Abstract 4976: Examining the association between chronic inflammation, stress, and resilience factors among diverse breast cancer survivors using the NIH All of Us dataset
Authors: Bathsheba Aklilu, Erica Tate, Cathy Samayoa
Journal: Cancer Research (2025)

Abstract Breast cancer disparities exist by race and ethnicity, including disparities in age at diagnosis, quality of life, and health outcomes. These disparities may be influenced by chronic stress, exacerbated by unique challenges that extend beyond disease management, such as the effects of psychosocial stress and social determinants of health (SDOH) on chronic inflammation. Elevated C-reactive protein (CRP) levels, a marker of chronic inflammation, are implicated in worse health outcomes. Understanding how stress and SDOH interact to influence CRP and other inflammatory biomarkers is critical for addressing disparities in survivorship care. However, most studies lack adequate representation of racial and ethnic minorities; thus, factors associated with chronic inflammation among diverse breast cancer survivors remain unknown. This study aims to investigate factors associated with chronic inflammation among diverse breast cancer survivors using the NIH All of Us research dataset. Using Python, a programming language available within the NIH All of Us research program dataset, we examined CRP and additional inflammatory biomarkers and their relationships with stress, economic, social, and environmental factors. Economic and environmental factors included income, housing security, and neighborhood characteristics. Social and psychological factors included social support, the Perceived Stress Scale (PSS), and the Everyday Discrimination Scale (EDS). Multivariate analyses were conducted to evaluate associations between stress, resilience, SDOH, and inflammation, with stratification by age, BMI, and allostatic load. Preliminary findings reveal significant racial and ethnic disparities in CRP levels. Black and Hispanic breast cancer survivors exhibited the highest CRP levels. We identified 3,110 participants with breast cancer in the All of Us research program dataset. Of those, 7.2% were African American or Black, 2.2% were Asian, and 6.7% were Hispanic. We hypothesize that inflammation will be higher among racial and ethnic minorities, as well as among women with higher levels of stressors, such as low income and increased PSS and EDS scores. Furthermore, we expect inflammation to be negatively associated with resilience factors, such as increased social support and greater neighborhood safety. This study will identify factors associated with chronic inflammation among diverse breast cancer survivors and provide a deeper understanding of the biological mechanisms driving breast cancer health inequities. Citation Format: Bathsheba Aklilu, Erica Tate, Cathy Samayoa. Examining the association between chronic inflammation, stress, and resilience factors among diverse breast cancer survivors using the NIH All of Us dataset [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 4976.