bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract A2: The efficacy of administrative and large-scale databases for measuring cancer health disparities among micro-minorities: The case of native Hawaiians and Pacific Islanders
Authors: Panapasa Sela V. , Williams David , McNally James
Published: December 2010

This study examines the effectiveness of administrative databases and national-level health surveys to increase our understanding of cancer health disparities among U.S. Pacific Islanders, a racially and ethnically diverse population that is medically underserved both in terms of screening and treatment. The study provides a systematic analysis of four data sources: 1) National Hospital Discharge Survey (NHDS), 2) Mortality Detail Files (MDF), 3) Surveillance, Epidemiology, and End Results (SEER) and 4) National Health Interview Survey (NHIS). These studies are examined to determine their efficacy in the statistical representation of Native Hawaiian and Pacific Islanders (NHPIs) in the United States. The paper presents a systematic and comparative evaluation of population coverage or sample attributes for each of the studies. The paper also evaluates the ability to obtain statistically robust measures of cancer incidence across select socioeconomic characteristics among the NHPIs in each study. The paper concludes with a summary of the strengths and limitations of these large-scale databases in advancing our understanding of cancer risks, prevalence, incidence, and mortality among NHPIs. Study findings will also examine the various ways that census data has been used in association with health data to provide detailed demographic, social, economic and geographic information on NHPIs. The strategic use of census data can allow us to in some ways overcome the lack of robust microdata on cancer patterns across NHPI subgroups and within geographic areas of specific concern for this population. The paper also discusses and evaluates some of the key barriers using administrative data and large-scale surveys to better understand cancer risks among NHPIs. Among these barriers, the lack of detailed information on NHPI subpopulations is particularly troublesome. While useful for establishing incidence, studies such as NHDS and MDFs continue to report only on Native Hawaiian, Samoan, and Guamanian/Chamorro subgroups and summarize the other NHPI populations in a residual other “Asian or Pacific Islander” category. In contrast, the SEER data base provides tremendous detail on NHPI subpopulations but does not attempt to estimate the annual population denominator estimates needed for the calculation of cancer rates. The paper concludes with a discussion of research methods and suggested approaches that may help overcome these kinds of data limitations and expand our understanding of cancer risks among this diverse and poorly understood population.

Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A2.
Abstract A50: Impacts of poverty threshold and health insurance on breast cancer screening in California
Authors: Kim Kyu
Published: December 2010

Background: Breast cancer screening rates have been stabilized in California. Although the effect of health insurance on breast cancer screening is well-documented in United States, the effect in California is not clear. The purpose of this study was to assess the association between having health insurance and being screened for breast cancer by different poverty threshold after controlling for observed factors

Methods: Data from the 2007 California Health Interview Survey were used to examine the association of health insurance coverage on breast cancer screening among all women ages ≥40 years (N= 24,060) using logistic regression model. After adjusting for educational attainment, employment status, race, marital status, age, nativity, smoking and doctor visit, potential effects of health insurance on breast cancer screening were analyzed by different groups: all women, women with ≤199 FPL (Federal Poverty Line) and women with 200+ FPL. All analyses accounted for the California Health Interview Survey sampling design.

Results: Overall, participants who reported having health insurance coverage were twice as likely to report being screened for breast cancer compared with those who reported having none [OR, 2.11; 95% confidence interval (95% CI), 1.73-2.57]. After adjusting for independent variables, self-reported insurance coverage had positive associations with report of being screened among women below federal poverty line (OR, 1.89; 95% CI, 1.40-2.55) and among women above federal poverty line (OR, 2.40; 95% CI, 1.78-3.24).

Conclusions: Women who reported having health insurance were more likely to report having breast screening than those who reported not having insurance coverage. This effect was higher for women at a higher income level. These findings, if confirmed in other study populations, indicate that improving breast cancer screening coverage may require not only insurance coverage but also income level for poverty.

Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A50.
Abstract A56: Mitochondrial DNA damage as a biomarker of colorectal cancer susceptibility
Authors: Torres-Ramos Carlos A. , Ayala-Torres Sylvette , Fonseca-Williams Sharon , El-Zein Randa
Published: December 2010

