Racial disparities in lung adenocarcinoma: The contribution of African ancestry.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 8516-8516
Author(s):  
Michelle Jeung-Eun Lee ◽  
Eric Chang ◽  
Manan Shah ◽  
Sanjay R. Jain
Keyword(s):  
Lung Cancer ◽  
Native American ◽  
African Americans ◽  
Racial Disparities ◽  
Racial Differences ◽  
African Ancestry ◽  
Genetic Alterations ◽  
Cancer Genome ◽  
Genetic Ancestry ◽  
Genomic Study

8516 Background: Racial disparities in lung cancer are well-known with African Americans disproportionally affected by lung cancer in terms of incidence and survival. Previous comparative analyses of molecular features of lung cancer revealed racial differences in genomic profiles, which supports somatic differences arising from genetic ancestry. Using The Cancer Genome Atlas (TCGA), we investigated the genetic alterations in lung adenocarcinomas (LUAD) on individuals of African (AFR) ancestry. Methods: The genomic and clinical data of TCGA PanCancer Atlas LUAD were downloaded through the GDC Data Portal. Given that substantial proportion of the US population consist of genetically admixed populations, we utilized The Cancer Genome Ancestry Atlas (TCGAA) and LAMP for estimates of genetic ancestry and quantitative ancestral compositions. This dataset contains 518 samples, including 393 self-reported whites and 52 African Americans. For each case the proportion of European, AFR, East Asian, native American ancestry was estimated. The dominant ancestry was defined as ≥50% of admixture from one reference population. Differences in gene mutation frequency were analyzed based on AFR ancestry proportion. The Kaplan-Meier curves were generated, and Cox regression analyses were performed. Results: Global ancestry analysis identified 50 AFR ancestry cases with mean ancestry of 78.3%. The dominant AFR ancestry group matched the self-reported race with 96% accuracy. We identified 9 subjects with ≥90% AFR ancestry, 22 subjects with 80-90% AFR ancestry, 12 subjects with 70-80% AFR ancestry, and 7 subjects with 50-70% AFR ancestry. TP53 was the most frequently mutated gene, and ≥90% AFR ancestry had the highest rate of mutations (77.8%) compared with 80-90% AFR ancestry (68.2%), and 70-80% AFR ancestry (66.8%). We evaluated classic driver gene mutations (EGFR, KRAS, NRAS, PIK3CA, ALK) and found only 33% of ≥90% AFR ancestry subjects carry a known driver mutation, compared to 58-77% in lower proportion of AFR ancestry subjects. Higher AFR ancestry was associated with worse overall survival (OS) and progression free survival (PFS). Median OS was 14.5 months for ≥90% AFR ancestry compared to 71.47 months in 70-80% AFR ancestry (P = 0.048). ≥90% AFR ancestry had median PFS of 12.8 months compared to 33.5 months in 80-90% AFR ancestry, and 47.1 months in 70-80% AFR ancestry (P = 0.002). Conclusions: This study demonstrates the power of genomic study to investigate the etiology of health disparities by analyzing the effect of ancestry on genetic alterations in LUAD. Our results reveal different mutation loads even among AFR ancestry patients. We observed that AFR ancestry is associated with worse OS, suggesting possible influence of germline ancestry in subsequent somatic alterations. Further work is needed to explore how genetic ancestry impacts tumorigenesis and cancer progression to eliminate lung cancer disparities.

Pan cancer analysis of the intra-tumoral microbiome’s correlation with racial disparities.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 2519-2519
Author(s):  
Wei Tse Li ◽  
Matthew Uzelac ◽  
Jaideep Chakladar ◽  
Lindsay M. Wong ◽  
Aditi Gnanasekar ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
African Americans ◽  
Racial Disparities ◽  
Racial Differences ◽  
Asian Americans ◽  
Environmental Influence ◽  
Microbial Abundance ◽  
Risk Of Death ◽  
Incidence And Mortality ◽  
Starting Point

