Lack of Disparities in Pharmacogenomics

Based on personal polymorphism and algorithmic interpretation, pharmacogenomics interventions in healthcare are chosen, directing pharmacotherapies in patients. As a part of precision medicine, pharmacogenomics offers a unique chance to set the bar for treating patients as particular individuals with specific needs. Like with any intervention, the benefit-to-risk ratio needs to be considered. Information gaps and people’s lack of knowledge of pharmacogenomics will always be problems, as will their unfamiliarity with the subject. As there are more genes, there are more potential diseases and environmental factors that could mask the impact of genes. As a result, multigene models in vast populations must always be considered for research. There aren’t many studies that look at how pharmacogenomics affects health disparities. Additional research is needed to assess health differences between ethnic groups and nations and within a single country

Interventions Addressing Breast Cancer Mammography Screening Barriers in Non-Hispanic Black Women: An Integrative Review

Breast cancer disparity in Non-Hispanic Black women is a major concern due to higher breast cancer death rates in this population. This integrative review explores interventions aimed at increasing screening mammography in this population. A literature search was conducted of full-text, peer-reviewed articles published over ten years between 2013-2023 using Cumulated Index to Nursing and Allied Health Literature and PubMed. Of the 396 articles identified, nine met the inclusion criteria. The studies identified used various strategies to implement screening interventions in Non-Hispanic Black women that were culturally tailored and considered social determinants of health, barriers to breast cancer screening, engaging community, and patient navigation. These findings suggest that focused interventions should consider the challenges to Non-Hispanic Black women to schedule and complete mammogram screenings. Future research is recommended to conduct interventional studies with Non-Hispanic Black women specifically tailored to meet their needs to promote engagement in the recommended mammography screening guidelines. &nbsp

The CAPCI Network: A CAncer Prostate Consortium of India for Conducting Next-Generation Genomic Sequencing Studies

The CAncer Prostate Consortium of India (CAPCI) was established in September 2020 by a group of researchers and clinicians interested in identifying inherited and somatic risk factors that are related to theonset of prostate cancer (PCa). The consortium aims to improve the patient care and treatment in India byexploring and expanding the utility of genomic repositories associated with PCa. These aims are reached by advancing discovery in genome science particular to Indian phenotypes, translating scientific discoveries to improved standard of care. One of the impending goals of the consortium is to combine the data from the west and other sub-population ancestries, and identify common and exclusive risk profiles associated with PCa in Indian scenarios. These findings would additionally allow us to validate in experimental settings to explore the molecular mechanisms underlying pathogenesis of PCa besides understanding new personalized therapeutic regimens

Strong Tumor Expression of ALDH1A1 is Associated with Black Race, Metabolic Disorders, and Poor Breast Cancer Outcomes

Racial differences in tumor biology may explain worse breast cancer outcomes in Black women relative to White women. This study provides a comparative racial analysis in Black and White women in terms of Aldehyde dehydrogenase 1 member A1 (ALDH1A1) expression and its association to clinicopathological features. Expression of ALDH1A1 in both tumor and stromal cells was assessed by immunohistochemistry in tissue microarrays containing 253 breast tumors including 161 tumors from White patients and 92 from Black patients. Relationships to clinicopathological features for strong and moderate to low ALDH1A1 staining were determined using Pearson’s Chi Square and an odds ratio was determined. Survival and recurrence were analyzed using Kaplan-Meier curves and Mantel Log-Rank tests. Multivariate analysis was conducted using Cox-proportional hazards tests.  Black, obese, and diabetic women showed higher staining intensity in both tumor and stromal tissue. Strong tumor staining was associated with Black race, advanced stage, high grade obesity and diabetes. Strong stromal expression was associated with estrogen receptor positivity, and prediabetes/diabetes. Patients with strong tumor ALDH1A1 had shorter recurrence free and overall survival compared to those with moderate to low expression. When stratified by race, Black women with strong tumor ALDH1A1 expression had shorter recurrence free survival compared to White women. Strong tumor ALDH1A1 staining was an independent predictor of poor overall survival in both Black and White women. These findings indicate that ALDH1A1 expression is associated with poor outcomes in breast cancer, particularly in Black women, and provide the first link between tumor ALDH1A1 expression, obesity, and diabetes

Racial/Ethnic Disparities in Thyroid Cancer Stratified by Risk Factors: A Literature Review: Thyroid Cancer Health Disparities

In the United States, thyroid cancer incidence has increased dramatically within the last few decades. Recent research suggests that this incidence along with cancer stage and mortality vary by race/ethnicity, highlighting health disparities in the United States. There are several risk factors for thyroid cancer incidence that may contribute to these disparities. The goal of this literature review is to analyze whether these potential risk factors impact incidence and aggressiveness differently by race/ethnicity, implicating their possible role in influencing thyroid cancer disparities in the United States. Through PubMed searches, we have reviewed recent literature on U.S. populations. We found that chromosomal alterations/non-hereditary conditions, autoimmunity, thyroid nodules, and socioeconomic differences potentially impacted thyroid cancer incidence and aggressiveness by race/ethnicity, whereas sex disparities did not. Six potential risk factors showed some variations by race/ethnicity but either did not specifically examine their relationship to thyroid cancer or did not impact thyroid cancer incidence and aggressiveness. Three other potential risk factors have not yet been studied regarding their influence on thyroid cancer incidence and outcomes for racial/ethnic groups in the United States. Therefore, we identify a critical need for subsequent research to examine these potential risk factors for different racial/ethnic groups and contribute toward our understanding of racial/ethnic health disparities in the United States. We also present several research areas relating to thyroid cancer health disparities that require further study.    &nbsp