The elucidation of the genetic defects in cancer prone diseases such as Xeroderma pigmentosum and hereditary nonpolyposis colorectal cancer have established that diminished nuclear DNA (nDNA) repair capacity leads to cancer. In addition to nDNA, mitochondrial DNA (mtDNA) preferentially harbors lesions induced by endogenous reactive oxygen species (ROS) or by xenobiotic agents. If these lesions are left unrepaired, they may lead to mutagenesis, which may be deleterious to mitochondrial function. Mutations in mtDNA have been described in most cancers including colorectal cancer. The functional significance of these mutations is not totally understood but mutations in some mitochondrial genes are associated with increased aerobic glycolysis and growth promotion in cancer cells. In addition, dysfunctional mitochondria are more prone to produce ROS that in turn can inflict further damage to both mitochondrial macromolecules and nDNA. ROS induce a variety of DNA lesions that include base modifications, abasic sites, and strand breaks. These lesions are mainly repaired by base excision repair (BER). BER is active in mitochondria and is considered the main mechanism by which mtDNA damage is repaired. We hypothesize that decreased mtDNA repair capacity is a risk factor for the development of cancer, particularly cancers in which inflammation and oxidative stress are critical components in tumor development and progression, such as colorectal cancer. Thus, increased levels of mtDNA damage could reflect decreased mtDNA repair capacity. The purpose of this work is to determine if mtDNA damage levels in peripheral blood mononuclear cells (PBMC) can be used as a biomarker of cancer susceptibility of colorectal cancer. For this purpose we applied a gene-specific PCR-based technique (QPCR) that can detect with high sensitivity a variety of DNA lesions such as base modifications, abasic sites, and strand breaks, among others. The results of our preliminary experiments indicate that mtDNA from colorectal cancer patients harbor more lesions than mtDNA from healthy control subjects. These results suggest that mtDNA damage may be used as biomarker for colorectal cancer susceptibility. Experiments are in progress to increase the sample size and the statistical power of this study. Sponsored by 5U54CA096297-07.

Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A56.
Abstract A6: Clinical trial awareness among racial/ethnic minorities in HINTS 2007: Sociodemographic, attitudinal, and knowledge correlates
Authors: Langford Aisha T. , Resnicow Ken , An Lawrence
Published: December 2010

Objective: The purpose of this study was (1) to examine the association of race/ethnicity on clinical trial awareness, controlling for several socio-demographic, attitudinal, and knowledge variables, and (2) to inform future communication campaigns to increase clinical trial awareness and participation.

Methods: Secondary analysis was conducted among 6754 Hispanic, black, and white adult respondents to the National Cancer Institute's 2007 Health Information National Trends Survey (HINTS). The dependent variable was awareness of clinical trials. Logistic regression was used to examine possible correlates of clinical trial awareness including sociodemographics, trust of sources of health information, beliefs about safety of health information, family/personal history of cancer, health seeking information, and awareness of three health agencies.

Results: Compared to whites, blacks and Hispanics were significantly less likely to have heard of a clinical trial. Other significant correlates of clinical trial awareness included education, income, belief that health information is safely guarded, family history of cancer, awareness of the CDC, trust of health information from the Internet and charitable organizations, and distrust of health information from religious institutions.

Conclusion: Blacks and Hispanics are significantly less aware of clinical trials. Campaigns that exploit unique beliefs and delivery channels for racial/ethnic subgroups should be considered.

Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A6.
Abstract A63: Effectiveness of a holistic mind-body intervention to treat fatigue in breast cancer survivors: Does race make a difference?
Authors: Appling Susan E. , MacDonald Ryan , Scarvalone Susan , Gallicchio Lisa , Helzlsouer Kathy
Published: December 2010

Introduction: Persistent fatigue affects up to 40% of breast cancer survivors and has multiple contributing factors including pain, sleep disturbance, depression, anxiety, decreased physical activity, weight gain, and treatment-induced menopausal symptoms. A holistic mind-body medicine intervention was developed by the Mercy Medical Center Prevention and Research Center team to address fatigue and its many contributing factors among breast cancer survivors. Overall, the intervention was shown to effectively decrease levels of self-reported fatigue among breast cancer survivors. The purpose of this analysis was to examine whether the effectiveness of the group-based mind-body medicine program differed by race, as little research has assessed the role of race in fatigue improvement among breast cancer survivors.

Design: Quasi-experimental design using a before/after evaluation to assess change in fatigue scores. Population: 206 breast cancer survivors (154 Caucasians; 52 African-Americans) with a chief complaint of fatigue. Outcome Measures: Change in severity of fatigue as measured by a 10 cm visual analog scale (0=no fatigue; 10=most fatigue). Fatigue was measured at baseline, end-of-program, two and six months post-program completion.

Results: African-Americans reported higher levels of fatigue than Caucasians at baseline and at the three follow-up time points; however, these differences were not statistically significant. African-Americans’ mean score from the visual analog scale showed improvement from 6.3 (SD 1.8) at baseline to 4.4 (SD 2.5) at end-of-program (p<0.001). Results were similar for Caucasians who scored 5.5 (SD 2.2) at baseline compared to 3.6 (2.2) after the intervention (p<0.001). Fatigue improvement was maintained for both groups at two and six month follow up evaluations.

Conclusion: A group-based holistic mind-body medicine intervention effectively improved fatigue across both African-American and Caucasian breast cancer survivors.

Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A63.
Abstract A64: Review on the application of laser thermal therapy for palliation of recurrent head and neck cancer
Authors: Paiva Marcos B. , Bublik Michael , Abrahao Marcio , Sercarz Joel
Published: December 2010

Background: The number of new cases of head and neck cancers in the United States was 40,490 in 2006, accounting for about 3% of adult malignancies. 11,170 patients died of their disease in 2006. The worldwide incidence exceeds half a million cases annually. In North America and Europe, the tumors usually arise from the oral cavity, oropharynx, or larynx, whereas nasopharyngeal cancer is more common in the Mediterranean countries and in the Far East. In the United States, African Americans are disproportionately affected by head and neck cancer, with younger ages of incidence, increased mortality, and more advanced disease at presentation.