2519 Background: Microbiome composition can influence cancer development and is moderated by diet, hygiene, sanitation, and other environmental variables. For example, a Mediterranean diet could increase breast Lactobacillus abundance, while the gut microbiome changes dramatically with fructose intake. Recent studies have revealed correlations between microbial abundance and racial disparities in cancer. Given these reports, it is critical to examine whether environmental influences on the microbiome contribute to racial disparities in cancer incidence and prognosis. Methods: We examined the intra-tumoral microbiome in the lungs, breasts, bladder, colon, rectum, cervix, head and neck, prostate, and pancreas (n = 4,169). Raw tumor RNA sequencing data were downloaded from The Cancer Genome Atlas (TCGA) and aligned to bacterial genomes. Microbial abundance was correlated to race, ethnicity, and prognostic variables (Kruskal-Wallis test or Cox regression, p< 0.05). Results: We identified several microbes correlated with racial disparities for breast and bladder cancer, two microbes for lung squamous cell carcinoma, and one microbe for colon cancer. For breast cancer, African Americans have the highest mortality rate, followed by white Americans and Asian Americans. We found that four microbes, all under the order Burkholderiales, were positively correlated with poor prognosis and were most abundant in African Americans and least abundant in Asian Americans. Therefore, increased abundance of these microbes may contribute to the observed mortality differences between races. For bladder cancer, Asian Americans have the lowest incidence and mortality rates. Seven microbes, including two Geobacillus, two Pseudomonas, and two Burkholderiales, positively correlate with good prognosis and are upregulated in Asian Americans. High Pseudomonas fluorescens abundance is positively correlated with decreased risk of death (HR: 0.57, 95% CI: 0.38-0.85). High abundance of the Burkholderiales R. pickettii (HR: 0.62, 95% CI: 0.42-0.92) and V. paradoxus (HR: 0.59, 95% CI: 0.36-0.98) also exhibit the same trend. Geobacillus and Pseudomonas are both present in food, while Burkholderiales can cause nosocomial infections and are altered by diet. Conclusions: Our study is the most comprehensive to date investigating racial differences in the intra-tumoral microbiome. Our data serve as a starting point for exploring whether environmental influence of microbial abundance contributes to racial disparities in cancer.

Abstract 491: Racial Disparities in the Trends of Acute Myocardial Infarction Outcomes Among Medicaid Patients, 2007-2011

2017 ◽  
Vol 37 (suppl_1) ◽  
Author(s):  
Oluwole M Adegbala ◽  
Akintunde Akinjero ◽  
Samson Alliu ◽  
Adeyinka C Adejumo ◽  
Emmanuel Akintoye ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
African Americans ◽  
Length Of Stay ◽  
Hospital Mortality ◽  
Racial Disparities ◽  
Racial Differences ◽  
Length Of Hospital Stay ◽  
The United States ◽  
Racial Groups

Background: Although, in-hospital mortality from acute myocardial infarction (AMI) have declined in the United States recently, there is a gap in knowledge regarding racial differences in this trend. We sought to evaluate the effect of race on the trends in outcomes after Acute Myocardial Infarction among Medicaid patients in a nationwide cohort from 2007-2011 Methods: We extracted data from the Nationwide Inpatient Sample (NIS) for all hospitalizations between 2007 and 2011 for Medicaid patients aged 45 years or older with principal diagnosis of AMI using ICD-9-CM codes. Primary outcome of this study was all cause in-hospital mortality. We then stratified hospitalizations by racial groups; Whites, African Americans and Hispanics, and assessed the time trends of in-hospital mortality before and after multivariate analysis. Results: The overall mortality from AMI among Medicaid patients declined during the study period (8.80% in 2007 to 7.46% in 2011). In the adjusted models, compared to 2007, in-hospital mortality from AMI for Medicaid patients decreased across the 3 racial groups; Whites (aOR= 0.88, CI=0.70-0.99), African Americans (aOR=0.76, CI=0.57-1.01), Hispanics (aOR=0.87, CI=0.66-1.25). While the length of hospital stay declined significantly among African American and Hispanic with 2 days and 1.76 days decline respectively, the length of stay remained unchanged for Whites. There was non-significant increase in the incidence of stroke across the various racial groups; Whites (aOR= 1.23, CI=0.90 -1.69), African Americans (aOR=1.10, CI=0.73 -1.64), Hispanics (aOR=1.03, CI=0.68-1.55) when compared to 2007. Conclusion: In this study, we found that in-hospital mortality from AMI among Medicaid patients have declined across the racial groups. However, while the length of stay following AMI declined for African Americans and Hispanics with Medicaid insurance, it has remained unchanged for Whites. Future studies are necessary to identify determinants of these significant racial disparities in outcomes for AMI.

