#21 - A salivary hormonal study on individuals of African ancestry living in different socio-economic environments, in order to understand etiology of prostate cancer

Prostate cancer ranks high among some of the most serious public health problems that significantly impact the lives of men globally. Established risk factors for this disease include age, family history, and African ancestry. While the incidence and mortality of prostate cancer have decreased in the US in recent decades, men of African descent are disproportionately affected. To better understand the etiology of prostate cancer among men of African ancestry, this study examined hormonal differences among men of African descent living in different socio-economic environments by using their saliva samples to study their hormone levels. Using ELISA kits specific to either testosterone or cortisol, hormone levels were determined for each individual’s saliva using standards and low and high-quality control samples for validation. The saliva samples collected from individuals living in African countries (n=21) had a mean testosterone concentration of 93.43 pg/mL and standard deviation of 35.924 pg/mL while the mean cortisol concentration was 0.120 mg/dL and the standard deviation was 0.078 mg/dL. The saliva samples collected from individuals with African ancestry in the United States (n=84) had a mean testosterone concentration of 94.680 pg/mL with a standard deviation of 35.218 pg/mL while the mean cortisol concentration was found to be 0.136 mg/dL with a standard deviation of 0.101 mg/dL. This poster will explain data collected for both hormones for males living in African countries and the United States and will discuss whether these hormone levels can be used to determine individuals at risk for prostate cancer. Any observed effects from socio-economic differences will also be discussed

PSYCHOSOCIAL IMPACT OF COVID-19 ON STUDENTS AT INSTITUTIONS OF HIGHER LEARNING

Students at higher institutions of learning are more susceptible to psychosocial problems compared to the general public. These may further be exacerbated by the measures put in place to curb the spread of COVID-19. This mixed methods study examined the factors associated with the psychosocial impact of COVID-19 on students’ financial stability, interpersonal relationships and worries related to achieving academic milestones. Data comprised of a series of closed and open-ended questions collected via Qualtrics from students in the United States and Africa (Central and West). The quantitative data were analyzed using frequency counts, percentages and chi-square, while the qualitative data was analyzed using thematic content analysis. More than 90% of the students resided in the United States, 72.5% were females and 78.4% were undergraduates. Financial hardship was experienced by 26.4% of the students, 55.8% indicated that COVID-19 negatively affected their relationship with friends and over 40% worried over delays in achieving academic milestones. Continent of residence, employment status and financial hardship were significantly associated with the negative impact of COVID-19 on one or more of the students’ relationships and with worries about achieving academic milestones. Qualitative data support the findings that financial hardship contributed to experience of psychological distress by students. It also revealed negative (compromised relationships – broken or fractured relationships and loneliness) and positive (bonding) impact of COVID-19 on interpersonal relationships. School administrators should provide students with resources to access economic relief packages and tele-counseling services to help meet their financial and psychosocial support needs amidst COVID-19.  Article visualizations

Development of a Minority Prostate Cancer Research Digest: Communication Strategy Statement for Black Men

Since prostate cancer incidence, prevalence and mortality are still highest among Black men in the United States, it is important to effectively address the factors that contribute to prostate cancer disparities in this at-risk population as well as their low participation in biomedical research/clinical trials. An effective communication strategy that can be used to disseminate information with high public health impact to Black men is one way to combat prostate cancer disparities. The objective of this study was to develop a Minority Prostate Cancer (MiCaP) research communication strategy using focus group methodology and expert in-depth interviews. The communication strategy statement developed in this study provides a guide for message concepts and materials for Black men, including communication content, source, channel, and location. Specifically, it provides recommendations on how to deliver information, how to choose the language and relevant images, how to gain attention, who is preferred to deliver messages, and other ways to engage Black men in health communication strategies. The communication strategy statement was used to develop the MiCaP Research Digest, a research communication program that is currently being tested in Orange County, Duval County, Leon County, Gadsden County, and the Tampa Bay area of Florida

Standardized Global Behavioral and Epidemiological Measures for Prostate Cancer Studies in Black Men

Multicenter trans-national studies may be required to understand the complex causes of and solutions to prostate cancer disparities in Black men. In 2014, two cancer epidemiology consortia supported by the US National Cancer Institute (NCI) - the Prostate Cancer Transatlantic Consortium (CaPTC), and African-Caribbean Cancer Consortium (AC3) - formed a consortia alliance to address the disproportionate burden of prostate cancer in Black men. As part of the alliance, this global study focused on developing standardized and culturally tailored data elements and measures for prostate cancer research in these populations.  The study objective was achieved by a Consensus Working Group using the NCI–Grid-Enable Measures (GEM) platform. The Consensus Working Group members were assigned to three Special Interest Groups to focus on behavioral, epidemiology and clinical topics. Based on crowd-sourcing methodology, the initial standardization decisions were made by each group using GEM. This was followed using nominal group technique to build consensus. Finally, a one-day consensus development conference was held to facilitate the input of the scientific community. The use of the GEM platform, nominal group technique and a consensus development conference resulted in agreement among stakeholders for a recommended set of measures that included 25 behavioral scales and 24 epidemiological scales. The measures developed in this process will facilitate data harmonization and data sharing for multiethnic studies of Black men globally and these measures can be used by other researchers in this are

Overcoming Barriers in Conducting a Transatlantic Prostate Cancer Familial Study in Africa: Best Practice from the CaPTC Cohort Study