Objective: To review the outcomes of a phase II study using laser-induced thermal therapy (LITT) as a palliative treatment for 106 patients with recurrent head and neck tumors.

Study Design: Retrospective study. Setting: Tertiary hospital in the United States. Subjects And Methods: The primary endpoints were tumor response and survival. Prognostic values were assessed by the Kaplan-Meier method.

Results: The best results were seen in oral cavity tumors, in which mean survival was 29.1 months, as compared to neck tumors (mean 14.4 +/-6.9 months; range 7.5-20.7 months; with a 95% confidence interval). Further analysis showed that clinical factors such as gender, smoking, and alcohol use were not indicators of poor prognosis, whereas neck disease and tumor stage at first treatment were relevant factors.

Conclusion: In this study, 40 out of 106 patients treated by LITT remained alive at the end of our follow-up, and a complete response was seen in 24 (22.6%) patients. The highest response rate was seen in oral cavity tumors, which suggests that tumor location at this site may be a predictor of favorable outcome with LITT

Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A64.
Abstract A72: A qualitative examination of the quality of life of African American prostate cancer survivors and their spouses
Authors: Rivers Brian , August Euna , Gwede Clement K. , Pow-Sang Julio , Green Bernard Lee , Quinn Gwendolyn P.
Published: December 2010

Few research studies have comprehensively examined the psychosocial issues experienced by African American prostate cancer survivors and their spouses, in spite of the disproportionate impact of this disease. The primary goal of this exploratory study was to identify the most salient psychosocial related dimensions of quality of life, as self-reported by African American prostate cancer survivors and their spouses.

Twelve African American couples were recruited to participate in an individual interview from a National Cancer Institute Comprehensive Cancer Center cancer registry and a state-based non-profit organization. The interview guide was structured according to Betty Ferrell's Quality of Life Conceptual Model. The interview transcripts were analyzed using a combination of hand coding and Atlas.ti software. Content analysis was conducted using an immersion/crystallizing analysis plan.

Common themes regarding the psychosocial needs of African American couples based on the behavioral, social, psychological, and spiritual domains emerged. Divergent perspectives were identified between the male prostate cancer survivors and their female spouses. A focus on cancer survivorship and quality of life is a growing priority. This study of African American couples surviving prostate cancer highlights the need for more in-depth investigations of psychosocial issues. Furthermore, different perspectives between African American patients and their spouses were identified, highlighting the need for couple-centered interventions.

The findings of this study will assist in the development and testing of culturally appropriate community education resources and interventions to minimize the impact of the burden of prostate cancer treatment among African Americans.

Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A72.
Abstract A74: Lifestyle patterns and the risk for prostate cancer among African American men: The multiethnic cohort
Authors: Paxton Raheem , Wilkens Lynne , Monroe Kris , Henderson Brian , Chang Shine , Kolonel Laurence
Published: December 2010

Background: Evidence linking lifestyle factors and risk for prostate cancer is neither clear or consistent and novel analytic techniques may help clarify the complex associations between lifestyle characteristics and risk for prostate cancer.

Methods: This prospective study utilized data from 12216 (Median age = 63 years) African American men from the Multiethnic Cohort, a large cohort study over-sampled for ethnic minorities in Hawaii and Los Angeles that began in 1993. Adjusted latent class analysis was used to create homogenous groups of African Americans based on 21 indicators including dietary intake and other lifestyle behaviors such as physical activity, body mass index, and sedentary behavior.

Results: Four lifestyle patterns were identified that differed by demographic and lifestyle characteristics indicating that the clustering algorithm converged properly. Adjusted Cox regression analyses stratified by smoking status indicated that among former smokers in a cluster characterized by lower caloric intake, less sedentary behavior, more physical activity, less fat intake and lower likelihood of being obese had lower risk for localized (HR= 0.8,95% CI =0.6-1.0) and advanced stage disease (HR = 0.3,95% CI = 0.1-0.8).

Conclusion: Studies should take into account the complexity of individual lifestyles and consider the co-occurrence of diet, physical activity, obesity when examining the relationship between lifestyle characteristics and risk for prostate cancer. Former smokers may have different cancer risk due to past exposures and different lifestyle behaviors.

Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A74.
Abstract A83: The Women's Circle of Health Study: Studying breast cancer disparities through collaborative efforts
Authors: Bandera Elisa V. , Ciupak Gregory , Hwang Helena , Zirpoli Gary , Jandorf Lina , Pawlish Karen , Demissie Kitaw , Bovbjerg Dana , Ambrosone Christine
Published: December 2010

Breast cancer in African American (AA) women tends to develop at an earlier age than in European American (EA) women and is more likely to have aggressive features characterized by high-grade, ER negative tumors and basal-like markers, which are associated with poorer prognosis. To address these issues, we are currently conducting a case-control study, the Women's Circle of Health Study, with two recruiting sites, one in NYC and another in NJ. AA and EA women newly diagnosed with invasive breast cancer or carcinoma in situ are identified through all major hospitals with large referral patterns for AA in Manhattan, Bronx, Brooklyn, and Queens (for the NYC site) and at all major hospitals in seven counties in northern NJ through rapid case ascertainment by NJ State Cancer Registry staff (for the NJ site). Controls residing in the same areas are identified by random digit dialing and, in NJ, also through community recruiting. Data collection, through an in-person interview includes completion of several behavioral questionnaires, including a food frequency questionnaire, collection of biospecimens (blood, saliva, and tissue), and body measurements, including body composition. Medical records acquisition and abstraction (for the NJ site) are based at UMDNJ-School of Public Health, where an ancillary study will evaluate determinants of disparities in treatment.

As of June 2010, a total of 1,618 cases (759 AA and 859 EA) and 1,674 controls (790 AA and 884 EA) have completed the study in the two recruiting sites. Preliminary analyses revealed some important differences between AA and EA cases, with AA women being more likely to be obese (52.4% vs. 26.8%), not to ever have had a screening mammogram after age 40 yrs. (15.3% vs. 6.6%), and not to have health insurance (14.2% vs. 3.8%). The method of first detection of their breast cancer also differed by race. Among cases over 40, AA women were more likely to first find it accidentally or by routine self-exam than EA women (44% vs. 27.7%), whereas detection by mammogram or physical exam was less common among AA women (48.8% vs. 62.1 %). Consistent with other studies, AA cases were more likely to have high-grade tumors (52.2% vs. 34.7%) with ER negative (32.6% vs. 30.9%) and PR negative (46.2% vs. 30.3%) status. Recruitment in NY was closed in December 2008 with planned enrollment in NJ through November 2010. By then, we will have a rich data biorepository that will allow us to address novel hypotheses aimed at reducing disparities in breast cancer etiology and treatment.

Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A83.
Abstract A97: Loss of function for FOXO1A contributes to poor outcome in African American and Latina women with breast cancer
Authors: Wu Yanyuan , Sarkissyan Marianna , Elshimali Yayha , Mohamed Hezla , Clayton Sheila , Slamon Dennis , Koeffler Phillip H. , Vadgama Jaydutt V.
Published: December 2010

Background: FKHR transcription factor FOXO1A plays a pivotal role in the regulation of cell differentiation and apoptosis. Deregulation of FOXO1A contributes to resistance to different chemotherapeutic drugs in cancer patients. In vitro studies from our laboratory (Cancer Research 2010) demonstrated that overexpressing FOXO1A in HER2 overexpressing breast cancer cells improved sensitivity of trastuzumab. The purpose of this study is to determine the prognostic relevance of FOXO1A in African American and Latina women with breast cancer.

Methods: The Association of FOXO1A expression with clinicopathological features of breast cancer and disease outcome was conducted in a cohort of 131 patients. The patients were retrospectively selected from our data base. Kaplan-Meier survival curves and Cox regression with multivariate analysis were used for accessing the disease-free survival. The FOXO1A expression and localization in malignant breast tissues, fibroadenoma and normal breast tissues were determined by immunohistochemistry analysis.

Results: The FOXO1A protein was observed in both nuclear and cell membranes of normal breast tissue; in cell membranes of fibroadenoma, and in cytoplasm of malignant breast tissue.

FOXO1A was significantly reduced in poorly differentiated tumors compared to well and moderately differentiated tumors. FOXO1A expression was inversely correlated between lymph node metastasis and HER2 status. FOXO1A is not associated with tumor size, stage and ER/PR status in our current cohort of patients. Interestingly, the loss of FOXO1A in breast cancer tissue was significantly associated with increased tissue pAkt and loss of PTEN. The relative risk (RR) for decrease in disease-free survival (DFS) was 2.0 in pAkt-/FOXO1 A-group compared to pAkt-/FOXO1A+ group. The RR for decrease in DFS increased to 4.2 in pAkt+/FOXO1A+ and further increased to 5.8 in pAkt+/FOXO1A-group. Compared to HER2+/FOXO1A+ tumors, a more than 30% further reduction in 5-year DFS was seen in patients with HER2+/FOXO1A-tumors. However, the Cox regression with multivariate analysis demonstrated that FOXO1A was not an independent contributor for the reduction of DFS. We did not find any association among ethnicity, age and the FOXO1A expression in this cohort of patients.

Conclusion: Analysis of FOXO1A expression in clinical cancer tissues may provide important prognosis for DFS and OS. It also suggests that FOXO1A could be an important therapeutic target regulated by the PI3K/Akt pathway.

Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A97.
Abstract B25: Prostate cancer factual knowledge and misconceptions among African American, Jamaican, and Bahamian men
Authors: Williams Shanita D. , Ross Louie , Hinton Lisa , Woods V. Diane , Roberts Robin
Published: December 2010

Introduction: The major risk factors for developing prostate cancer are age, African American (AA) race, and family history. AA men have greater burden of incidence and mortality from this disease. Prostate cancer knowledge has been linked with prostate specific antigen (PSA) testing in some studies but not in others. The purpose of this study was to examine the levels of knowledge about prostate cancer among AA (U.S.-born), Jamaican, and Bahamian black men, and to examine selected socio-demographic and ethno-cultural correlates.