Highlights from First International Conference on Cancer Health Disparities

The first International Conference on Cancer Health Disparities (ICCHD) was held on August 13-14, 2021, in Harlingen, TX, USA. This two-day ICCHD-2021 was organized by the University of Texas Rio Grande Valley, School of Medicine (UTRGV-SOM). About 200 national and international delegates from 10 countries attended this hybrid meeting in person and through online digital methods. The event delegates were representatives from NIH, CPRIT, and the City of Harlingen, in addition to clinicians, faculty, researchers, scientists, bioinformaticians, geneticists, bioethicists, and others. Abstracts were submitted through an online portal, reviewed, and accepted for inclusion in the program. Under the theme of Cancer Health Disparities, this event featured a number of special talks and showcased the work done by researchers from a broad array of disciplines (academia, community, health care) to identify gaps and/or solutions to multi-faceted heath and health disparity issues impacting minority and underserved populations across the country and worldwide. The conference was comprised of six sessions: Session 1: Introduction to the conference and tackling cancer health disparities; Session 2: Elimination of cancer health disparities; Session 3: Cancer cellular and molecular biology; Session 4: Diversity and Inclusion in cancer research: Session 5: Poster and oral presentations; Session 6: Early Career Investigator talks; and an award ceremony and closing remarks. This conference report summarizes the meeting’s content, discussions, and conclusions

Race is Related with Increased COVID-19 Infection and Outcomes in Oncology Patients

We seek to assess racial disparities in oncology patients with COVID19 compared to appropriately matched controls with and without COVID19. All patients treated at the Seidman Cancer Center with a diagnosis of COVID19 and cancer were identified from the electronic medical record using ICD9/ICD10 codes for cancer diagnoses and database of all patients diagnosed with COVID19. Two control groups, cancer patients without COVID19 and patients without cancer but with COVID19, were generated and matched 3:1 on age at date of data extraction, age at cancer diagnosis, and sex to COVID19 positive cancer cases. African Americans (AA) and Whites made up 8.6% vs. 76.9% of the baseline oncologic population without COVID19, respectively. AA representation (41.0%) was significantly increased in cancer patients positive for COVID19 compared to those negative for COVID19 (p<0.001). In the comparison of patients with COVID19 with or without cancer, the proportion of AA cases was greater in the non-oncologic population (41.0% vs. 47.6%, p=0.014). AA are disproportionately affected with COVID19 in oncologic and benign populations. Despite similar rates of adverse outcomes to COVID19 in cancer patients by race, we found a 32.4% increase in the AA proportion compared to those without COVID19. These findings suggest COVID19 prevention policies and future studies should account for racial differences in the oncology population

Breast and Cervical Cancer Disparities in Alabama: Current Scenario, Ongoing Efforts to Reduce the Disparity Gaps, and What More We Could be Doing

Over the years, we have made considerable progress in our understanding of the biology of various cancers leading to advancements in cancer management strategies. Consequently, we have witnessed steady improvement in survival rates of cancer patients post-diagnosis, although the progress has been slow for some cancer types. Moreover, the advances in cancer care have not equally benefited all the minority and ethnic populations residing in the United States. The state of Alabama has one of the most diverse demographics in the country and as a result, we witness significant health disparities among our populations. Breast and cervical cancers are two major cancer types that disparately affect the women in our state. Here, we discuss the extent of disparities in the diagnosis and death rates from these cancers in the state of Alabama and potential underlying causes affecting the health outcomes. We also discuss ongoing efforts undertaken to reduce the disparity gaps and provide a perspective for addressing these disparities more effectively. &nbsp

Racial differences in prostate tumor microenvironment: implications for disparate clinical outcomes and potential opportunities

Disparities in cancer are common among the racial and ethnical minorities in the United States and are of significant social and clinical concern. Prostate cancer is the most commonly diagnosed non-cutaneous malignancy in American men and exhibits substantial racial disparities with African American men bearing the highest burden in terms of incidence and mortality. A multitude of factors, including socioeconomic, behavioral, and access to healthcare, have been implicated as the underlying causes of such disparities. More recent data also suggest that there are inherent genetic and biological differences in prostate tumors of patients having distinct racial backgrounds. Tumor microenvironment has tremendous impact on the course of cancer progression and clinical outcome and may also contribute to the racial disparities observed in prostate cancer. A better understanding of critical differences in the tumor microenvironment components will provide newer directions to study the biological causes of prostate cancer health disparities and may identify novel therapeutic targets. This review discusses the findings related to the tumor microenvironment differences between the of African American and Caucasian American prostate cancer patients to suggest their potential significance in prostate cancer disparities

Intersection of COVID-19, Cancer, and Racial Health Disparities

In this article, the authors explore the intersection between the COVID-19 pandemic with cancer and the health disparities experienced by African Americans. Using extant literature and contemporaneous data, they point out how overlooking the intersections of this triad could lead to the exacerbation of existing disparities for cancer patients based on race and ethnicity. They suggest best practices to balance cancer treatment and survivorship with increasing the potential COVID-19 exposures for patients, families, and health care workers. Drawing upon their analysis, the authors offer a list of recommendations and strategies for system level responses that are designed to foster practice and policy for cancer care health care equity and relate to cancer care equity, infection prevention and control,  and cancer pain management, that may reduce disparities among African Americans