bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract A65: Evaluating the reliability of an instrument assessing cancer clinical trial perceptions in a predominantly African American sample
Authors: Ford Marvella E. , Burshell Dana , Mack Franshawn , Wei Wei , Garrett-Mayer Elizabeth
Published: May 2015

Background: African Americans (AA) are disproportionately impacted by cancer mortality compared to their European American (EA) counterparts. Greater participation in cancer clinical trials among AA could help to reduce this disparity. However, negative perceptions of trials appear to negatively impact trial participation among AA. The Attitudes towards Randomized Trials Questionnaire (ARTQ) has been found to be a reliable measure of trial perceptions among EA. However, the utility of this instrument has never before been tested among AA.

Objective: To evaluate the reliability of the ARTQ in assessing perceptions of cancer clinical trials in a predominantly AA sample.

Methods: Principal component analysis (PCA) and Cronbach's alpha estimates were used to assess the reliability of the ARTQ. The sample consisted of residents from South Carolina counties with high racial disparities in cancer mortality rates (N=315, 81.4% AA) who participated in the study between 2008 and 2013.

Results: Slightly more than half of the participants had at least a college diploma (60.8%), 84.8% were female, and 53.4 % had an annual household income of $40,000 or more. In this study, the PCA analysis confirmed the unidimensionality of the ARTQ. Cronbach's alpha for the ARTQ was 0.86.

Conclusion: The ARTQ displayed strong evidence of high statistical reliability in this predominantly AA sample. This analysis has great implications for future research as it represents the first test of reliability of the ARTQ in AA. The results lay the groundwork for use of the ARTQ in future studies in diverse populations. The ARTQ could be administered to potential trial participants to identify those whose trial perceptions indicate that they could benefit from participating in a clinical trials education program. The ARTQ could thus be used to foster communication with potential trial participants by highlighting areas where investigators could spend additional time describing the trial design and the safeguards in place for participants.

Citation Format: Marvella E. Ford, Dana Burshell, Franshawn Mack, Wei Wei, Elizabeth Garrett-Mayer. Evaluating the reliability of an instrument assessing cancer clinical trial perceptions in a predominantly African American sample. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr A65. doi:10.1158/1538-7755.DISP13-A65
Abstract A80: Acral melanoma in the Hawaiian Islands: Exploring immunologic PDL-1 signature in the minority population
Authors: Morita Shane Y.
Published: May 2015

Background: While acral melanoma (AM) is the least common subtype amongst the principal histologic variants of cutaneous melanoma (CM), darker-skinned individuals such as Asians, Pacific Islanders, and African Americans are more frequently affected. Asian/Pacific Islanders with AM in particular, exhibit the worst survival amongst all ethnic groups. Recent studies have profiled the importance of programmed cell death ligand 1 (PDL-1) in the therapeutic armamentarium for melanoma. However, the pathologic features and immunologic characteristics of AM evaluating PDL-1 in the minority population have not been thoroughly analyzed.

Methods: IRB approval was obtained for this retrospective analysis. From 2004 to 2011, 17 Asian/Pacific Islander patients histologically confirmed to have invasive AM were evaluated at a tertiary institution. Data including age, gender, tumor location, Breslow thickness, ulceration, tumor infiltration lymphocyte (TIL) status, and mitoses per mm squared were compiled. Immunohistochemistry was performed targeting the PDL-1 (CD274) antigen on primary tumor cells in formalin-fixed paraffin-embedded archived biospecimens. PDL-1 expression was graded on a scale from 0 (absent) to 2 (high).

Results: Our findings demonstrated that PDL-1 expression was low in this series (3/17; 17.6%). All AM patients had a non-brisk TIL response. A significant proportion of our entire cohort (8/17; 47.1%) exhibited thick primary lesions (>4.0 mm) with a high propensity for ulceration (8/17; 47.1%). Demographics of the Asian/Pacific Islander cohort included mean age of 63.8 years (range 40-86) and male gender (9/17; 53 %). Tumor location primarily involved the foot (11/17; 64.7%); median Breslow thickness was 3.98 mm (range 0.96-11.0), and mean mitoses per mm squared was 3.9 (range 0-10). Conclusion: Asian/Pacific Islanders with AM were found to have a low frequency of PDL-1 expression. The lack of a brisk lymphocytic host response in AM may provide insight into its mechanism of tumorigenesis. This is the first study to our knowledge that has examined the immunologic signature of TIL and PDL-1 status in a multi-ethnic population of AM patients. This is compelling data that may be applied to patient selection in future trials utilizing immunotherapy.

