United States, 72% had public health insurance. In all, 48% of cases demonstrated under-utilization of EoL care, and 45% demonstrated aggressive EoL care. A multivariate analysis demonstrated that, after adjusting for other factors, every month of increased survival was associated with a 3% decreased risk of aggressive EoL care and of under-utilization of hospice. We also demonstrate that having a documented healthcare proxy and older age was also associated with utilization of EoL care. Conclusions In conclusion, appropriate EoL care is critical for all advanced cancer patients and can be improved for patients seeking care at safety net hospitals. Our study demonstrates that advanced age, having a healthcare proxy, and longer survival from a cancer diagnosis was associated with improved EoL care. These findings can help to inform targeted interventions to improve EoL care for diverse populations.

Citation Format: Vina P Nguyen, Kate Festa, Minda Gowarty, Shabatun Islam, Gregory J Patts, Naomi Y Ko. End-of-life care in patients with advanced cancer in an urban safety net hospital [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr C004.
Abstract C015: Cardiovascular disease and health-related quality of life among African American and white cancer survivors
Authors: Kyko Jaclyn M. , Beebe-Dimmer Jennifer L. , Baird Tara E. , Schwartz Ann G. , Hastert Theresa A.
Published: September 2020

Background: Cardiovascular disease (CVD) is common among cancer survivors and is a leading cause of death among survivors of several forms of cancer. Race disparities exist in the prevalence of several forms of CVD, and these may have implications for the health-related quality of life (HRQOL) of cancer survivors. The current study estimates the association between several forms of CVD and HRQOL among a diverse cohort of cancer survivors. Methods: This analysis was conducted using data from 979 participants (574 African American, 405 white) with female breast, colorectal, lung, or prostate cancer in the Detroit Research On Cancer Survivors (ROCS) pilot study who were diagnosed and/or treated at the Karmanos Cancer Center in Detroit, Michigan. The analyses were conducted using linear regression with binary measurements of five different forms of CVD included in the ROCS pilot survey (self-reported history of congestive heart failure (CHF), myocardial infarction (MI), hypertension, peripheral vascular disease (PVD), and stroke) as predictors of HRQOL measured using the Functional Assessment of Cancer Therapy – General (FACT-G), controlling for demographic, socioeconomic, and cancer-related characteristics. We also tested for effect modification by race. Results: FACT-G scores were 2.2 (95% CI: -4.3, 0.0) points lower among cancer survivors who were diagnosed with any type of CVD compared to those who were not. This association did not differ by race (Pinteraction=0.25). FACT-G scores were somewhat lower among survivors diagnosed with hypertension [-1.9; 95% confidence interval (CI): -4.1, 0.1], MI (-4.1; 95% CI: -8.4, 0.2), CHF (-3.7; 95% CI: -8.2, 0.9), or stroke (-4.0; 95% CI: -8.5, 0.5); however, the magnitude of these differences was not clinically meaningful and the findings did not reach statistical significance. History of MI was associated with clinically meaningful differences in HRQOL among African American (-6.1; 95% CI: -11.3, -0.8) but not white survivors (-0.4, 95% CI: -7.9, 7.2; Pinteraction=0.15). Conclusions: Overall, any type of CVD was not associated with meaningful differences in HRQOL among cancer survivors. Our finding that history of MI was associated with clinically meaningful differences in HRQOL among African American survivors, but not white, could represent an opportunity for future efforts to improve survivors’ HRQOL.

