Health Disparities and Health Equity

  • Wei Zheng, Chris Haiman (University of Southern California)  Julie Palmer (Boston University)     
    Funding Agency: NCI      
    Grant Number:  R01CA202981 

    The age-adjusted breast cancer mortality rate is more than 40% higher in African Americans than in whites for reasons poorly understood. To date, genome-wide association studies (GWAS) are mostly conducted in Asian and European descendants. However, only a few of the GWAS-identified risk variants can be directly replicated in African-ancestry women. GWAS are often not equipped to study structural variants and are inefficient for capturing low-frequency variants. These variants, although not yet adequately investigated, may contribute substantially to the heritability of breast cancer. In this consortium, we will generate new genomic data using whole genome sequencing and high-density genotyping arrays and consolidate GWAS data from existing studies to search genetic risk variants for breast cancer. Furthermore, we will evaluate how germline risk variants identified in this study and previous studies affect the major signaling pathways of breast cancer. More than 40,000 breast cancer patients and controls of African descent recruited from >20 studies conducted in the US and Africa will be included in this study. 

  • Loren Lipworth, Immaculata De Vivo, Wendy Setiawan  Margaret Du
    Funding Agency: NCI 
    Grant Number: R01CA250476

    Endometrial cancer is becoming increasingly common, particularly in women with aggressive tumors who have poor outcomes. African American women have higher mortality than other racial/ethnic groups even after accounting for stage, histology, comorbid conditions, and treatment. Here, we will use the largest, most diverse population to date (including >1,000 African American and >2,000 non-African American endometrial cancer patients) in the Epidemiology of Endometrial Cancer Consortium (E2C2) to investigate endometrial tumor genomics, distinct risk factor profiles across tumor types, and the role of underlying tumor biology in driving this large survival disparity. 

  • Yacob Tedla
    Funding: Bristol-Myers Squibb and Pfizer Alliance
    Grant Number: CV185-767

    Recent studies showed racial disparity in the prescription of oral anticoagulants (OAC) and risk of stroke among insured atrial fibrillation patients with access to care. The aims of this project are i) to explore whether patient drug cost-sharing and OAC contraindications explain the racial disparity in prescription of OAC and ii) to investigate whether the patient level of adherence to OAC medications and receiving a non-recommended dosage of OAC explain the racial disparity in the incidence of thromboembolic stroke.

  • Tina Hartert, MD, MPH, James Gern, MD (consortium PI)
    Funding Agency: NCI
    Grant Number:: UH3 OD023282

    CREW will provide a large (nearly 9000 births and long-term follow-up of 6000-7000 children and young adults) and diverse national dataset that will be optimized for systems analysis of early life exposures and events that influence asthma endotypes. The study goals are to establish how environmental and host factors in early life promote the development of specific asthma endotypes.

  • Tina Hartert
    Funding Agency: NIH/NIAID 
    Grant Number: U19 AI 095227 

    Twelve city SARS-CoV-2 surveillance study of household units to understand immune response, transmission, symptomatology and role of asthma and allergies in infection. 

  • Qiuyin Cai, Jirong Long
    Funding Agency: NIMHD    
    Grant Number:  R01MD015396

    To investigate how individual and social contextual factors might affect DNA methylation and biological aging in racial minorities and identify potential mechanisms by which individual and social contextual factors might affect lung cancer risk in AAs and low SES EAs.

  • Wei Zheng, Jirong Long
    Funding Agency: NCI
    Grant Number: R01CA235553 

    Genetic factors play an important role in the etiology of both sporadic and familial breast cancer. Since 2007, common genetic variants in ~200 loci have been identified in genome-wide association studies (GWAS) correlating to breast cancer risk. However, it is often difficult to translate GWAS findings to disease prevention and treatment since causal genes in most GWAS-identified loci are unknown. Furthermore, a large part of breast cancer heritability remains unexplained. We propose a well-powered transcriptome-wide association study (TWAS) to systematically search the whole transcriptome to identify genes associated with breast cancer risk using data from approximately 320,000 breast cancer patients and controls. We will also perform in vitro assays to functionally characterize promising genes identified in TWAS. Finally, we will evaluate whether TWAS-identified genes may contribute to racial differences in breast cancer risk by molecular subtypes. 

  • Christianne Roumie, Carlos G. Grijalva
    Funding Agency: AHRQ
    Grant Number: 1T32HS026122

    This training program provides support for personalized mentoring for projects related to the learning healthcare system paradigm.

  • Qiuyin Cai, Lynn Rosenberg
    Funding Agency: NIH/NCI
    Grant Number:  R01 CA207466 

    To investigate whether oral microbiome may be associated with lung cancer risk among African Americans and European Americans.

  • Song Yao (Roswll Park Cancer Institute), Wei Zheng (VUMC)  John Carpten (USC)  Julie Palmer (Boston University)
    Funding Agency: NIH
    Grant Number: R01CA228156 

    Women of African ancestry are disproportionately afflicted with triple-negative breast cancer (TNBC), and bear the highest mortality rate of all populations from the disease in the U.S. In this research consortium, we propose to characterize the mutational landscape of TNBC in African American women by performing whole-exome sequencing and RNA-sequencing. We will then compare significantly mutated genes and mutational signatures between African- and European-ancestry women. Finally, we will investigate genetic and environmental factors in relation to somatic mutations. This research will greatly advance the field of breast cancer research by characterizing the tumor mutational landscape in African American women and determine whether cancer biology at the somatic mutation level differs by ancestral populations. 

  • Wei Zheng, Martha Shrubsole
    Agency: NIH
    Grant Number: U01CA202979 

    The SCCS was initiated in 2001. Nearly 86,000 adults aged 40-79 at cohort entry were recruited during 2002-2009 across 12 southern states, mostly at Community Health Centers (institutions providing basic health and preventive services in underserved areas). By design, two-thirds of the cohort was selected to be African American and the remainder predominantly non-Hispanic white to help remedy the underrepresentation of African Americans in health studies and enable direct black/white comparisons. Most of the cohort members, both black and white, had low income and education levels. In addition to detailed survey data, biospecimens were collected from more than 76,000 cohort members at baseline, with blood obtained and stored for approximately 39,000, mouth rinses/saliva for 38,000, and urine for 24,000, so that genomic DNA could be extracted from nearly 90% of participants. In 2018, we initiated stool sample collection and have collected these samples from ~8,500 cohort members. This cohort is being followed for incidence of site-specific cancers and cause-specific mortality. Data and biospecimens collected in the SCCS have been used to support large numbers of epidemiologic and genetic studies of cancer and other chronic diseases. 

  • GO2 Foundation (Melinda Aldrich is site PI)
    Genentech; Bristol Meyers Squibb

    To further define barriers and facilitators to clinical trial accrual among minority patients with lung cancer.

  • Maureen Sanderson, Samuel Adunyah
    Funding Agency: NIMHD
    Grant Number: 2 U54 MD007586-35S7

    The major goal of this project is to examine societal barriers to COVID-19 testing and vaccine uptake among minority women and their families.

  • Melinda Aldrich
    Funding Agency: Lung Cancer Research Foundation

    This project will provide a deeper understanding of which factors influence lung cancer stage of diagnosis among community health center patients and provide outreach to the community about the importance of early detection for lung cancer.