Methods: Data were collected on a convenience sample of 448 AA men, 48 Jamaican men residing in the Southeastern U.S., and 55 Bahamian men in the Bahamas. Men were asked questions about their knowledge, awareness, and attitudes regarding prostate cancer and prostate cancer screening behaviors using DRE and PSA. Data were self-reported survey responses and analyzed using SAS.

Results: Study participants were likely married (54%), had some college or technical training (78%), and employed (60%). Over 90% of the men reported hearing of the DRE and 77% had heard of the PSA test. Prostate cancer knowledge was found to have two dimensions, a scientific or factual dimension and a misconceptions dimension. Four variables: education, income, perceived health status, and PSA screening interval were found to be associated with fact-based knowledge and misconceptions. Men with higher levels of education and men who reported recent screening (within 2 years) with a PSA test were associated with higher scores on the factual dimension. By contrast, men who reported never or rarely having had a PSA test, men with higher incomes, and men reporting higher levels of health status were associated with higher scores on the misconceptions factor. There were no differences by ethnicity on either dimension of prostate cancer knowledge (factual knowledge; misconceptions).

Conclusions: Ethnically diverse black men appear to have varying levels of both factual knowledge and misconceptions regarding prostate cancer despite targeted cancer communication and health promotion efforts. It appears that black men with higher levels of misconceptions regarding prostate cancer and prostate cancer screening were less likely to report recent screening with a PSA test. PSA testing has been positively linked with early stage diagnosis and improved treatment outcomes in black men. Hence, future strategies and culturally targeted interventions may seek to increase the levels of factual knowledge and reduce the levels of misconceptions that black men may have about this highly complex disease.

Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):B25.
Abstract B52: Predictor of distinct genetic alterations in African Americans with colon cancer by genomic analysis
Authors: Ashktorab Hassan , Nouraie Mehdi , Smoot DuaneT , Brim Hassan
Published: December 2010

Purpose: Chromosomal instability (CIN), microsatellite instability (MIN), and CpG island methylation phenotype (CIMP) are known processes through which colorectal cancer (CRC) can occur. In a given tumor, one or more of these events might be responsible for tumor development. We previously reported the results of our MSI and CIMP analysis of colorectal tumors in African Americans (AA), a group at high risk. Here, we report our array comparative genomic hybridization (aCGH) population analysis of AA and Caucasian CRC and its implication for the understanding of CRC development in this population.

Experimental design: We used 30 AA and 22 Caucasian CRC patients and applied aCGH (105k chip) to identify copy number aberrations in samples. In addition, we did a population comparative analysis with aCGH data in Caucasians as well as with a widely publicized list of colon cancer candidate genes (CAN genes). Bioinformatics analysis was done to calculate the chromosomal imbalance using Agilent Genomic Workbench 5.0.

Results: There was an average of 30 aberrations per patient with all samples displaying some level of chromosomal instability. Analysis of DNA copy number of frequently altered chromosomes revealed that deletions occurred primarily in chromosomes 4, 8 and 18. Chromosomal duplications occurred in more than 50% of cases on chromosomes 7, 8, 13, 20 and X. The CIN profile showed some differences when compared to alterations in Caucasians.

Conclusions: Prominent chromosome X amplification in male patients and chromosomes 4, 8 and 18 deletions were the primary targets in AAs. Most CAN genes were altered at high frequencies in AAs with EXOC4, EPHB6, GNAS, MLL3 and TBX22 as the most frequently deleted genes and HAPLN1, ADAM29, SMAD2 and SMAD4 as the most frequently amplified genes. CIN seems to be more prominent in AAs and may play a distinctive role in CRC development in this population.

Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):B52.
Abstract B58: hnRNP H1, a novel coactivator of the androgen receptor implicated in progression and hormone resistance of prostate cancer in African Americans
Authors: Yang Yijun , Jia Dingwu , Davis Rodney , Srivastav Sudesh , Moroz Krzysztof , Crawford Byron E. , Moparty Krishnarao , Thomas Raju , Abdel-Mageed Asim B.
Published: December 2010

The causes of ethnic disparity in the clinical manifestation and outcome of prostate cancer (CaP) are not well understood. African Americans (AA) have twice the incidence and mortality of CaP than Caucasian Americans (CA). We identified by a novel functional genomics approach, encompassing laser capture microdissection (LCM), suppressive subtractive hybridization (SSH) and custom race-based CaPspecific cDNA array chips, selective expression of heterogeneous nuclear ribonucleoprotein H1 (hnRNP H1) in prostate tumor cells of AA in comparison to CA men. hnRNP H1 expression correlates with disease progression and score and poor prognosis in AA men. Subsequent functional studies demonstrate that hnRNP H1 up-regulates transcription, and physically interacts with, and confers hormone-dependent and independent transactivation of androgen receptor (AR) in CaP cells. In addition, hnRNP H1 enhances AR binding to its cognate DNA element on promoter and enhancer element of PSA gene and selective exonic domains of the AR gene. These findings support a model in which hnRNP H1 is an auxiliary coactivator for ligand-dependent and independent transactivation of AR in tumor cells. Furthermore, siRNA silencing of hnRNP H1 elicited growth arrest and enhanced cytotoxicity of antiandrogen bicalutamide in CaP cells. Our data support a new role for hnRNP H1 in ethnic disparity of CaP and further demonstrate a previously uncharacterized mechanism for AR-hnRNP H1 axis in disease progression and development of hormone refractory in AA men.

Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):B58.
Abstract B6: Social marketing intervention to increase HPV vaccine utilization among Hispanic girls: Preliminary data
Authors: Hull Pamela C. , Sanderson Maureen , Khabele Dineo , Canedo Juan
Published: December 2010

Incidence and mortality rates from cervical cancer are higher in Hispanic women compared to non-Hispanic white women. The recently approved HPV (human papillomavirus) vaccine has been proven effective in preventing 70% cervical cancer cases (those caused by two types of high-risk HPV). This translational research study draws on Rogers’ Diffusion of Innovation theory to address the need to hasten the pace of diffusion of this new vaccine, especially among populations with high rates of cervical cancer. An academic-community partnership employed the methodology of community-based prevention marketing (CBPM) to develop a culturally appropriate, multilevel intervention aimed at increasing the utilization of the HPV (human papillomavirus) vaccine against cervical cancer among Hispanic girls. CBPM combines social marketing theories and techniques with community-based participatory research (CBPR) approaches for the development and implementation of public health interventions aimed at producing behavior change. In this presentation we will present the social marketing plan used in the intervention and preliminary data. The intervention uses a combination of Spanish-language media-radio, newspaper and printed brochures-to disseminate the messages throughout the community. A trained lay health promoter (promotora de salud) at Progreso Community Center receives phone calls to answer general questions about the vaccine and eligibility requirements for the VFC program, refers patients to appropriate locations to obtain the vaccine, and provides follow-up reminders. We present baseline intervention data on rates of HPV vaccine utilization by race/ethnicity and preliminary data on responses to the media campaign. The study contributes valuable knowledge about culturally and linguistically appropriate social marketing strategies for HPV vaccine use among Hispanics.

Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):B6.
Abstract B62: Epigenetic DNA methylation changes may underlie racial differences and susceptibility to prostate cancer.
Authors: Kwabi-Addo Bernard , Wang Songping , Yegnasubramanian Srinivasan
Published: December 2010

Prostate cancer (PCa) is a common malignancy and a leading cause of cancer deaths among men in the United States. African American (AA) men have both a higher incidence and significantly higher mortality rates than Caucasian (Cau) men. Abundant evidence has accumulated to suggest that epigenetic DNA methylation changes may appear earlier during PCa development than genetic changes, as well as more commonly and consistently. Most studies have emphasized DNA hypermethylation as an important mechanism for inactivation of key regulatory genes in prostate cancers. Thus methylated genes can serve as biomarkers for the detection of cancer from clinical specimens such as tissue biopsies or body fluids. We used pyrosequencing to quantitatively measure methylation status of GSTP1, AR, RAR 2, SPARC, TIMP3 and NKX2-5 in prostate tissue specimen from AA and Cau men. Statistical analysis showed significantly higher methylation in the prostate cancer tissue samples in comparison with matched normal samples. Overall, we observed significant differences (p < 0.05) in the methylation level for all genes (except GSTP1) in the AA samples in comparison to the Cau samples. Furthermore, regression analysis revealed significantly higher methylation for NKX2-5 (p = 0.008) and TIMP3 (p = 0.039) in normal prostate tissue samples from AA in comparison with Cau, and a statistically significant association of methylation with age for NKX2-5 (p = 0.03) in AA in comparison with Cau. In conclusion, we observed higher prevalence of DNA methylation changes in prostate tissue samples from AA in comparison to Cau men. The DNA methylation differences in AA in comparison to Cau men may potentially contribute to racial disparity associated with prostate cancer. Gene specific DNA methylation changes could potentially lead to the identification of “ethnic sensitive” biomarker for PCa detection.

Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):B62.
Abstract B75: Racial differences in Helicobacterpylori infection in the southeastern United States
Authors: Epplein Meira , Signorello Lisa B. , Blot William J.
Published: December 2010

Context: Gastric cancer incidence in African Americans is twice that in whites, and differing prevalence of strain-specific Helicobacter pylori infection may explain the disparity.

Objective: To investigate if there are racial differences in Helicobacter pylori infection.

Design, Setting, and Participants: The Southern Community Cohort Study recruited 86,000 participants, two-thirds African American, from 12 southeastern states from 2002-2009. Serum levels of antibodies to Helicobacter pylori proteins were assessed for a sample of 712 African American and non-Hispanic white participants using multiplex serology. Sero-positivity to each Helicobacter pylori protein was defined by predetermined cut-points based on median reporter fluorescence intensity. African and European admixture was estimated using a panel of 276 ancestry genetic markers, with “low,” “medium,” and “high” categories of African ancestry defined as <85%, 85-95%, and ≥95%.