Citation Format: Shane Y. Morita. Acral melanoma in the Hawaiian Islands: Exploring immunologic PDL-1 signature in the minority population. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr A80. doi:10.1158/1538-7755.DISP13-A80
Abstract A93: Human papillomavirus vaccine recommendations and beliefs among primary care providers in federally qualified health centers
Authors: Roland Katherine , Benard Vicki , Greek April , Hawkins Nikki , Manninen Diane , Saraiya Mona
Published: May 2015

Introduction: Human papillomavirus (HPV) vaccines that protect against most cervical cancers are widely available; however, HPV vaccination uptake is low in states and regions with low cervical cancer screening rates and greater cervical cancer morbidity and mortality. Provider recommendation is a key facilitator for vaccine uptake. Assessing vaccine recommendations given by primary care providers (PCPs) serving populations at increased risk for developing cervical cancer is critical to reduce health disparities and unnecessary clinical services. Methods: Data were collected from 98 PCPs in 15 Federally Qualified Health Center (FQHC) clinics in Illinois between August 2009 and March 2010 using a cross-sectional survey to assess HPV vaccine recommendations and beliefs. Federally Qualified Health Centers are safety-net clinics serving individuals who disproportionately face cost and access barriers to healthcare. Results: The PCPs completing this survey were primarily Obstetricians/Gynecologists (56%) and Family Practice (35%) physicians serving a low-income and underinsured community. 92% of providers recommend the HPV vaccine, most frequently for females aged 13-26 years (98%) and 9-12 years (68%). Some providers report sometimes to always using results from a HPV test (12%) or a Pap test (7%), or the number of sexual partners (33%) to determine who should receive the vaccine, which is not consistent with guidelines. Conclusion: A high percentage of cervical cancer screening providers are also vaccinating girls and young women in FQHCs, and some practices are not consistent with national guidelines and may result in less eligible females receiving the vaccine. Understanding how the HPV vaccine is used by screening providers in FQHCs is of increasing public health significance as FQHCs receive funding to expand evidence-based clinical services. Guideline-consistent recommendations of the HPV vaccine for cervical cancer prevention in medically underserved and high-risk communities may reduce unnecessary clinical intervention and improve opportunities to eliminate cervical cancer disparities.

Citation Format: Katherine Roland, Vicki Benard, April Greek, Nikki Hawkins, Diane Manninen, Mona Saraiya. Human papillomavirus vaccine recommendations and beliefs among primary care providers in federally qualified health centers. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr A93. doi:10.1158/1538-7755.DISP13-A93
Abstract B13: Do adipokines mediate the association between obesity and adenomatous polyps?
Authors: Ochs-Balcom Heather M. , Cannioto Rikki , Chen Zhengyi , Thompson Cheryl , Nie Jing , Millen Amy E. , Freudenheim Jo L. , Tracy Russell , Li Li
Published: May 2015

Background. Obesity is now a well-established risk factor for colon neoplasia, yet the biological mechanisms underlying this link are not fully understood. Increasing data support that adipokines play an important role in colon carcinogenesis, and it is hypothesized that adipokines may in part mediate the link between obesity and colon neoplasia. To date, few epidemiological studies have explicitly examined this hypothesis.

Methods. We investigated whether adipokines mediate the obesity-colon adenoma association and whether mediating effects differ by race in a sample of Caucasians (217 cases and 650 controls) and African Americans (175 cases and 378 controls) participating in the Cleveland Colonoscopy Screening Study. We examined potential mediating effects of leptin and adiponectin by 1) regression analyses assessing whether leptin and adiponectin attenuate the association of waist-to-hip ratio and adenomatous polyps, and 2) path analysis assessing whether leptin or adiponectin are mediators of the obesity-adenomatous polyp association.

Results. Neither leptin nor adiponectin showed evidence for attenuation of the WHR-adenomatous polyp association, nor did we identify a statistically significant mediating effect of leptin or adiponectin via the Sobel method (all Sobel p>0.27).

Conclusion. Our study is unable to support mediating roles of leptin and adiponectin in association of obesity and colon adenoma. Larger studies on how these associations vary by race, sex, and obesity are needed, as well as studies that investigate whether adipokines have mediating effects in later stages of carcinogenesis.

Citation Format: Heather M. Ochs-Balcom, Rikki Cannioto, Zhengyi Chen, Cheryl Thompson, Jing Nie, Amy E. Millen, Jo L. Freudenheim, Russell Tracy, Li Li. Do adipokines mediate the association between obesity and adenomatous polyps?. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr B13. doi:10.1158/1538-7755.DISP13-B13
Abstract B19: A clinical evaluation of the clinical utility of genotype risk scores in cancer health disparities
Authors: Yoo Wonsuk
Published: May 2015

Background: Substantial uncertainty exists as to whether combining multiple disease-associated single nucleotide polymorphisms (SNPs) into a genotype risk score (GRS) can provide clinically useful information.

