African American Males and Fatherhood: Issues in Research and Practice

Background: Disparities in prostate cancer (PrCa) incidence and mortality between African American (AA) and European American (EA) men are partially mediated by underlying disease biology. The goal of this study was to determine how DNA methylation and transcriptomic changes drive PrCa health disparities in AA men. Methods: Transcriptomic alterations potentially mediated by DNA methylation were identified by Illumina arrays and RNA-sequencing in PrCa from 30 AA and 32 EA men. Androgen receptor (AR) protein expression was measured using tissues microarray of matched PrCa tissues from 95 EA and 92 AA men. In vitro, MDA PCa 2a (2a)/MDA PCa 2b (2b) cells derived from an AA man and LNCaP/LaPC-4 cells derived from EA men were stimulated with ionomycin, a calcium ionophore to measure intracellular calcium using fluorescent-based live imaging. Results: Unsupervised hierarchical clustering revealed DNA methylation clusters (Cluster A and Cluster B) with differential methylation of loci that regulate intracellular calcium levels including RYR2, TRPC6, and TRPA1. Increased methylation of calcium regulatory genes in Cluster A was associated with reduced disease-free time (DFT) (21.65 vs 46.71 months, p<0.05) only in AA men with PrCa. RYR2 (-0.122 vs -0.004, p=0.69), TRPC6 (0.006 vs -0.639, p=0.06) and TRPA1 (-0.070 vs -0.269, p<0.05) transcript levels were lower in Cluster A compared to Cluster B. These data suggest DNA methylation can regulate expression of calcium regulating genes. In vitro, we found AA PrCa derived 2b cells have reduced RNA levels of RYR2, TRPV6 and CALB1 compared to EA PrCa derived LNCaP cells. Reduced transcription can result in lower protein expression and thus activity of calcium regulatory genes. To test this, we stimulated cells with ionomycin and found a rapid increase in intracellular calcium in 2a/2b cells (within 60 seconds) compared to LNCaP/LAPC-4 cells (120-300 seconds). This suggests that decreased transcription correlates to reduced buffering capacity of calcium regulatory genes. Others have shown that increased intracellular calcium reduces AR protein levels. Therefore, we analyzed AR protein expression in a subset of tumors from Cluster A and B. AR levels were lower in adjacent non-tumor and tumor tissue in these overlapping samples. AR low PrCa are associated with basal like features and respond poorly to androgen deprivation therapy. Therefore, we analyzed the PAM50 basal/luminal gene sets and AR target genes and found differentially expression of these genes in AA PrCa derived 2b and EA PrCa derived LNCaP cells. Conclusions: Our study shows that AA men with PrCa have epigenetically dysregulated calcium signaling that is associated with worse DFT. Our ongoing work seeks to identify how these alterations regulate AR expression and thus basal/luminal features. Our long- term goal is to establish novel molecular subtypes using calcium-AR-basal/luminal features that can guide design of rationale therapies in a subset of AA men with PrCa. Citation Format: Swathi Ramakrishnan, Xuan Peng, Eduardo C. Gomez, Kristopher Attwood, Ivan V. Maly, Wilma A. Hoffmann, Wendy Huss, Gissou Azabdaftari, Li Yan, Jianmin Wang, Anna Woloszynska. Intracellular calcium regulates androgen receptor expression and basal-luminal features in prostate cancer from African American men [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-134.

10502 Background: Germline testing (GT) for prostate cancer (PCA) is central to metastatic disease management, PCA screening strategies, and hereditary cancer assessment. African American (AA) males have a higher burden of PCA, yet have lower engagement in germline testing which limits understanding of genetic contribution to PCA. Here we evaluated the germline spectrum of AA and White males with PCA undergoing clinical multigene panel testing (MGPT) to inform germline testing strategies with attention to equity. Methods: Study participants included AA men and White men with PCA who underwent a 14-gene MGPT between April 2012 - December 2020 at a clinical diagnostic laboratory (Ambry Genetics). Exclusions were men with known pathogenic variants reported in their families or who had prior genetic testing. MGPT included: ATM, BRCA1, BRCA2, CHEK2, EPCAM, HOXB13, MLH1, MSH2, MSH6, NBN, PALB2, PMS2, RAD51D, TP53. Sanger or next generation sequencing analysis was performed per standard clinical testing protocol. Variant classification was per ACMG 5-tier system. Descriptive statistics summarized results with counts and percentages for categorical variables and mean and standard deviation for continuous variables. Data were compared with Fisher’s exact, Chi-squared, two proportion z-test, or two sample t-test, as appropriate. Significance level was set a priori at 0.05. Results: The dataset included genetic and clinical data from 427 males who had undergone MGPT: White males (n = 190; 45.5%) and AA males (n = 237; 55.5%). Mean age at diagnosis was 59 + 9.3 years. Among men whose Gleason score was indicated (72%), 47% had Gleason > = 8. Majority of men indicated having a 1st/2nd degree relative with PCA (68.97%) or 1st/2nd degree relative with any cancer (99.2%). In the entire cohort, 8.2% tested positive for a pathogenic/likely pathogenic variant; AA males (n = 14, 5.91%) and White males (n = 21, 11.05%). VUS only was reported in 21.31% of the overall cohort with a significant difference noted between AA and White males (25.32% vs. 16.32%, respectively; p = 0.0238). Mutation spectrum in AA males included: BRCA2 (n = 7), PALB2 (n = 3), ATM (n = 3), and BRCA1 (n = 1). Among White males, a wider spectrum of mutations was observed: BRCA2 (n = 6), ATM (n = 5), HOXB13 (n = 5), CHEK2 (n = 2), TP53 (n = 1), and NBN (n = 2). The proportion of AA males with multiple VUS was significantly higher than for Caucasian males (5.1% vs. 0.53%, p = 0.003). Conclusions: Clinical germline testing among AA males reveals a narrow spectrum of mutations in key DNA repair genes, with important implications for precision therapy and hereditary cancer assessment. Furthermore, AA males had significantly higher rates of multiple VUS, indicating critical need for greater inclusion of diverse populations in genetic studies to discern the pathogenic spectrum contributing to PCA aggressiveness and risk.