Main Outcome Measures: Odds ratios (ORs) for sero-positivity to antibodies to Helicobacter pyloriproteins, by race and African ancestry.

Results: In this sample of low-income African Americans and whites, 88% of African Americans and 69% of whites were sero-positive for Helicobacter pylori. Being African American, compared to being white, was associated with a 2- to 6-fold increased risk for sero-positivity to 8 of 15 Helicobacter pylori proteins examined, including CagA (OR, 5.88; 95% CI, 4.21 −8.22), and VacA (OR, 2.70; 1.96-3.72), previously established as virulence factors for gastric cancer risk. Compared to whites, African Americans of low, medium, and high African ancestry had 1.5-, 4.1 -, and 5.0-fold increased risks of sero-positivity to Helicobacter pylori, respectively, primarily related to CagA+ strains, for which increasing African ancestry led to 2.7-, 8.7-, and 12.3-fold increased risks, respectively (all Pfor trend <0.0001).

Conclusions: African American race and increasing percentage of genetic estimation of African ancestry are strongly associated with prevalence of infection with Helicobacter pylori, particularly its virulent strains.

Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):B75.
Abstract B77: Ethnicity and hematopoietic stem cell transplantation (HSCT) outcomes in British Columbia, Canada
Authors: Noparast Maryam , Hogge Donna , Spinelli John J. , Gotay Carolyn , Bajdik Chris
Published: December 2010

Purpose: There are documented ethnic disparities in cancer care access, use and clinical outcomes in North America; however, the role of ethnicity on different outcomes of unrelated donor hematopoietic stem cell transplantation (HSCT) as an established treatment for many hematological and non-hematological malignancies has not been studied for Canadian patients.

Patients and Methods: We reviewed the registry data of 395 patients receiving first time unrelated donor HSCT for hematological malignancies at leukemia/BMT center of British Columbia (BC) between 1988 and 2008. They were reported to be white (N=340), Asian (N=32), native (N=8), Hispanic (N=3), black (N=2), mixed (N=9) and other- not specified (N=1) which were further categorized as white (N=340) and non-white (N=55). Different HSCT outcomes were compared by log-rank test and Cox proportional hazard regression adjusting for significant patient, disease and transplant related factors at 95% significance level.

Results: Univariate and multivariate analysis didn't show any statistically significant difference for overall survival, disease-free survival, relapse, acute graft versus host disease (aGVHD) grade 2+ and chronic graft versus host disease (cGVHD) rates between whites and non-whites. We reanalyzed a subset of 115 cases (88 whites and 27 non-whites) who received their HSCT after June 2001 (start date for application of high resolution DNA-based HLA matching in the study center) and their underlying diagnosis was acute myeloid leukemia, acute lymphoid leukemia, chronic myeloid leukemia and myelodysplastic syndrome. The results showed a higher risk of cGVHD for non-whites in univariate analysis (HR1.82, 95% CI1.07-3.12, P=0.03), however; adjusting for covariates in the multivariate analysis resolved this difference (P = 0.09).

Conclusion: According to our data, HSCT clinical outcomes are comparable between white and non-white ethnic minorities in BC. The contrasting result with that of US studies might be due to different ethnic composition of BC and using a heterogeneous non-white ethnic group as the comparator (to increase the power of study) which could mask any unsought differences in the subgroups.

Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):B77.
Abstract B79: Racial and socioeconomic disparities in time to treatment for breast cancer in the District of Columbia
Authors: Young Heather A. , Ulfers Margaret , Patierno Steven R.
Published: December 2010

The objective of this research was to determine if there were racial and socioeconomic disparities in time to treatment among women diagnosed with breast cancer in the District of Columbia from 1998-2006.

The D.C. Cancer Registry provided a data file containing female breast cancer cases identified from 1998-2006 along with age at diagnosis, census tract, race, ethnicity, diagnosis date, stage, date of first treatment, treatment type, grade, and insurance status. Cancer registry data were linked to 2000 Census data by census tract to create a variable for socioeconomic status based on percentage of the population below the poverty level in each census tract. Analysis of covariance was utilized to determine if the time from diagnosis to first treatment was predicted by race, Hispanic ethnicity, insurance or socioeconomic status while controlling for stage, grade, and age at diagnosis. Time to treatment was also dichotomized into <2 months and >=2months and a multiple logistic regression model using the above variables was utilized to generate odds ratios and 95% confidence intervals to determine if any of the above variables predicted a treatment delay. Finally analysis was stratified by calendar year periods to determine if disparities were reduced or persisted over time.