Methods: We critically evaluated the ability of a simple count GRS to predict the risk of a dichotomous outcome, under both a multiplicative (log additive) and linear additive model of combined effects. We also evaluated the ability of a count GRS to predict the level of a continuous outcome variable. We then compared the results of these simulations with the observed results of published GRS measured within multiple epidemiologic cohort studies on cancer health disparities.

Results: If the combined effect of each disease-associated SNP included in a GRS is multiplicative on the risk scale, then a count GRS score should be useful for risk stratification with as few as 10-20 SNPs. Adding additional SNPs to the GRS under this model dramatically improves risk stratification with modest gains in risk discrimination. By contrast, if the combined effect of each SNP included in a GRS is linearly additive on the risk scale, a simple count GRS is unlikely to provide clinically useful risk prediction or discrimination. Adding additional SNPs to the GRS under this model does not improve any measures of clinical utility. The combined effect of SNPs included in a GRS measured in several epidemiologic cohort studies appears to be more consistent with a linearly additive combined effect. Unlike the case for predicting a dichotomous outcome, a simple count GRS can potentially provide clinically useful information to predict the level of a continuous outcome variable under a wide variety of circumstances, even when the amount of explained variance is low.

Conclusion: A simple count GRS can provide clinically useful information to predict the level of a continuous variable under a variety of circumstances. By contrast, a count GRS is unlikely to be clinically useful for predicting the risk of a dichotomous outcome. To provide clinically useful information about the genetic risk of dichotomous outcomes, alternative methods for constructing GRS that attempt to identify and include SNPs whose combined effect is at least multiplicative are needed.

Citation Format: Wonsuk Yoo. A clinical evaluation of the clinical utility of genotype risk scores in cancer health disparities. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr B19. doi:10.1158/1538-7755.DISP13-B19
Abstract B23: Colombians with high percentage of African ancestry, carrying a specific IL1B haplotype, have increased risk of colorectal cancer
Authors: Sanabria-Salas Maria Carolina , Hernandez-Suarez Gustavo , Umaña-Perez Adriana , Serrano-Lopez Martha Lucia , Sanchez-Gomez Myriam , Rojas Martha Patricia , Zabaleta Jovanny
Published: May 2015

Background: Colorectal cancer mortality rates are heterogeneous across Colombian territory and this variation could be explained by regional differences in Colombian ethnicity due to our high population admixture. Different frequencies of the interleukin 1 beta (IL1B) genetic variations have been described among diverse ethnical groups, but there are no reports on the possible association of these variants with colorectal cancer (CRC) risk as an effect of the genetic population dynamics in Colombia.

Methods: To evaluate the association of IL1B haplotypes with colorectal carcinogenesis, we genotyped 317 CRC cases, 199 adenomatous polyps (AP) and 511 age-sex matched controls recruited from six Colombian cities located either on the coastal or the inner zone of the country. Five IL1B SNPs (-3737, -1464, -511, -31 and +3954) were genotyped and all were in HWE (p>0.05). We used data from previous analysis to estimate individual ancestral genetic fractions using STRUCTURE software based on allele frequencies of 678 autosomal SNPs cross-matched with the HapMap dataset, not in LD, and assuming three distinct population origins (CEU, LWJ and CHB populations) from HapMap project as references.

Results: We found a 4-SNPs haplotype block (-3737C/-1464G/-511T/-31C) with high LD associated with CRC risk. Additional analysis revealed that this association persisted after adjusting by confounding variables including ancestry information (OR 1.95; CI 1.12 - 3.38; p =0.02). Interestingly, this association was evident among individuals from the coastal zone of the country and it was related with their higher African ancestry fraction (OR 2.26; 95%CI 1.22-4.18; p =0.01). Our results are in agreement with previous reports showing that this haplotype increase the IL1B promoter activity and that is highly prevalent in African-Americans.

Conclusions: To the best of our knowledge, this is the first study seeking for the association between CRC risk and IL1B gene in a haplotype context in a population-based association study in Colombia, an admixed population. Our results represent consistent evidence on how the identification of genetic biomarkers of susceptibility could be used to discriminate populations at increased risk of CRC development.

Citation Format: Maria Carolina Sanabria-Salas, Gustavo Hernandez-Suarez, Adriana Umaña-Perez, Martha Lucia Serrano-Lopez, Myriam Sanchez-Gomez, Martha Patricia Rojas, Jovanny Zabaleta. Colombians with high percentage of African ancestry, carrying a specific IL1B haplotype, have increased risk of colorectal cancer. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr B23. doi:10.1158/1538-7755.DISP13-B23
Abstract B32: Heterogeneity of breast cancer clinical characteristics and outcomes in U.S. black women - effect of place of birth
Authors: Camacho-Rivera Marlene , Kalwar Tricia , Sanmugarajah Jasotha , Shapira Iuliana , Taioli Emanuela
Published: May 2015

Background: Breast cancer mortality in black women is disproportionately high; reasons for this phenomenon are still unclear. In addition to socioeconomic factors, the biology of the tumor may play a role.

