bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract D077: Sociodemographic and geographic disparities in treatment for early-stage non-small cell lung cancer (NSCLC) patients in California
Authors: Obrochta Chelsea A , Nara Atsushi , Murphy James , Thompson Caroline A 
Published: September 2020

Abstract
Background: Lung cancer is the second most commonly diagnosed cancer and the leading cause of cancer-related death in the U.S. In 2013, the U.S. Preventive Services Task Force began recommending lung cancer screening, which has resulted in earlier stage diagnosis for many tobacco users. The National Comprehensive Cancer Network (NCCN) provides evidence-based cancer treatment recommendations. Evidence suggests that a patient’s receipt of guideline-concordant treatment (GCT) increases survival, especially for screen-detected, earlier stage cancers. The objective of this study is to describe receipt of timely GCT in California NSCLC patients by sociodemographic characteristics and geography. Methods: We studied 23,080 patients diagnosed with stage I/II NSCLC (2006-2015) in the California Cancer Registry. We classified treatment received as: undertreated, GCT, or over-treated according to NCCN guidelines, and timeliness (treatment began ≤ 45 days after diagnosis) among patients who received GCT. We describe the population according to treatment received, and timeliness by detailed race/ethnicity, stage of diagnosis, sex, age, insurance type, marital status, cancer approved program, and neighborhood socioeconomic status. We calculated absolute and relative inequalities in GCT and timeliness between race/ethnic groups. Hotspot analyses were conducted to identify regions at increased risk for under-treatment/overtreatment, and treatment delay by patient residential census tract. Results: Overall, 69.95% of patients received GCT, 14.53% were undertreated and 15.55% over-treated. Among patients who received GCT, 56.78% began treatment within 45 days of diagnosis. Under-treatment and treatment delay were more frequent in patients who were black or Hispanic, had public insurance, and were of lower socioeconomic status. We detected moderate absolute inequalities in receipt of GCT and timely care; no relative inequalities were observed. Cold and hot spots for under- and over-treatment and timeliness were identified within Metropolitan areas across California. Conclusion: Under-treatment and delayed treatment for early stage lung cancer disproportionately affect priority populations. With rising numbers of early stage lung cancers due to screening smokers, administration of timely proper treatment of lung cancer is critical.
Citation Format: Chelsea A Obrochta, Atsushi Nara, James Murphy, Caroline A Thompson. Sociodemographic and geographic disparities in treatment for early-stage non-small cell lung cancer (NSCLC) patients in California [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr D077.
Abstract D085: Differences in the use of proton beam therapy among patients diagnosed with American Society for Radiation Oncology Group 1 proton beam therapy indication cancer types in the United States
Authors: Sineshaw Helmneh M. , Yabroff K. Robin , Jemal Ahmedin , Nogueira Leticia M. , Efstathiou Jason A. 
Published: September 2020

Abstract
Purpose: To examine the extent of racial/ethnic and geographic differences in the use of proton beam therapy (PBT) among newly diagnosed cancer patients in the United States. Methods: We included all patients diagnosed from 2009 to 2016 with invasive single or first primary cancer categorized as Group 1 indication (recommended) for PBT by the American Society for Radiation Oncology. We conducted descriptive and multivariable multinomial logistic regression analyses to assess patient and facility characteristics associated with receipt of PBT. Results: Of the total 246,932 patients diagnosed with Group 1 indication cancer types, 0.6% received PBT. PBT use was lower in non-Hispanic (NH) blacks compared with NH whites (0.3% vs 0.6%). Patients who were older, uninsured, with low median income, higher comorbidity score, treated at low volume or community programs or at facilities located in the south, and residing in rural areas had the lowest PBT use. There was a 46% relative difference in PBT use between NH blacks and NH whites, with marked variation by geographic region of facility. NH black had 37% lower odds of receiving PBT compared with NH whites (odds ratio, 0.63; 95% confidence interval, 0.50-0.79), which became nonsignificant after accounting for difference in cancer type. Further, minority race/ethnicity, older age, high comorbidity score, uninsurance/non-private insurance, treatment out of NCI-designated center, and treatment out of facilities in the northeast region were significantly associated with lower odds of PBT use versus no radiation treatment. Conclusions: Despite very low overall PBT use in the United States, there were marked differences in PBT use among patients diagnosed with Group 1 indication cancer types by race/ethnicity and geographic region of treatment facility.
Citation Format: Helmneh M. Sineshaw, K. Robin Yabroff, Ahmedin Jemal, Leticia M. Nogueira, Jason A. Efstathiou. Differences in the use of proton beam therapy among patients diagnosed with American Society for Radiation Oncology Group 1 proton beam therapy indication cancer types in the United States [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr D085.
Abstract D087: Racial/ethnic differences in ovarian cancer incidence and mortality among adult women in the United States, 2001-2016
Authors: Guo Fangjian , Berenson Abbey B. , Kuo Yong-Fang 
Published: September 2020