After controlling for the above variables black women were significantly more likely than white women to have a time from diagnosis of breast cancer to treatment of >=2 months (OR=2.19; 95% CI: 1.57, 3.06). Women who were diagnosed in 2001–;2003 (OR=1.72; 95% CI: 1.20,2.40) and 2004-2006 (OR=2.31; 95% CI: 1.62,3.35) were also significantly more likely to have a time to first treatment of 2 or more months compared to women diagnosed in 1998-2000. The adjusted mean times to treatment were significantly different for black versus white women (26.1 vs. 14.1 days). The mean time to treatment differed significantly by time period as well, at 14.8,19.4, and 26.1 days for 1998-2000,2001–;2003, and 2004-2006 respectively. A subgroup analysis of women with estrogen and progesterone receptor status data yielded similar results to the overall analysis. Lastly, when stratified by calendar period, black women were significantly more likely to experience longer time to treatment if diagnosed in 2001–2003 and 2004-2006 but not in 1998-2000.

Overall, black women with breast cancer in the District of Columbia are more likely to experience delays in treatment regardless of insurance type, socioeconomic status, and cancer characteristics such as stage and grade. Racial disparities in time to treatment have not abated over time and may have increased. Further research should be undertaken to determine the reasons that could underlie these delays and determine if disparities are actually worsening over time.

Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):B79.
Abstract B81: A spatial analysis of racial variation in post-treatment outcomes in prostate cancer
Authors: Oliver M. Norman , Wells Kristen , Stukenborg George
Published: December 2010

Prostate cancer exhibits marked geographic variation with regard to incidence, tumor characteristics, disease progression, and mortality at the local, national, and international level. Within the United States, African American men are approximately twice as likely as white men to die from the disease. It is hypothesized that racial variations in post-diagnosis treatment contribute in part to this disparity. The purpose of this study is to investigate the independent effect of race on the probability of recurrent prostate cancer among patients receiving definitive therapy (surgery or radiation) while adjusting for patient- and area- level characteristics. Incident prostate cancer cases among African American and white men that received definitive therapy within 6 months of diagnosis and were reported to the SEER-Medicare linked database between 1995 and 2002 were identified. Spatial patterning in receipt of definitive therapy treatment by race was mapped using GIS and statistically evaluated using Moran's I global index of spatial autocorrelation. A series of hierarchical logistic regression models with county level random effects were used to characterize the relationship between race and the probability of receipt of post-treatment PSA screening and recurrent prostate cancer. African American men were slightly less likely than white men to receive post-treatment surveillance (OR= 0.99,95% CI= 0.88,1.78) and to be diagnosed with recurrent prostate cancer (OR= 0.98,95% CI= 0.86,1.12), although the difference was not statistically significant. Our findings might underestimate receipt of post-treatment PSA surveillance due to limitations inherent in the use of SEER-Medicare data. Researchers should continue to investigate the implications of access to care and healthcare utilization by various populations and their effect on prostate health.

Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):B81.
Abstract B93: Does race predict the likelihood of laparoscopic versus open colorectal cancer resection?
Authors: Lee Michael Y. , Wallet Joshua , Bell Theodore , Grim Rodney , Ahuja Vanita
Published: December 2010

Background: Laparoscopic colorectal surgery has become an acceptable technique in the treatment of colorectal cancer. Recent studies have shown that laparoscopic resection may have lower complication rates than open surgery. This study analyzes if any racial disparity exists between black and white populations for receiving laparoscopic vs. open colorectal surgery and to identify any contributing factors to the choice of the type of surgery in the treatment of colorectal cancer.

Methods: Admissions with a diagnosis of colorectal cancer undergoing laparoscopic or open elective colorectal surgery were selected from the 2007 Healthcare Cost & Utilization Project (HCUP) National Inpatient Sample. Chi-square and t-tests were used to assess patient characteristics using demographic information and ICD-9 codes. Multivariate logistic regression was used to analyze independent predictors of laparoscopic approach to colorectal surgery.

Results: We identified 12,831 admissions (black n=1411, white n=11,424). Black and white patients were comparable in disease presentation (localized stage 57% vs. 61%) and geographic location (urban 96% vs. 90%). Blacks more often than whites were diagnosed with diabetes (24% vs. 17%), hypertension (64% vs. 53%), obesity (95 vs. 7%) and renal failure (8% vs. 4%) (all p<0.05). Overall, laparoscopic surgery was performed in 738 cases (5.8%) with blacks receiving laparoscopic surgery significantly less (4.5%) than whites (5.9%, p= .028). Laparoscopic compared to open surgery was associated with fewer complications especially in those patients with co-morbidities (20.5% vs. 25.4%), shorter length of stay (6.6 vs. 9 days), lower mortality (0.4% vs. 2.3%), and lower median hospital charges ($38,021.50 vs. $41,444.50) (all p < 0.05). Independent predictors of undergoing laparoscopic resection were white race (OR=1.44, p=0.024), localized disease stage (OR=1.816, p<0.01), teaching hospital (OR=1.57, p0.05).

Conclusion: Significant racial disparity exists between black and white populations in use of laparoscopic colorectal surgery in the treatment of cancer. Even though laparoscopic colorectal surgery has a lower complication rate than open surgery for patients with co-morbidities, blacks undergo laparoscopic colorectal surgery less often than whites.

Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):B93.