Methods: We analyzed 1,097 incident invasive breast cancer cases diagnosed between 2000 and 2010 in black US women from Long Island and Brooklyn. Kaplan-Meier curves were calculated and fitted for cancer mortality; when data were stratified, the log-rank test was used to assess statistical differences in survival across strata. A multivariable Cox hazard model was applied to assess the independent contributions to survival of several factors such as age, histology, stage at diagnosis, and hormone receptor status.

Results: Thirty-five percent of women had an estrogen receptor (ER) negative tumor, 46% a progesterone receptor (PR) negative tumor. ER, PR negative tumors were diagnosed at an earlier age (55.8 vs 55.3 yrs), at a later stage (p= 0.06), were larger in size (p=0.04), and more frequently treated with neoadjuvant chemotherapy (p=0.06) than ER, PR positive tumors. Determinants of shorter survival were: ER, PR negativity (HR: 2.2, 95% CI: 1.4-3.4), age, and stage at diagnosis (HR: 2.0; 95% CI: 1.5-2.7). ER, PR negative women born outside of the US experienced significantly worse survival than ER, PR negative women who were born in the US. There were no differences in survival based on therapeutic strategy (radiation, chemotherapy, or surgery).

Conclusions: ER, PR negative tumors in black women born outside the US, mainly in the Caribbean, are biologically more aggressive than the same tumor size and age matched tumors in black women born in the US. Our study suggests that environmental exposures in the country of origin may impact on host cancer interactions and cancer outcome.

Citation Format: Marlene Camacho-Rivera, Tricia Kalwar, Jasotha Sanmugarajah, Iuliana Shapira, Emanuela Taioli. Heterogeneity of breast cancer clinical characteristics and outcomes in U.S. black women - effect of place of birth. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr B32. doi:10.1158/1538-7755.DISP13-B32
Abstract B39: Clinical characteristics of breast cancers in African American women with benign breast disease: A comparison to the Surveillance, Epidemiology and End Results Program
Authors: Mitro Susanna D. , Ali-Fehmi Rouba , Bandyopadhyay Sudeshna , Alosh Baraa , Albashiti Bassam , Ahmed Quratulain , Radisky Derek C. , Frost Marlene H. , Degnim Amy C. , Ruterbusch Julie J. , Cote Michele L.
Published: May 2015

Although the association between benign breast disease (BBD) and risk of subsequent breast cancer is well-established, no previous studies have compared characteristics of breast cancers in women with a history of BBD to characteristics of cancers in the general population. In this study, we compared the characteristics of 109 breast cancers that developed in a population of African-American women with a history of benign breast disease (BBD population) to 10,601 breast cancers that developed in a general population of African-American women whose cancers were recorded by the Metropolitan Detroit Cancer Surveillance System (MDCSS population). The populations were compared on demographic characteristics such as age, marital status, and previous cancers, as well as clinical characteristics such as tumor hormone receptor status, grade, stage, behavior, size, and treatment. Overall and breast cancer-specific survival were also compared between populations. Women in the BBD population developed lower grade, earlier stage cancers that were more likely to be hormone receptor-positive and less likely to exhibit invasive behavior. Women in the BBD population were also significantly less likely to die from breast cancer after ten years of follow-up. These results suggest that although women with a history of BBD are at greater breast cancer risk, their breast cancers may be more likely to be detected early, leading to better breast cancer-specific survival.

Citation Format: Susanna D. Mitro, Rouba Ali-Fehmi, Sudeshna Bandyopadhyay, Baraa Alosh, Bassam Albashiti, Quratulain Ahmed, Derek C. Radisky, Marlene H. Frost, Amy C. Degnim, Julie J. Ruterbusch, Michele L. Cote. Clinical characteristics of breast cancers in African American women with benign breast disease: A comparison to the Surveillance, Epidemiology and End Results Program. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr B39. doi:10.1158/1538-7755.DISP13-B39
Abstract B48: Gastric cancer presentation and survival among California Asians
Authors: Barzi Afsaneh , Stern Mariana , Zhang Juanjuan , Deapen Dennis , Liu Lihua
Published: May 2015

Gastric cancer (GC) is the 4th cause of cancer death worldwide. In the US, GC results in more than 10,000 cancer related deaths annually. Furthermore, it is associated with significant morbidity in the affected individuals. The disease has a high incidence in Asian and Hispanic population. In the US, California has the highest number of GC cases per year, possibly due to high number of Asian and Hispanic population. We designed a study to explore the disparities in the presentation and outcome of GC in the Asian population.