Abstract
Background: Ovarian cancer is the fifth most common cause of cancer death among US women. Assessing racial/ethnic differences in ovarian cancer incidence and mortality will provide important information regarding improving efforts of prevention, early detection, and treatment in population groups that need to be targeted. Methods: We included adult women diagnosed with ovarian cancer ≥ ages 20 from the National Program for Cancer Registries and Surveillance, Epidemiology, and End Results Incidence Incidence–-U.S. Cancer Statistics 2001–2016 database. Incidence of ovarian cancer was age- adjusted to the U.S. standard population. Joinpoint analyses were used to assess incidence trend and calculate annual percentage change (APC). Hazard ratios (HRs) and 95% CIs were estimated from the Cox proportional hazard models for comparing differences in 5-year survival probability across races/ethnicities, after controlling for age at diagnosis and county of residence. Results: Among adult women ≥ 20 years old, ovarian cancer incidence decreased among Hispanics, non-Hispanic Whites, and non-Hispanic Blacks, from 9.4 per 100,000 in 2001 to 6.9 per 100,000 in 2016 (APC -1.8, 95% confidence interval (CI) -2.2 - -1.5) in Hispanics, from 11.0 per 100,000 in 2001 to 7.6 per 100,000 in 2016 (APC -2.1, 95% CI -2.3 - -1.9) in non-Hispanic Whites, and from 8.0 per 100,000 in 2001 to 6.6 per 100,000 in 2016 (APC -1.3, 95% CI -1.6 - -1.0) in non-Hispanic Blacks. No joinpoints were found among those racial/ethnic groups. Among ovarian cancer patients, observed 5-year ovarian-cancer-specific survival was 51.6% (95% CI 50.4%-52.8%) in Hispanics, 44.7% (95% CI 44.2%-45.1%) in non-Hispanic Whites, and 37.4% (95% CI 36.1%-38.8%) in non-Hispanic Blacks (HR for dying from ovarian cancer, Whites vs. Blacks 0.68, 95% CI 0.66-0.71; Hispanics vs. Blacks 0.73, 95% CI 0.69-0.76). Similar patterns were also observed for 5-year overall survival and 5-year relative survival among adult ovarian patients. Conclusions: Ovarian cancer incidence decreased across all three racial/ethnic groups from 2001 to 2016. Although Non-Hispanic Blacks had the lowest ovarian cancer incidence, they had the lowest survival rate. More efforts are needed to focus on this underserved population to target early detection and treatment of ovarian cancer.
Citation Format: Fangjian Guo, Abbey B. Berenson, Yong-Fang Kuo. Racial/ethnic differences in ovarian cancer incidence and mortality among adult women in the United States, 2001-2016 [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr D087.
Abstract D113: Socioeconomic disparities underlie outcomes in patients with pancreatic neuroendocrine tumors
Authors: Underwood Patrick W , Riner Andrea N , Maduka Michael U , Reddy Sushanth , Rose J. Bart , Trevino Jose G 
Published: September 2020

