Abstract A085: Exploring disparities in cancer disease cohort prevalence: Unpacking Hispanic heterogeneity within All of Us
Authors: Smith JoAnn , Keyho Juan , Moore Rhonda , Sanchez Janeth 
Published: September 2024

Abstract
The objective of this study is to explore differences in cancer prevalence across self-identified Hispanic sub-categories using All of Us Research Program data. Cancer is a leading cause of morbidity and mortality worldwide, with substantial variation in prevalence and outcomes across different population groups. Understanding variation in disparities is crucial for developing effective public health strategies and personalized medicine. The All of Us Research Program, a landmark initiative by the National Institutes of Health (NIH), aims to gather health data from a diverse cohort of one million or more U.S. participants to accelerate research and improve health outcomes.This study leverages the rich All of Us dataset to explore cancer disease cohort prevalence within Hispanic subgroups, populations often underrepresented in biomedical research. This study is part of an All of Us demonstration project and used Researcher Workbench CDRv8 Controlled Tier data. Cohort participants included those who completed the initial study enrollment steps (i.e., completed Basics, Lifestyles, and Overall Health Survey, provided electronic health records, and have short-read whole genome sequencing (WGS) data). Self-identified Hispanic and sub-group information was extracted from the ‘Basics’ survey. Cancer diagnosis was extracted from the ‘Personal and Family Health History' survey. Participants who responded to having any type of cancer listed in the survey response options were considered cancer cases. Participants having multiple cancers were only counted once. We identified a total of 1,967 Hispanic participants with self-reported cancer diagnosis. Of these, the majority self-identified as Mexican, (46%), Puerto Rican (13%), Dominican (7%), Cuban (7%),Columbian (4%), More than 1 sub-race (4%) Spanish (&lt;4%), Salvadoran (&lt;4%) and Other (10%). The majority of participants identified as female (68%), married or living with a partner (52%) receiving Medicare and/or Medicaid (37%), and having incomes less than $25,000. After adjusting for predisposing, need, and enabling factors, we found significant variation in cancer prevalence across Hispanic subgroups. Compared to participants self-identifying as Mexican, those who self-identified as Dominican were significantly less likely to have a cancer diagnosis (OR 0.48, 95%CI 0.40 to 0.58). We did not observe any significant difference in cancer prevalence among Columbian, Cuban, Puerto Rican, Salvadorian, or Spanish sub-groups compared to individuals who self-identified as Mexican. Addressing cancer disparities requires a nuanced and intersectional approach that considers the multifaceted nature of Hispanic heterogeneity that exists within broad racial and ethnic descriptors and the interplay of multiple health determinants. All of Us provides a unique opportunity to advance our knowledge in this area and pave the way for more equitable healthcare solutions. By unpacking the complexities within Hispanic subgroups, we can move closer to achieving health equity and improving cancer outcomes for all.
Citation Format: JoAnn Smith, Juan Keyho, Rhonda Moore, Janeth Sanchez. Exploring disparities in cancer disease cohort prevalence: Unpacking Hispanic heterogeneity within All of Us [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A085.