New study aims to better understand major factors affecting African American cancer survivors

The Karmanos Cancer Institute and Wayne State University School of Medicine will launch the nation's largest study of African American cancer survivors to better understand disproportionately high incidence and mortality from cancer and its impact on this specific patient population.

The study is being funded with a five-year, $9 million grant from the National Cancer Institute (NCI). Principal Investigators Ann G. Schwartz, Ph.D., M.P.H., professor and deputy center director, and Terrance Albrecht, Ph.D., professor and associate director for population sciences at Karmanos and Wayne State, will lead the research.

According to Drs. Schwartz and Albrecht, the Detroit Research on Cancer Survivors (Detroit ROCS) study will include 5,560 cancer survivors to better understand major factors affecting cancer progression, recurrence, mortality and quality of life in African American cancer survivors.

African Americans continue to experience disproportionately higher cancer incidence rates than other racial/ethnic groups in the United States. They are also diagnosed with more advanced-stage disease and experience higher cancer mortality rates than other groups.

"Disparities in cancer survivorship that disproportionately burden African Americans are the product of the complex interactions occurring among genetic and biological factors and social, behavior and environmental factors," Dr. Schwartz said. "It is crucial that we better understand why African Americans are often diagnosed with cancer at higher rates and why survival after that diagnosis is lower than in other populations.

"This study represents a critically important opportunity to bring together the extraordinary expertise of our population scientists and our laboratories and resources at Karmanos and the Wayne State School of Medicine. We will use the knowledge gained through this study to improve treatment outcomes, thereby improving survival."

The Detroit ROCS study will focus on lung, breast, prostate and colorectal cancers -- the four most common cancers -- each of which is marked by poorer survival rates among African Americans than whites.

Multiple factors contribute to poorer survival among African Americans with cancer, but most studies lack enough participants to adequately study these factors. Researchers at Karmanos and the Wayne State School of Medicine will investigate the factors that may affect cancer survival such as type of treatment, genetics, social structures, support, neighborhood context, poverty, stress, racial discrimination, literacy, quality of life and behaviors such as smoking, alcohol use, diet and physical activity.

"Race disparities in cancer outcomes result at least in part from preventable or modifiable factors such as the ability to access and utilize care and also obtain other necessary health care services and resources," said Dr. Albrecht. "This project will provide an infrastructure for designing and conducting an array of studies to reduce disparities and will ultimately lead to interventions focused on improving outcomes in African American cancer survivors across the United States."

A unique aspect of this study is the inclusion of 2,780 family members to understand how a cancer diagnosis affects the mental, physical and financial health of those providing care.

Detroit ROCS leverages the Detroit area population-based cancer registry, which is part of NCI's Surveillance, Epidemiology and End Results (SEER) program, to identify African Americans who were recently diagnosed with cancer. NCI's SEER program supports cancer registries and provides information on cancer statistics in an effort to reduce the cancer burden among the U.S. population.

Researchers will collect comprehensive data through interviews with participants, information from medical records and collection of biospecimens from participants who live in Wayne, Oakland and Macomb counties. These counties account for more than 70 percent of Michigan's African American population, and approximately 21,000 people in these counties are diagnosed with cancer every year.

The study also brings an added benefit to doctors who treat African American cancer patients.

"Several of our medical oncologists are directly involved in the study and together we are already developing training programs for our residents, fellows and community oncologists," Dr. Albrecht said. "These programs will be directly informed by what we learn about survivorship from this large group of African American cancer survivors."

Karmanos and Wayne State University have a long-time partnership in conducting cancer-related research within minority populations living in metro Detroit. Gerold Bepler, M.D., Ph.D., Karmanos president and CEO, said this project will further extend this legacy.

"As a National Cancer Institute-designated comprehensive cancer center, an important area of our focus is on population studies and disparities research," said Dr. Bepler. "We are uniquely prepared to conduct cutting-edge research because of the rich and productive synergistic collaborations among our genetic and molecular epidemiologists and our social and behavioral scientists at Karmanos and Wayne State University School of Medicine."

"This study is critical to ensuring that underserved populations in Detroit and around the country benefit from new approaches for cancer diagnosis, treatment, and prevention," said Dr. M. Roy Wilson, president of Wayne State University. "Focusing on the complex factors that generate disparities in cancer among underserved populations, such as African Americans, will lead to better treatments and improved approaches to cancer care for all Americans."