Abstract
Background Disparities are known to underlie outcomes in pancreatic ductal adenocarcinoma (PDAC). Pancreatic neuroendocrine tumors (PNET) represent a rare yet deadly form of pancreatic cancer. Health disparities have not been well described in this patient population. We hypothesize that given the significant health disparities in PDAC, cancer health disparities exist in patients with PNETs. Methods Patients treated for PNETs were identified in a National Cancer Database (NCDB) Patient User File for the years 2004-2015. Kaplan-Meier analysis was performed to assess survival. Cox proportional hazards models were used to assess the effect of clinical and socioeconomic factors on survival. Results Review of the NCDB found 19,752 reported cases of PNETs. Of those, 15,589 (78.9%) were non-Hispanic white (NHW), 2,462 (12.5%) were black (B), and 1,710 (8.6%) were Hispanic, white (H). On univariate analysis, greater age, male sex, higher Charlson comorbidity score, higher disease stage, lack of insurance, decreased median household income in area of residence, and no surgery were associated with worse survival (p&lt; 0.05). While not statistically significant and unlike pancreatic adenocarcinoma, black patients had greater median survival (89.6 months; 95% CI 77.9-101.196) compared to NHW (76.4 months; 95% CI 72.9-79.8) and H (80.1 months; 95%CI 70.7-89.5) patients. On multivariate analysis, the same factors from the univariate analysis were associated with worsened survival (p&lt; 0.05). Sub-analyses of patients who received surgery and those who did not again showed no significant difference in survival based on race. Conclusion While insurance status, median income in area of residence, and sex were associated with clinical outcomes in PNETs, race was not a contributing factor. This is in contrast to literature in PDAC which has demonstrated that black patients have worse survival. The reasons for this difference are unclear, but may biologically driven. It is important to understand disparities from different types of pancreatic tumors. Further work to understand biologic contributions to health inequities are needed.
Citation Format: Patrick W Underwood, Andrea N Riner, Michael U Maduka, Sushanth Reddy, J. Bart Rose, Jose G Trevino. Socioeconomic disparities underlie outcomes in patients with pancreatic neuroendocrine tumors [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr D113.
Abstract D130: The importance of closing the gap in cancer disparities
Authors: Alexander Kimberly 
Published: September 2020

Abstract
My poster will outline the current state of cancer/multiple myeloma disparities and why it is important to close the gap.
Citation Format: Kimberly Alexander. The importance of closing the gap in cancer disparities [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr D130.
Abstract D135: Early low-dose lung cancer screening education
Authors: Reese David R 
Published: September 2020

Abstract
Research results of the Terminate Lung Cancer (TLC) low dose CT early lung cancer screening and detection campaign in three regional study groups in rural East Kentucky. Results include the identification of effective field-tested communication protocols for lung cancer prevention, screening and detection with rural Appalachian population that included many hard to engage participants.
Citation Format: David R Reese. Early low-dose lung cancer screening education [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr D135.
Abstract IA05: Sexual orientation, race/ethnicity, and human papillomavirus vaccination disparities among young U.S. women: An intersectional approach
Authors: Agénor Madina 
Published: September 2020

Abstract
Introduction: Human papillomavirus (HPV) vaccination, which is recommended for U.S. women and girls aged 11–26 years, effectively prevents cervical cancer. Researchers have identified HPV vaccination disparities among groups of women and girls defined in relation to sexual orientation identity or race/ethnicity. However, no study has used an intersectional approach to ascertain HPV vaccine uptake among sexual orientation identity and racial/ethnic subgroups of U.S. women and girls.
Methods: Using 2011–2015 National Survey of Family Growth data, we used multivariable logistic regression to estimate differences in the odds of HPV vaccination initiation (i.e., &gt; one dose) across sexual orientation identity and racial/ethnic subgroups of black and white U.S. women aged 15–24 years (N = 2,413), adjusting for demographic factors. We also assessed whether socioeconomic and health care factors helped explain observed disparities.
Results: The overall prevalence of HPV vaccination initiation was 47.7%. Compared to white heterosexual women, black lesbians (odds ratio [OR] = 0.16; 95% confidence interval [95% CI]: 0.06, 0.46) had the lowest adjusted odds of HPV vaccination initiation, followed by white lesbians (OR = 0.33; 95% CI: 0.13, 0.82) and black heterosexual women (OR = 0.63; 0.47, 0.85). Including socioeconomic factors in the model only slightly attenuated the HPV vaccination initiation odds ratios for black lesbians (OR = 0.19; 95% CI: 0.06, 0.56), white lesbians (OR = 0.37; 95% CI: 0.15, 0.90), and black heterosexual women (OR = 0.70; 95% CI: 0.52, 0.93) compared to white heterosexual women. Adding health care factors only slightly additionally attenuated the odds ratio comparing black lesbians and white heterosexual women (OR = 0.21; 95% CI: 0.07, 0.67).
Conclusions: Our findings identified black lesbians as a particularly underserved subgroup and suggest that sexual orientation identity and race/ethnicity may have a compounding effect on HPV vaccination initiation among black and white U.S. women and girls. Evidence-based interventions that are adapted to the specific needs and experiences of black lesbians and other multiply marginalized groups are needed to promote equity in HPV-related outcomes.
Citation Format: Madina Agénor. Sexual orientation, race/ethnicity, and human papillomavirus vaccination disparities among young U.S. women: An intersectional approach [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr IA05.
Abstract IA06: What do we know about sexual minorities and cancer and where do we go from here?
Authors: Boehmer Ulrike 
Published: September 2020

