Abstract B127: The impact of sociodemographic and lifestyle factors on the vaginal microbiome and cervical cancer disparities in Native American women
Authors: Joe Tawnjerae , Łaniewski Paweł , Eddie Tristen , Bordeaux Skyler , Quiroz Verity , Cui Haiyan , Roe Denise , Peace Donna , Caporaso J. Gregory , Lee Naomi , Herbst-Kralovetz Melissa M. 
Published: December 2023

Abstract
Cervical cancer morbidity and mortality are continually experienced by Native American women compared to white women. Human papillomavirus (HPV) is the most common sexually transmitted infection and can cause cervical cancer in women when HPV is not cleared by an individual. Depletion of Lactobacillus species in the vaginal microbiome (VMB) is linked to HPV acquisition and persistence of HPV infection and development/progression of cervical neoplasm. Most Lactobacillus spp. protect the host against invading pathogens of the genital mucosa, including the cervix. Changes in the VMB composition to dysbiotic anaerobes decrease an individual’s ability to clear HPV, increasing susceptibility to malignancy. Depletion of Lactobacilli is associated with race and ethnicity, despite research showing genetics to be statistically similar across ethnicities. However, there may be other factors that drive changes in the microbiome, including demographic, socio-economic, lifestyle and sexual & reproductive health factors. Here, we aim to determine which demographic, socioeconomic, lifestyle and sexual & reproductive health factors impact the microbial community within the VMB, regardless of race and ethnicity. These factors have not been studied in the context and inclusion of NA women. In this study, 31 women at the Native American for Community Action Clinic in Flagstaff, Arizona, U.S. were enrolled, and participants completed self-reported surveys. The survey assessed the individual’s socioeconomic, demographics, lifestyle, reproductive health, as well as their knowledge on HPV and VMB. Vaginal swabs were also collected for microbiome analysis via 16S rRNA sequencing. Surveys were collected and stored in REDCap. Surveys were statistically analyzed using t-test, Fisher’s exact, or Chi-square tests. Most women identified as NA (n=16), white (n=13), and Hispanic (n=5). We identified bacterial profiles of 28 of the 31 participants to be Lactobacillus-dominant (n=16) and non-Lactobacillus-dominant (n=12) and stratified them into two groups. Significant differences were observed, suggesting association of multiple people in a household (p=0.0228), lower level of education (p=0.0093), and high parity (p=0.0283) to undesirable non-Lactobacillus-dominant VMB. It is noteworthy that there were no differences between groups regarding race/ethnicity, age, body mass index, marital status, employment status, household income, hrHPV positivity, vaccination status, use of contraceptives, sexual activity, number of partners and knowledge of HPV and VMB. Yet, the non-Lactobacillus group tended to have more women with high-risk HPV infection. Ongoing analysis includes global health and perceived stress data in relation to the VMB and HPV status. Upon full analysis, we will report on trends between the VMB composition and sociodemographic, lifestyle factors and quality of life. The findings will improve ways for people to find solutions to decrease HPV infections and cervical cancer in Native American populations.
Citation Format: Tawnjerae Joe, Paweł Łaniewski, Tristen Eddie, Skyler Bordeaux, Verity Quiroz, Haiyan Cui, Denise Roe, Donna Peace, J. Gregory Caporaso, Naomi Lee, Melissa M. Herbst-Kralovetz. The impact of sociodemographic and lifestyle factors on the vaginal microbiome and cervical cancer disparities in Native American women [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B127.