Citation Format: Jaclyn M. Kyko, Jennifer L. Beebe-Dimmer, Tara E. Baird, Ann G. Schwartz, Theresa A. Hastert. Cardiovascular disease and health-related quality of life among African American and white cancer survivors [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr C015.
Abstract C026: Energy-related risk factors and breast cancer subtypes in African American women
Authors: Fortune Mieke , Dujon Steffie-Ann , Fadden Mary K , Lipworth Loren , Sanderson Maureen
Published: September 2020

Purpose: To investigate the association between energy-related risk factors and breast cancer subtypes in African American women. We hypothesized that African American women with triple negative breast cancer (TNBC), based on being negative for estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2, would be less likely to have energy-related risk factors than women with other breast cancer subtypes (1) estrogen receptor positive (ER+), and (2) estrogen receptor negative (ER-). Methods: African American women ages 25-75 years diagnosed with primary invasive breast cancer in 2009-2014 in Tennessee, South Carolina, and Georgia were eligible for the study. A total of 697 women (premenopausal n=156; postmenopausal n=541) provided information on energy-related risk factors in a telephone interview and consented to review of tumor tissue. Energy-related risk factors were defined as: no physical activity (54%), high meat intake (upper quartile), obese class II/III (32%), and high weight gain since age 18 (upper quartile). Breast cancer subtype was obtained from pathology reports that accompanied tumor tissue. Results: Although not significantly different, premenopausal (odds ratio (OR) 1.34) and postmenopausal (OR 1.26) women with TNBC were more likely to have high meat intake relative to women with ER+ disease. Premenopausal, but not postmenopausal, women with TNBC were also more likely to have high weight gain since age 18. Women with ER- disease were more likely to have high meat intake, be obese class II/III, and have high weight gain than women with ER+ disease which was more pronounced among premenopausal than postmenopausal women. Conclusions: Histologic subtyping is currently being performed on collected tissue to confirm the reported breast cancer subtypes in the pathology reports. The large number of African American women participating in our study can further our understanding of the relationships between energy-related risk factors and breast cancer subtypes in this population.

Citation Format: Mieke Fortune, Steffie-Ann Dujon, Mary K Fadden, Loren Lipworth, Maureen Sanderson. Energy-related risk factors and breast cancer subtypes in African American women [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr C026.
Abstract C121: Cervical cancer knowledge and perceptions among women in Malawi: Qualitative data from a high-burden, low-resource setting
Authors: Moucheraud Corrina , Kawale Paul , Kafwafwa Savel , Bastani Roshan , Hoffman Risa M
Published: September 2020

Introduction: Coverage of routine cervical cancer screening in Malawi is very low, even though it has the highest cervical cancer burden in the world. We performed a multi-level assessment of Malawian women’s knowledge and perceptions of cervical cancer risk and screening, following recent scale-up of screening and treatment programs. Methods: Based on the Multi-Level Health Outcomes Framework, we conducted interviews with 60 adult Malawian women at facilities that offer cervical cancer screening; eligible participants were recruited regardless of HIV status or history of cervical cancer screening. Trained female researchers asked women about their experiences with and opinions of cervical cancer disease and screening. Interviews were audio recorded with permission, transcripts were translated from Chichewa (the local language) to English, and a theory-informed codebook was developed. Analysis focused on thematic differences across groups by age, HIV status and screening history. Results: Half of the sample (n=30) had either never been screened for cervical cancer or were at the facility for their first-ever screen. Most women said that cervical cancer is dangerous, and many knew someone affected. Many women spoke about the importance of screening for prevention of cancer. Risk factors were generally well-understood, including increased risk with HIV, although this was misunderstood by some HIV-negative women to mean they were not at risk. Gender issues were highly salient, relating to sexual transmissibility, husbands’ support of screening, and modesty if screened by a male clinician. Women had commonly heard rumors about the procedure being painful or dangerous. Conclusions: Despite high knowledge among Malawian women about cervical cancer disease and the importance of screening, there remain significant challenges. This study highlights the role of interpersonal and system-level barriers. Future work should work to strengthen service delivery, target social networks and spouses, and develop targeted language for HIV-positive and -negative groups especially in high-burden settings.

Citation Format: Corrina Moucheraud, Paul Kawale, Savel Kafwafwa, Roshan Bastani, Risa M Hoffman. Cervical cancer knowledge and perceptions among women in Malawi: Qualitative data from a high-burden, low-resource setting [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr C121.