Conducting prostate cancer research, especially prospective data collection in Africa, has numerous challenges. Some of the difficulties stem from socio-cultural factors that consider sensitive topics about men’s health as taboo. Our primary aim was determine how to overcome barriers in conducting a transatlantic prostate cancer familial study in African males.Key research personnel of the CaPTC Transatlantic Prostate Cancer Familial Project were surveyed about their experiences in implementing the study. The data from the survey was analyzed using SPSS version 18. A total of 15 key study personnel responded to the survey. About 73% of the respondents reported that the participants requested a home or office visit rather than visit a data collection center. Eighty percent (80%) of the respondents reported that the participants had no preference for interviewer gender. The majority (80%) of the interviewers agreed that answers to questions about participants’ sexuality were most challenging to obtain, but with an in-depth explanation of the importance of the study and assurance of privacy, the answers were obtained. The best practice for engaging the community for research include community mobilization through sensitization visits and one-on-one talks, use of community ‘gatekeepers’, introduction by relatives, assurance of privacy of health data obtained, the use of incentives and a promise to give feedback on the results of the study both on a personal and community level

Tumor only analysis of whole exome sequencing from a multi-institutional Nigerian prostate cancer cohort reveals DNA repair genes associated with African ancestry

Men of African ancestry (MAA) have the highest global incidence and mortality of prostate cancer (PCa); however, the biology underlying this harsh disease presentation remains poorly understand, largely due to Africans and people within the African diaspora being under-represented in genomics research. MAA are younger at diagnosis, have higher tumor volume at diagnosis and have higher tumor aggression compared to European American men. Additionally, genomic profiling continues to show that PCa etiology and phenotype are influenced by higher amounts of African ancestry and that West African ancestry is associated with unique genomic alterations. Herein we utilize whole exome sequencing of a unique cohort of 45 advanced stage, treatment naïve Nigerian primary PCa tumors and 11 unmatched non-tumor tissue to compare genomic variants with African (AA) and European (EA) American TCGA PCa tumors. Nigerian samples were collected from 6 sites in central and southwest Nigeria. After whole exome sequencing, samples were processed using GATK best practices. Four genes [BRCA1 (100%), BARD1 (45%), BRCA2 (27%) and PMS2 (18%)] had germline variants in at least two Nigerian non-tumor samples. Across 111 germline variants, the AA cohort reflected a pattern [BRCA1 (68%), BARD1 (34%), BRCA2 (28%) and PMS2 (16%)] similar to Nigerian samples. Of the most frequently mutated genes, BRCA1 showed a statistically (p ≤ 0.05) higher mutation frequency in MAA. Disaggregating gene level mutation frequencies by variant revealed both ancestry linked and Nigerian specific germline variant patterns. Driven by rs799917, BRCA1 showed increasing mutation frequency as African admixture increased. BRCA2_rs11571831 was only present in MAA and BRCA2_rs766173 was increased in Nigerian men. 133 somatic variants were present in 26 PCa associated genes within the Nigerian tumor cohort. Nine genes [BRCA2 (27%), APC (20%), ATM (20%), BRCA1 (13%), DNAJC6 (13%), EGFR (13%), MAD1L1 (13%), MLH1 (11%) and PMS2 (11%)] showed mutation frequencies above 10%. Compared to TCGA cohorts, BRCA2, APC and BRCA1 showed statistically significant increases in Nigerian tumors. The Nigerian cohort variant pattern shared similarities (cosign similarities ≥ 0.734) with COSMIC signatures 5 and 6 and mutated genes showed significant (q < 0.001) GO and functional enrichment in mismatch repair and non-homologous repair deficiency (HRD) pathways. Here, we show that variants in DDR genes are increased in Nigerian PCa and that a portion of those variants correlate with increased African ancestry. Moreover, we identify variants of unknown significance that may contribute to population specific routes of tumorigenesis and treatment. These results present the most comprehensive characterization of the Nigerian PCa exome to date and further highlight the need to increase study population diversity

Utility of formalin-fixed, paraffin-embedded prostate biospecimens from low-resource settings for use in next-generation sequencing studies in African-descent populations

# Background Men of African ancestry experience higher burden from prostate cancer compared to men of other ancestral backgrounds. Limitations in the availability of high-quality biospecimens hinder the inclusion of this population in genetic studies of prostate cancer. The use of formalin-fixed paraffin-embedded (FFPE) tissues represent a potential rich source of genetic material particularly in some international settings, where fresh frozen tissue is difficult to obtain. In this study, we investigate the feasibility of using FFPE biospecimens acquired from various international sites for utility in next-generation sequencing. # Methods A total of 976 FFPE blocks were collected between 2002 and 2017 from six international sites in Africa and the Caribbean representing three consortia: Prostate Cancer Transatlantic Consortium; African-Caribbean Cancer Consortium; and Men of African Descent and Carcinoma of the Prostate. Genomic DNA was checked for quality and quantity. Differences in mean quality control (QC) for pre-and-post pathology training were assessed using t-test. Pearson chi-square with trend analysis examined association between time-category and QC success status. Association of continuous DNA quality (Q129/Q41 ratio) and time of specimen collection was estimated with linear regression. Samples with a DNA quantity \>0.2µg and a Q129/Q41 ratio \>0.00225 were submitted for whole exome sequencing (WES). # Results There was a positive relative percentage change in DNA quantity from 2002 to 2017 for Jamaica, Kenya and Senegal. There was a decline in DNA quantity over the same time period for Nigeria. There was a statistically significant improvement in quality of samples from Kenya (*P*=0.032), Nigeria (*P*\<.001) and Senegal (*P*=0.043). There was a significant improvement in the collected DNA sample quality over time with an R^2^ of 0.12. # Conclusions FFPE samples from low-resource settings could potentially provide sufficient DNA for WES. Improvements in biospecimen collection processing and storage for research are needed in some of these settings