Advancing team science and health equity in clinical oncology using the All of Us Research Program dataset.

Abstract

e13741 Background: The All of Us Research Program ( All of Us) is one of the largest, most diverse health databases developed to expedite medical breakthroughs and is a resource for cancer researchers. The size and diversity of participants along with data types within the program, coupled with the program’s cloud based data analytics platform, encourage both team science and equitable health research outcomes. All of Us is dedicated to advancing the science of health equity with a focus on populations underrepresented in biomedical research and workforce, and embedding health equity across all aspects of the program. Methods: All of Us uses a centralized protocol where participants may elect to 1) enroll, consent, and authorize EHR, 2) answer surveys, 3) provide physical measurements, 4) provide biosamples, and 5) share data from wearables. High levels of participant diversity was achieved through an Engagement Ecosystem of outreach leaders, participants, and engagement awardees. Outreach, engagement, enrollment, and retention efforts are strategically directed by a Community and Participant Engagement Framework and a Health Equity Strategic Plan. Results: As of January 2024, health data from 413,450+ participants is available, including eight survey types from 337,500+ participants, electronic health records (EHR) from 287,000+ participants, wearable data from 15,600+ participants and whole genome sequencing from 245,350+ participants. Over 75% of participants self-identify as underrepresented in biomedical research, and about 45% self-identify as racial and ethnic minority groups. Cancer data includes history at enrollment as well as incident ascertainment via EHR (N = 26,323 total cancers and 13,067 incident cancers, from 7,544 participants assigned female at birth and 5,264 participants assigned male at birth). As of February 2024, All of Us data has been used in more than 221 publications. Of these, 35% (78) discuss cancer or oncology. More than 10% of active workspaces (921 out of 8000+ as of January 2024) include “cancer” in workspace descriptions. Commonly studied cancer types include breast, prostate, lung, ovarian, and colorectal. Conclusions: All of Us has established itself as a resource for cancer researchers. This database has the potential to provide insights into the development of treatment guidelines and emerging indicators for screening and early detection guided by health equity built on participant engagement, diversity, and broad data availability. Finally, the breadth of All of Us data also offers potential insight into cancer etiology and opportunities for prevention.