scholarly journals Racial/Ethnic Differences in Lung Cancer Incidence in the Multiethnic Cohort Study: An Update

2019 ◽  
Vol 111 (8) ◽  
pp. 811-819 ◽  
Author(s):  
Daniel O Stram ◽  
S Lani Park ◽  
Christopher A Haiman ◽  
Sharon E Murphy ◽  
Yesha Patel ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cohort Study ◽  
African Americans ◽  
Cancer Risk ◽  
Racial Differences ◽  
Lung Cancer Risk ◽  
Native Hawaiians ◽  
Japanese Americans ◽  
Urinary Biomarker ◽  
Multiethnic Cohort

Abstract Background We previously found that African Americans and Native Hawaiians were at highest lung cancer risk compared with Japanese Americans and Latinos; whites were midway in risk. These differences were more evident at relatively low levels of smoking intensity, fewer than 20 cigarettes per day (CPD), than at higher intensity. Methods We apportioned lung cancer risk into three parts: age-specific background risk (among never smokers), an excess relative risk term for cumulative smoking, and modifiers of the smoking effect: race and years-quit smoking. We also explored the effect of replacing self-reports of CPD with a urinary biomarker—total nicotine equivalents—using data from a urinary biomarker substudy. Results Total lung cancers increased from 1979 to 4993 compared to earlier analysis. Estimated excess relative risks for lung cancer due to smoking for 50 years at 10 CPD (25 pack-years) ranged from 21.9 (95% CI = 18.0 to 25.8) for Native Hawaiians to 8.0 (95% CI = 6.6 to 9.4) for Latinos over the five groups. The risk from smoking was higher for squamous cell carcinomas and small cell cancers than for adenocarcinomas. Racial differences consistent with earlier patterns were seen for overall cancer and for cancer subtypes. Adjusting for predicted total nicotine equivalents, Japanese Americans no longer exhibit a lower risk, and African Americans are no longer at higher risk, compared to whites. Striking risk differences between Native Hawaiians and Latinos persist. Conclusions Racial differences in lung cancer risk persist in the Multiethnic Cohort study that are not easily explained by variations in self-reported or urinary biomarker-measured smoking intensities.

Marital Status and Sexually Transmitted Infections Among African Americans

2010 ◽  
Vol 31 (9) ◽  
pp. 1147-1165 ◽  
Author(s):  
Eboni M. Taylor ◽  
Adaora A. Adimora ◽  
Victor J. Schoenbach
Keyword(s):  
African Americans ◽  
Marital Status ◽  
Racial Disparities ◽  
Racial Differences ◽  
Risk Behaviors ◽  
Ethnic Disparities ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Marriage Rates ◽  
Racial Ethnic

This article assesses the relationship between low marriage rates and racial disparities in sexually transmitted infection (STI) rates. Data from the 2002 National Survey of Family Growth was used to examine the prevalence of sexual risk behaviors by marital status. Logistic regression was used to examine whether racial differences in marriage patterns help account for racial disparities in STI rates. Results indicate that the 12-month prevalence of multiple partners and high-risk partnerships was lowest among currently married, intermediate among cohabiting, and highest among formerly and never-married respondents. Of all racial/ethnic groups, African Americans were least likely to be married. In multiple logistic analyses adjustment for marriage attenuated the association between race and STI risk behaviors for African Americans. Low marriage rates may be an important contributing factor to racial/ethnic disparities in STI rates, particularly for African Americans.

scholarly journals New Evidence on the Biobehavioral Mechanisms of Chronic Pain in Aging African Americans

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 784-784
Author(s):  
Staja Booker
Keyword(s):  
Older Adults ◽  
Chronic Pain ◽  
African Americans ◽  
Racial Differences ◽  
Pain Catastrophizing ◽  
Later Life ◽  
Genetic Alterations ◽  
Cross Sectional ◽  
Older African Americans ◽  
New Evidence