Using data from the California Cancer Registry (CCR), we investigated the GC incidence and survival rates among Asians in California from 2000-2010. We explored the significance of demographics in the anatomic presentation of gastric cancer and survival in the Asian population compared to non-Hispanic Whites (NHW). We identified 18,377 GC cases (inclusive of NHW and Asians) in this time period. In this population 70% were NHW, 8% Chinese, 7% Korean and 5% Japanese, the rest included Filipino, Vietnamese and other Asian sub-groups.

Koreans have the highest age adjusted incidence rate of GC compared to NHW and all other Asian groups. Moreover, the frequencies of stomach cancer by anatomical subsites were statistically significantly different between Asians and NWH for both males and females (p<0.001). Compared to NHW, Asians had lower frequency of proximal (cardia and fundus) stomach cancer (44% in NHW and 14% in Asians). The difference was more dramatic in Korean population than other groups (only 7% had proximal cancers).

Despite higher incidence, Koreans have better survival than NHW when adjusted for age, gender, SES, nativity, stage, anatomical subsite, and type of treatment received. Prognostic factors for death from gastric cancer included age > 65 and immigration status, with immigrants doing better than US born.

The differences in the anatomical distribution of GC and outcome in the Asian population may be due to differences in etiologic factors that deserve further exploration. In Japan and Korea, early detection had resulted in a dramatic decline in mortality and morbidity. Although overall low incidence of the disease in US is prohibitive for a generalized screening program, there are subpopulations that may benefit from screening. Given that early detection has proven to be effective and cost saving in Asian countries with high incidence of gastric cancer consideration of screening for this population is intriguing and should be explored.

Citation Format: Afsaneh Barzi, Mariana Stern, Juanjuan Zhang, Dennis Deapen, Lihua Liu. Gastric cancer presentation and survival among California Asians. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr B48. doi:10.1158/1538-7755.DISP13-B48
Abstract B49: Androgen receptor CAG repeat length association with prostate cancer risk in obese and non-obese African American men
Authors: Chornokur Ganna , Amankwah Ernest K. , Park Jong Y. , Phelan Catherine M. , Powsang Julio , Kumar Nagi B.
Published: May 2015

Background. Prostate cancer (PCa) racial disparity is likely to be multifactorial, involving the individual's genotype, the environment and their interaction. The trinucleotide (CAG)(n) repeat polymorphism in exon 1 of the androgen receptor (AR) gene regulates AR activity, with longer alleles conferring reduced activity. Significant interethnic variations in the allele frequencies of the AR (CAG)(n) polymorphism have been reported. We investigated the association between the AR CAG(n) repeat length and PCa risk in African American (AA) and Non-Hispanic White (NHW) men. We further explored if this association varied by body mass index (BMI) in the two races.

Methods. We tested DNA samples from 259 (136 cases and 123 controls) AA and 269 (147 cases and 142 controls) NHW men, matched by age, Gleason score and PSA. The CAG repeat region was PCR amplified, and the PCR fragments were analyzed using the Beckman Coulter CEQ8000 DNA sequencer to establish the repeat length. Associations between repeats and PCa risk were evaluated using unconditional logistic regression to estimate odds ratios (OR) and 95% confidence intervals (95%CI) for each race. Repeats were categorized using the median (22 repeats) as a cutpoint.

Results. AA men with longer AR CAG repeats (≥22) had a statistically significantly increased PCa risk, compared to AA men with shorter (<22) repeats (OR=1.81; 95%CI=1.05-3.13; P=0.034). The association was further evident among obese AA men (BMI≥30) (OR=3.12; 95%CI=1.12-8.73; P=0.03), but not in non-obese AA men (BMI<30) (OR=1.43; 95%CI=0.73-2.77; P=0.30). No associations were observed between short or long AR CAG repeats and PCa risk among NHW men, regardless of BMI status.

Conclusions. Our results suggest that PCa risk may be increased among AA men with longer AR CAG repeats (≥22), especially obese (BMI≥30) AA men. The data provide evidence for ethnic differences in androgenic pathway activity and androgen sensitivity which may contribute to PCa disparity.