Abstract
Lesbian, gay, bisexual, and individuals with same-sex partners are defined as sexual minority individuals and have been recognized as an underserved population. By reviewing key findings from population-based studies of sexual minority and heterosexual cancer survivors, we can determine characteristics of sexual minorities with cancer that are consistent across existing studies. Moreover, existing studies allow for the identification of potential mechanisms for consideration in interventions and to move towards development of tailored programs and interventions that improve sexual minority survivors’ well-being. At the same time, it is important to describe gaps in knowledge about sexual minorities and cancer to direct future research needs to more fully understand sexual minority cancer survivorship.
Citation Format: Ulrike Boehmer. What do we know about sexual minorities and cancer and where do we go from here? [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr IA06.
Abstract IA12: Border Health Consortium of the Californias
Authors: Quijada Prisci 
Published: September 2020

Abstract
San Diego County is a minority-majority region, in which non-Hispanic whites are not the majority population (46%). Hispanics comprise 33.5% of the population and Asian Pacific Islanders (APIs) make up 12.8%. For risk factor burden, data based on California Health Interview Survey and Behavioral Risk Factor Surveillance System show that Hispanics in San Diego County have the lowest colorectal, breast, and cervix cancer screening rates, the highest obesity prevalence, and the highest proportion of no physical activity. The mission of the Border Health Consortium of the Californias-Binational Cancer Work Group is to promote cancer-free lives and erase borders in our region. We will identify and characterize priority cancer topics for our border region, organize along the cancer control continuum, identify key border region cancer activities and resources (binational), and identify key border region cancer needs (binational). To reach our objectives we will optimize collaboration, coordination, and cooperation.
Citation Format: Prisci Quijada. Border Health Consortium of the Californias [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr IA12.
Abstract IA26: Breast tumor microenvironment in black women: A distinct signature of CD8+ T-cell exhaustion
Authors: Yao Song , Cheng Ting-Yuan , Elkhanany Ahmed , Yan Li , Omilian Angela , Abrams Scott I. , Evans Sharon , Hong Chi-Chen , Qi Qianya , Davis Warren , Liu Song , Bandera Elisa V. , Odunsi Kunle , Takabe Kazuaki , Khoury Thaer , Ambrosone Christine B. 
Published: September 2020

Abstract
Background: Blacks tend to have a stronger inflammatory immune response than Whites. We hypothesized that racial differences in host immunity also manifest in the tumor microenvironment (TME), constituting part of a distinct tumor biology underlying more aggressive breast cancer and higher mortality in Black women.
Patients and Methods: Pathologic and gene expression profiling approaches were used for comprehensively characterizing infiltrating immune cells in breast TME from 1,315 patients from the Women’s Circle of Health Study (WCHS). Racial differences in tumor immune phenotypes were compared, with results validated in data from The Cancer Genome Atlas (TCGA). Prognostic associations of immune phenotypes were assessed in WCHS, TCGA and Molecular Taxonomy of Breast Cancer International Consortium (METABRIC) cohorts.
Results: We found marked and consistent differences in tumor immune responses between Black and White patients. Not only did tumors from Blacks display a stronger overall immune presence, but the composition and quality of immune infiltrates differed, independent of tumor subtypes. Black patients had a stronger humoral immunity response, and further, a more exhausted CD8+ T-cell profile featuring the coexpression of PD-1, LAG3, and CTLA4. A signature indicating a higher ratio of exhausted CD8+ T cells to total CD8+ T cells (ExCD8-r) was consistently associated with poorer survival, particularly among hormone receptor-positive patients. Combinations of the absolute fraction of CD8+ T cells and ExCD8-r signature identified the CD8-low/ExCD8-r-high subgroup, the most prevalent among Blacks, as having the worst survival.
Conclusions: Our findings of a distinct exhausted CD8+ T-cell signature in Black breast cancer patients indicates an immunobiologic basis for their more aggressive disease, and also a rationale for the use of immune checkpoint inhibitors targeting the exhaustion phenotype.
Citation Format: Song Yao, Ting-Yuan Cheng, Ahmed Elkhanany, Li Yan, Angela Omilian, Scott I. Abrams, Sharon Evans, Chi-Chen Hong, Qianya Qi, Warren Davis, Song Liu, Elisa V. Bandera, Kunle Odunsi, Kazuaki Takabe, Thaer Khoury, Christine B. Ambrosone. Breast tumor microenvironment in black women: A distinct signature of CD8+ T-cell exhaustion [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr IA26.