Abstract African American older adults are living longer with chronic pain, which presents a huge personal and societal burden. A growing group of scholars are now devoted to accurately and precisely characterizing and phenotyping the experience of pain in aging using within-group and advanced methodological designs to elucidate the biopsychosocial-behavioral responses to pain. In this symposium, five dynamic presenters present new evidence on mechanisms of pain in older African-Americans. Dr. Roach’s investigation reveals the effect of genetic alterations of sickle cell disease (SCD) on stress-related pain in younger and older adults; this scientific inquiry is especially important because there is little research on SCD in aging. Next, Dr. Terry, extends these findings by exploring the association between psychosocial factors such as experiences of discrimination, pain catastrophizing, and perceived stress on neural (brain) responses via magnetic resonance imaging. From a clinical perspective, Dr. Booker reports on the first-ever model of intra-racial differences in movement-evoked pain in older African-Americans with knee osteoarthritis and healthy controls. Our final two presenters use a translational approach to identify how older African-Americans cope with chronic pain. Dr. Robinson-Lane’s study highlights the unique experience and predictors of coping, adaptation, and self-management of chronic pain in Black dementia caregivers. Finally, Dr. Cobb’s research from a large cross-sectional study correlates social, behavioral, and health factors with opioid and psychotropic use in economically disadvantaged older African-Americans. This symposium offers novel ways of understanding social determinants of pain and assisting African-Americans and their caregivers to manage complex chronic pain in later life.

Disparities in esophageal cancer care based on race: a National Cancer Database analysis

2021 ◽  
Author(s):  
Ikenna C Okereke ◽  
Jordan Westra ◽  
Douglas Tyler ◽  
Suzanne Klimberg ◽  
Daniel Jupiter ◽  
...  
Keyword(s):  
Overall Survival ◽  
Esophageal Cancer ◽  
African Americans ◽  
Racial Disparities ◽  
Cancer Patients ◽  
Racial Differences ◽  
Tumor Biology ◽  
High Volume ◽  
National Cancer Database ◽  
Survival Difference

Summary Esophageal cancer is one of the most common cancer killers in our country. The effects of racial disparities on care for esophageal cancer patients are incompletely understood. Using the National Cancer Database, we investigated racial disparities in treatment and outcome of esophageal cancer patients. The National Cancer Database was queried from 2004 to 2017. Logistic regression and survival analysis were used to determine racial differences in access, treatment and outcome. A total of 127,098 patients were included. All minority groups were more likely to be diagnosed at advanced stages versus Caucasians after adjusting for covariates (African American OR—1.64 [95% confidence interval 1.53—1.76], Hispanic OR—1.19 [1.08—1.32], Asian OR—1.78 [1.55—2.06]). After adjustment, all minorities were less likely at every stage to receive surgery. Despite these disparities, Hispanics and Asians had improved survival compared with Caucasians. African Americans had worse survival. Racial disparities for receiving surgery were present in both academic and community institutions, and at high-volume and low-volume institutions. Surgery partially mediated the survival difference between African Americans and Caucasians (HR—1.13 [1.10–1.16] and HR—1.04 [1.02–1.07], without and with adjustment of surgery).There are racial disparities in the treatment of esophageal cancer. Despite these disparities, Hispanics and Asians have improved overall survival versus Caucasians. African Americans have the worst overall survival. Racial disparities likely affect outcome in esophageal cancer. But other factors, such as epigenetics and tumor biology, may correlate more strongly with outcome for patients with esophageal cancer.

Impact of African ancestry on the relationship between BMI and survival in early stage breast cancer: Retrospective analysis from E5103.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 1010-1010
Author(s):  
Tarah Jean Ballinger ◽  
Guanglong Jiang ◽  
Fei Shen ◽  
Kathy Miller ◽  
Bryan P. Schneider
Keyword(s):  
Breast Cancer ◽  
Racial Disparities ◽  
Early Stage ◽  
African Ancestry ◽  
Genetic Ancestry ◽  
Early Stage Breast Cancer ◽  
European Ancestry ◽  
A Genome ◽  
The Impact ◽  
The Relationship