Citation Format: Ganna Chornokur, Ernest K. Amankwah, Jong Y. Park, Catherine M. Phelan, Julio Powsang, Nagi B. Kumar. Androgen receptor CAG repeat length association with prostate cancer risk in obese and non-obese African American men. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr B49. doi:10.1158/1538-7755.DISP13-B49
Abstract B53: A case study on differences on cervical cancer screening knowledge and prevention practices among Latinas at two sites in a community-based participatory randomized control trial in South Florida
Authors: Rodriguez Brendaly , Carrasquillo Olveen , Kobetz Erin , Gonzalez Martha , Koru-Sengal Tulay , Miao Feng , McCann Shelia , Amofah Anthony , Frett Brigitte
Published: May 2015

Immigrant Latinas are less likely to be screened for cervical cancer. With National Cancer Institute (NCI) support, we are examining the effectiveness of community health workers (CHWs) at increasing cervical cancer screening using self-sampling for the Human Papilloma virus (HPV, done free) versus clinic referral for traditional Pap Smear screening (nominal co-payments). Out of 455 participants enrolled to date, one site (Hialeah) serves mostly Cuban women (N=152) and the other site (Southern Miami-Dade County, SMD) serves a predominantly non-Cuban Latino population (N=112 plus 39 non Hispanic). Using a mixed methods quantitative/qualitative approach, we examined differences in demographics, cervical cancer knowledge and prevention practices among participants at these sites. Latino participants in Hialeah were younger, more recent immigrants, more educated, insured, higher literacy (SAHLSA), and higher cervical cancer knowledge that those in SMD. Most participants in Hialeah (95%) preferred HPV self-sampling citing familiarity with home based vaginal screening in Cuba and preferences for health services that were free as main reason for choosing HPV self-sampling. In SMD only half the population chose the HPV self-sampler. Cultural discomfort with vaginal self-sampling, preference for a doctor to perform a vaginal exam, and greater willingness to pay for health care services (despite lower SES) were found be major reasons why many women in SMD preferred being referred to a clinic for a traditional Pap smear. This study again highlights major differences in health knowledge and behaviors among different Latino subgroups. It also emphasizes the need for community based health programs to be tailored to the specific needs and practices of distinct Latino communities.

Citation Format: Brendaly Rodriguez, Olveen Carrasquillo, Erin Kobetz, Martha Gonzalez, Tulay Koru-Sengal, Feng Miao, Shelia McCann, Anthony Amofah, Brigitte Frett. A case study on differences on cervical cancer screening knowledge and prevention practices among Latinas at two sites in a community-based participatory randomized control trial in South Florida. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr B53. doi:10.1158/1538-7755.DISP13-B53
Abstract B56: Prostate cancer knowledge, myths, and misconceptions among Haitian men
Authors: Moline Olivia M.
Published: May 2015

Similar to other Black men, Haitian men are at risk for prostate cancer. However, little is known about prostate cancer in Haitian American men. To address this gap in the literature, the purpose of this study was to assess the prostate cancer knowledge and misconceptions of Haitian American men. The research questions were: (1) What is the level of prostate cancer knowledge among Haitian men? (2) What are the common myths and misconceptions associated with prostate cancer among Haitian men? (3) Which demographic factors are associated with prostate cancer knowledge, myths, and misconceptions? The inclusion criteria for participants were men of Haitian ancestry, 40 – 70 years old, with ability to speak, read and write in English. Data collection took place in Orlando and Miami (Florida); and was by self-administered survey. A total of 95 men were recruited during two health forums and at a church. T-shirts or a bag was provided as incentives for participation in the study. Descriptive analyses and simple regression was employed to analyze the data. Prostate cancer knowledge was found to be low among the participants. In addition, prostate cancer myths and misconceptions was low.

Citation Format: Olivia M. Moline. Prostate cancer knowledge, myths, and misconceptions among Haitian men. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr B56. doi:10.1158/1538-7755.DISP13-B56
Abstract B94: Examining the process of patient navigation for screening colonoscopy among African American and Latinos
Authors: Sly Jamilia , Pelto Debra , Winkel Gary , Thompson Hayley , Redd William , Itzkowitz Steven , Jandorf Lina
Published: May 2015

Patient Navigation (PN) reduces many of the barriers to successful completion of screening colonoscopy. To optimize the efficiency of PN and further reduce racial and ethnic disparities in cancer incidence and mortality, it is important to examine associations between the process of patient navigation and screening colonoscopy completion. The objectives of this study were to assess the amount of time patient navigators spent contacting and communicating with minority participants and to determine whether the number of calls and contact time predict completion of screening colonoscopy. In the context of a prospective, randomized controlled trial of PN for screening colonoscopy conducted in New York City from 2007-2012 among African Americans and Latinos, participants received three scripted telephone calls from a navigator during which the appointment was scheduled and bowel preparation instructions, transportation needs, health education regarding colorectal cancer and screening, and support were discussed. African American and Latino participants (N=742) at least 50 years old referred for screening colonoscopy received either culturally-targeted PN or standard PN (no differences in study arms were detected). Call logs documented the number of calls each participant received as well as the length of each phone call. Socio-demographic characteristics were also assessed. Completion of Call 2 and 3 were the strongest predictors of screening colonoscopy completion. Participants who spent less time on Call 1, more time on Calls 2 and 3 and who had fewer Call 1 attempts were also more likely to complete a screening colonoscopy. Completion of colonoscopy may be predicted from the length of time PNs spend with patients during the first and third telephone calls. This information could improve the efficacy of patient navigation programs for screening colonoscopy among minorities and provides further support for the effectiveness of patient navigation as a strategy to reduce cancer screening disparities.

