Ongoing cancer research mainly focuses on disparities and equity

Years of cancer research continues to yield valuable insight and life-saving measures. The topic of cancer disparities and equity, which aims to understand why some groups of people may be more or less likely to develop cancer, experience cancer-related health problems, or have less frequent use of screening tests than other groups of people, is one of many research areas being explored and critical to progress against the disease.

To highlight the importance of lifesaving cancer research, National Cancer Research Month, led by the American Association for Cancer Research (AACR), is recognized during May. Rutgers Cancer Institute of New Jersey together with RWJBarnabas Health, the state's only National Cancer Institute-designated Comprehensive Cancer Center, has curated a selection of ongoing research focusing on cancer disparities which features members from the Cancer Health Equity Center of Excellence.

Elisa V. Bandera, MD, PhD

The research: Association of Body Mass Index, Central Obesity, and Body Composition With Mortality Among Black Breast Cancer Survivors (doi:10.1001/jamaoncol.2021.1499)

Why it's important: "Obesity is very common, particularly among Black women, and has been shown to have a major impact on cancer risk and survival. The majority of previous studies based the assessment of obesity on body mass index (BMI), a measure calculated from weight and height. However, we know that BMI is not a perfect tool because it does not capture body fat distribution or body composition. For example, where fat accumulates in the body is important, and women who have higher waist circumference (i.e., central obesity), have higher cardiometabolic risk. However, few studies have evaluated associations of central adiposity and percent body fat with mortality after a breast cancer diagnosis among Black women. Our study showed that very simple measures of waist and hip circumferences can identify Black breast cancer survivors at higher risk of mortality, which can be easily implemented in clinical practice in survivorship plans for breast cancer survivors."

Denalee O'Malley, PhD

The research: Currently exploring racial and ethnic disparities in colorectal cancer screening among patients with diabetes in primary care safety-net settings.

Why it's important: "Screening for colorectal cancer (CRC) is a cost-effective way to reduce diagnosis and improve early detection. When colorectal cancer is detected early, there are improvements in both the quality and quantity of life. For example, colonoscopies can detect polyps before they become cancer and remove them preventing a potential colorectal cancer diagnosis. There are long-standing disparities in CRC screening with non-Hispanic Blacks and Hispanic populations receiving less screening than non-Hispanic whites. Non-Hispanic Black and Hispanic populations have a greater burden of diabetes and patients with diabetes have a 27% greater lifetime risk of developing colorectal cancer. We know that opportunities are missed to prevent CRCs in priority populations disproportionately. My research investigates strategies to prioritize CRC screening in primary care "safety-net" settings for patients with diabetes. The goal is to provide additional supports to ensure that patients with greater risk of CRC receive screenings at the appropriate intervals to address known cancer disparities. For example, non-Hispanic Black colorectal cancer patients have lower survival rates and are more likely to be diagnosed at advanced stages compared to non-Hispanic White patients. This research is designed to optimize and test cancer prevention strategies in populations with greater chronic disease burden and social needs by developing implement strategies that promote equitable screening to prevent loss of life."

Shawna V. Hudson, PhD

The research: Strategies for conducting complex clinical trials in diverse community practices (DOI: 10.1097/MLR.0b013e31814847a0)

Why it's important: "Many system-level quality improvement trials in U.S. primary care practices are conducted in large health systems and in academic medical centers that are well resourced. While important learnings have come from these studies their applicability to less resourced, diverse practice settings are limited. This study focused on recruiting a range of smaller, independent primary care practices with racial/ethnically diverse practice champions, leadership and patient populations served to understand their needs as participants in clinical research. We developed a structure and activities for relationship building and through our engagement found the importance and impact of consistent communication, sharing information in a timely manner, evolving a diverse research team, and providing technical assistance. These were important strategies for developing and cultivating long-term relationships with practice members that kept study engagement high."

Bo Qin, PhD

The research: Multilevel Factors for Adiposity Change in a Population-Based Prospective Study of Black Breast Cancer Survivors (DOI: 10.1200/JCO.21.02973)

Why it's important: "Weight gain and unintentional weight loss after breast cancer diagnosis are known to predict higher mortality and pose challenges for the clinical management of breast cancer. There has been great interest in identifying risk factors for weight change after a breast cancer diagnosis. Unfortunately, prior studies have focused on individual-level factors. Individual-level behaviors and decision making are often shaped by the surrounding social and built environment. Ignoring the upstream risk factors may inhibit the success or sustainability of weight management strategies, especially for patients who are unable to comply with recommendations from cancer care providers due to residential neighborhood factors beyond their control. Our study shows that both individual and neighborhood factors are clinically meaningful in identifying cancer survivors at a higher risk of unfavorable weight change, providing insight into weight management strategies and community actions."

Nur Zeinomar, PhD, MPH

The research: Association of pre-diagnostic cigarette smoking and alcohol consumption with mortality in Black breast cancer survivors (DOI: https://doi.org/10.1158/1538-7755.DISP21-PO-205)

Why it's important: "There is limited data about how lifestyle factors are associated with breast cancer prognosis in Black women, as the majority of evidence is based on studies in White breast cancer survivors. For example, currently smoking at the time of a breast cancer diagnosis has been associated with increased risk of breast cancer-specific and all-cause mortality, however it is unclear how this varies by race and ethnicity. Given the 40% increased risk of death for Black women diagnosed with breast cancer compared to non-Hispanic White women, better understanding how these modifiable risk factors are associated with prognosis is important for clinical recommendations and management following a breast cancer diagnosis."

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