1010 Background: Both Black race and obesity are associated with worse survival in early stage breast cancer. Obesity disproportionately affects Black women; however, the degree this contributes to racial disparities in breast cancer remains unclear. Prior work evaluated heterogeneous populations or used self- reported race, rather than genetic ancestry. African ancestry is associated with higher BMI and worse survival in breast cancer; however, the intersection between genetic ancestry and obesity on survival outcomes remains unknown. Methods: We analyzed data from the adjuvant trial E5103. Patients with high risk, HER2 negative breast cancer received doxorubicin/cyclophosphamide x 4, followed by weekly paclitaxel x 12, with or without bevacizumab. Genetic ancestry was determined on the 2,854 patients with available germline DNA, BMI, and outcome data using principal components from a genome-wide array. The primary objective assessed impact of BMI on DFS and OS by ancestry. Multivariate Cox proportional hazard models evaluated correlation between continuous or binary BMI and survival in African (AA) and European (EA) Americans. Results: 13.4% of patients were genetically classified as AA and 86.6% as EA. Higher continuous BMI was significantly associated with worse DFS and OS only in AAs (DFS: HR = 1.25 95% CI 1.07-1.46, p = 0.004; OS: HR = 1.38 95% CI 1.10-1.73, p = 0.005); not in EAs (DFS HR = 0.97 95% CI 0.90-1.05, p = 0.50; OS HR = 1.03 95% CI 0.93-1.14, p = 0.52). By disease subtype, BMI was associated with worse outcomes only in AAs with ER+, and not TNBC. By categorical BMI, WHO class III obesity (³ 40) significantly associated with worse DFS and OS only in AAs (DFS HR = 1.98, p = 0.010; OS HR = 2.07, p = 0.064), not in EAs (DFS HR = 0.97, p = 0.86; OS HR = 1.28, p = 0.30). Proportion of African ancestry (proAA) was associated with higher BMI and worse outcomes in the total population; however, within AAs there was no significant interaction between proAA and BMI on DFS (HR = 0.36, p = 0.06) or OS (HR = 0.38, p = 0.24). In AAs, BMI remained associated with DFS (HR = 2.78, p = 0.019), suggesting higher BMI is associated with worse DFS regardless of proAA. Coefficients for the interaction term indicate that as proAA increases the impact of BMI on outcome is lessened. Conclusions: Higher BMI is significantly associated with worse breast cancer outcomes in women of African ancestry in E5103, but not in those of European ancestry. Categorically, this association was significant only for severe obesity, indicating the relationship may depend on the degree of obesity. As proAA increased in AAs, the impact of BMI on outcome was lessened, suggesting other host factors may contribute more to obesity’s influence on outcome than genetics. Determination of the optimal populations for weight loss interventions will advance precision medicine efforts to impact racial disparities and outcomes in early stage breast cancer.

scholarly journals Role of Place in Explaining Racial Heterogeneity in Cognitive Outcomes among Older Adults

2015 ◽  
Vol 21 (9) ◽  
pp. 677-687 ◽  
Author(s):  
Sze Yan Liu ◽  
M. Maria Glymour ◽  
Laura B. Zahodne ◽  
Christopher Weiss ◽  
Jennifer J. Manly
Keyword(s):  
Older Adults ◽  
African American ◽  
African Americans ◽  
Racial Disparities ◽  
Racial Differences ◽  
Cognitive Aging ◽  
School Attendance ◽  
Cognitive Outcomes ◽  
Older Americans ◽  
Years Of Schooling

AbstractRacially patterned disadvantage in Southern states, especially during the formative years of primary school, may contribute to enduring disparities in adult cognitive outcomes. Drawing on a lifecourse perspective, we examine whether state of school attendance affects cognitive outcomes in older adults and partially contributes to persistent racial disparities. Using data from older African American and white participants in the national Health and Retirement Study (HRS) and the New York based Washington Heights Inwood Cognitive Aging Project (WHICAP), we estimated age-and gender-adjusted multilevel models with random effects for states predicting years of education and cognitive outcomes (e.g., memory and vocabulary). We summarized the proportion of variation in outcomes attributable to state of school attendance and compared the magnitude of racial disparities across states. Among WHICAP African Americans, state of school attendance accounted for 9% of the variance in years of schooling, 6% of memory, and 12% of language. Among HRS African Americans, state of school attendance accounted for 13% of the variance in years of schooling and also contributed to variance in cognitive function (7%), memory (2%), and vocabulary (12%). Random slope models indicated state-level African American and white disparities in every Census region, with the largest racial differences in the South. State of school attendance may contribute to racial disparities in cognitive outcomes among older Americans. Despite tremendous within-state heterogeneity, state of school attendance also accounted for some variability in cognitive outcomes. Racial disparities in older Americans may reflect historical patterns of segregation and differential access to resources such as education. (JINS, 2015, 21, 677–687)

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