Citation Format: Jamilia Sly, Debra Pelto, Gary Winkel, Hayley Thompson, William Redd, Steven Itzkowitz, Lina Jandorf. Examining the process of patient navigation for screening colonoscopy among African American and Latinos. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr B94. doi:10.1158/1538-7755.DISP13-B94
Abstract C03: Disparitome-Miner: A data visualization web-application for ‘gene-of-interest’ in health disparities
Authors: Madamanchi Aasakiran , Cappel David , Madamanchi Chaitanya , Covarrubias Roman , Thomson John Micheal
Published: May 2015

Attempting to understand the gene-environment interactions that lead to disease is the basis of modern molecular medicine. DNA microarray technology has provided vast quantities of new data for building up these models. Unfortunately the vast majority of studies using this technology consist of samples from populations of European ancestry. To understand the gene-environment interactions that contribute to racial and ethnic health disparities data from studies with samples from diverse populations must be analyzed.

Currently, this data is limited and hard to access. The few studies that use samples from diverse populations are lost among the millions of published microarray datasets. To address this issue we have developed Disparitome-Miner, a microarray database and web-based data-mining platform that will serve as a tool for facilitating discovery from published transcriptomic datasets. To date, Disparitome-Miner contains 18 microarray datasets consisting of samples from diverse patient populations. Differential expression analyses comparing tissue samples from healthy and disease states in multiple ancestry backgrounds are provided. Transcriptomic microarray data is analyzed and visualized interactively through Shiny Server, an open-source package for web-based R applications. Our hope is that Disparitome-Miner allows life scientists without advanced statistical training to evaluate their gene-of-interest for a role in the gene-environment interactions that contribute to racial and ethnic health disparities. This web-app can provide help in hypothesis-generation and facilitate further investigation into health disparities.

Citation Format: Aasakiran Madamanchi, David Cappel, Chaitanya Madamanchi, Roman Covarrubias, John Micheal Thomson. Disparitome-Miner: A data visualization web-application for ‘gene-of-interest’ in health disparities. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr C03. doi:10.1158/1538-7755.DISP13-C03
Abstract C05: Analysis of oxidative modified proteins in serous subtype of ovarian carcinoma
Authors: Mehrabi Sharifeh , Cohen Shakeria , Partridge Edward E. , Aikhionbare Felix O.
Published: May 2015

Serous subtype of ovarian cancer accounts for approximately 60% to 80% of ovarian cancer cases and is by far the most aggressive histology. Fewer than 25% of the serous ovarian cancer cases are detected at an early stage (stages I and II), a statistic which reflects grimly on the low survival rates, especially among African-American women. Elevated levels of reactive oxygen species (ROS) are one of many of known and suspected risk factors associated with ovarian cancer. Oxidative stress, which results from an imbalance between ROS and antioxidant capacities, can cause a wide range of direct or indirect DNA damage. There are extensive DNA repair systems that can correct DNA damage caused by ROS before cell replication and mutation fixation. Given that serous cancer subtype is considered to have originated from the fallopian epithelium mucosa that was exposed to immense physiological changes, driven by cyclically altering hormone levels as a result of ovulation. The influence of ovulation is a cause of increased oxidative stress. In this study, we applied spectrophotometric DNPH assay, two dimension gel electrophoresis (2-D SDS-PAGE), and Oxidized protein western blot analysis to identify and evaluate the level of oxidative modified protein, using derivatisation of protein carbonyl group with 2,4-dinitrophenylhyrdozine(DNPH) assay in the obtained 155 snap-freeze primary serous epithelial ovarian tissues including, normal, normal surrounding, cystoadenoma, borderline and carcinoma with age range of 65±12, (55% Caucasian 45% Africa American). Our results showed that the index of carbonyl protein /total protein increased by onset and progression of the serous ovarian malignancy. The elevation of oxidized protein among African American was 40 % higher than Caucasian in advanced stages of disease. SDS-PAGE profiles and western blot analysis of oxidized proteins showed a distinct protein pattern among cancerous and non-cancerous tissues. Our study suggests that level of oxidative stress, may involve the selective modification of some enzymes and structural proteins and play a role in etiological differences that may exist between stages of benign and invasive epithelial ovarian tumors.

This study was funded in part as a result of the grants from NIH-CHDRD CA150317 and NCI CA150039.

Citation Format: Sharifeh Mehrabi, Shakeria Cohen, Edward E. Partridge, Felix O. Aikhionbare. Analysis of oxidative modified proteins in serous subtype of ovarian carcinoma. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr C05. doi:10.1158/1538-7755.DISP13-C05
Abstract C09: Planning for the future: Reaching an inner city Mexican American population
Authors: Strom Sara S. , Yamamura Yuko
Published: May 2015

Hispanics comprise 17% of the overall US population and 40% of the population in Texas. Approximately 90% of Hispanic Texans are of Mexican descent. This population presents unique challenges in access to health care and utilization of preventive screening. Although the internet has been rapidly integrated into education and outreach strategies for cancer prevention, its potential impact in reducing health disparities among Hispanics has not been evaluated. The few surveys conducted to date among Hispanics have focused on only those individuals who use the internet and were primarily done for marketing purposes. This study was conducted to identify differences between individuals who use internet compared to non-users in a large cohort of Mexican Americans residing in inner city neighborhoods (Houston, TX). Given that technology has evolved so quickly over the past decade, we limited our analyses to 1313 individuals enrolled in the past 2 years. In our population, most of the participants (58%, N=756) reported that they do not use the internet.

Using multivariable logistic regression, we constructed the final model in a backwards, stepwise approach to determine factors associated with internet use. Compared to those who reported using the internet, non-users were significantly (P<0.05) more likely to be male, older (mean age 51.4 vs. 41.3 years old), non-English speakers (71.4% vs. 42.0%), and not have private insurance (14% vs. 25%). Notably, 87% of participants that did not use the internet reported that they almost always spoke in Spanish; in contrast, 44% of internet users reported that they almost always spoke in English. Overall, individuals who do not use the internet were more likely to have traits associated with poorer health and higher risk for health disparity.

One of the most important findings from this study is that almost 60% of the Hispanics in this population do not use the internet; additionally, among individuals who use the internet, only 61% reported using any form of social media (Facebook, Google+, Twitter, myspace). These results suggest that the use of social media and internet would not be effective methods to reach this population and have an impact in reducing health disparities in an inner city minority population.

Citation Format: Sara S. Strom, Yuko Yamamura. Planning for the future: Reaching an inner city Mexican American population. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr C09. doi:10.1158/1538-7755.DISP13-C09
Abstract C29: Occurrence of comorbidities among multi-ethnic breast cancer survivors
Authors: Ashing Kimlin T.
Published: May 2015

Purpose: Disease co-occurrence is not uncommon. Comorbidities are concurrent, etiologically independent chronic health conditions, unrelated to the disease under study. Cancer, unfortunately is no exception with 68-85% of adult cancer patients diagnosed with other chronic illnesses. Among cancer survivors comorbid conditions that can negatively influence health and survivorship outcomes. Ethnic minorities report more co-occurring illnesses and poorer survivorship outcomes. Thus, the purpose of this study was to document the occurrence of comorbidities among African-American and Latina (English language preferred (ELP) and Spanish language preferred (SLP)) breast cancer survivors (BCS).

Methods: In total, 88 African-American, 95 ELP Latina, and 137 SLP Latina BCS were recruited via case ascertainment from the California Cancer Registry and hospital registries. Participants completed a self-report questionnaire in which they provided demographic and cancer-related medial characteristics and completed a comorbidity checklist indicating their comorbid conditions.

Results: Almost 1 in 4 BCS endorsed at least one comorbid condition with arthritis (37%), high blood pressure (37%), psychological difficulties (29%), and diabetes (19%) being among the most commonly endorsed. The occurrence of comorbidities differed by ethnic and linguistic group. Specifically, SLP Latina BCS were more likely to report having diabetes (29%) and experiencing psychological difficulties (42%). Latina BCS were twice as likely to endorse osteoporosis and headaches compared to African-Americans. Hypertension (49%) and arthritis (48%) most commonly co-occurred in African-American BCS. Older age was correlated with arthritis, diabetes, glaucoma, high blood pressure, and osteoporosis.

Conclusions: The findings suggest that investigating the occurrence of comorbidities in ethnically diverse groups may shed some light in understanding cancer risk, outcomes and cancer health disparities. Having a better grasp of comorbid conditions in specific ethnic groups may aid in more appropriate early co-occurring chronic illness assessment and integration into cancer treatment regimens, and better follow-up care and management of the cancer and the comorbid condition(s). Integrated control and management of comorbidities has the potential to improve quality care for the whole person, and increase survival and decrease morbidity.

Citation Format: Kimlin T. Ashing. Occurrence of comorbidities among multi-ethnic breast cancer survivors. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr C29. doi:10.1158/1538-7755.DISP13-C29