The article presents an overview of challenges that African American men and boys face in disease incidence and in accessing suitable health care. A discussion of statistics which focus on the rates of several diseases which are found among African American men and boys, and of increased incidences of violence which African American boys and men are subject to, is presented. The positive role that the health care reform legislation may play in helping African American boys and men gain access to health care services is discussed. The U.S. Office of Minority Health's Commission on the Impact of Trauma and Violence on the Health of African American Men is mentioned.

B54 Background Men with a family history (FH) of prostate cancer (PCA) and African American (AA) men are at 2 to 7-fold increased risk for the disease. Assessing risk for PCA in these high-risk men has been challenging due to the lack of available genetic testing. Recently, five genetic single nucleotide polymorphisms (SNPs) at chromosomal loci 8q and 17q (rs1859962, rs6983267, rs4430796, rs1447295, and rs16901979) were found to have a cumulative increased association with PCA in multiple studies. These genetic variants need to be characterized in screening populations to determine their utility in the early detection of PCA. The Prostate Cancer Risk Assessment Program (PRAP) at Fox Chase Cancer Center is a prospective screening program for high-risk men. Currently there are over 700 participants, and 60% are AA. This study evaluates the clinical characteristics of high-risk men carrying these risk SNPs and time to PCA diagnosis based on the presence of these 8q/17q risk markers. Methods Eligibility for PRAP includes men ages 35-69 years with one first degree relative with PCA, two second degree relatives with PCA on the same side of the family, any AA man regardless of FH of PCA, and men with BRCA1/2 mutations. Current criteria for biopsy include PSA > 2.0 ng/mL, PSA 1.5-2.0 ng/mL with free PSA < 25%, any abnormality on digital rectal examination, or PSA velocity of 0.75 ng/mL/year. All biopsies are 12-core under transrectal ultrasound guidance with additional cores taken at physician discretion. Genotyping of SNPs rs1859962, rs6983267, rs4430796, and rs1447295 was performed using the Taqman® SNP Genotyping Assay (Applied Biosystems) per manufacturer’s instructions. Pyrosequencing methods were used for SNP rs16901979 as Taqman assays did not produce reliable results. Standard statistical methods were used to determine allele and genotype distributions by race. Cox models were used to determine time to PCA diagnosis by number of high risk SNPs. Results Genotypes for all five SNPs was able to be determined on 633 PRAP participants of whom 60% were AA. Average follow-up for these participants in PRAP has been 3-4 years. There was a statistically significant difference in the baseline distribution of risk alleles and risk genotypes of these five SNPs within self-reported race groups (p<0.0001). Age-adjusted baseline PSA differed significantly among high-risk Caucasian PRAP participants, with a higher baseline PSA in men carrying the risk genotype at rs4430796 vs. men without the risk genotype at this SNP (p=0.0063). More AA men were found to carry 2-3 and 4-5 risk-associated SNPs than high-risk Caucasian men in PRAP (p<0.0001). Time to PCA diagnosis was evaluated in 332 PRAP participants who had at least one follow-up visit. Among the 210 AA participants with at least one follow-up visit, there was a trend for earlier time to PCA diagnosis for those with 4-5 risk SNPs vs. 0-1 risk SNPs (p=0.059). Hazard ratios for PCA risk increased substantially in AA men with 4-5 SNPs vs. 2-3 SNPs (4.28 vs. 1.84), although this was not significant. No trends were observed for high-risk Caucasian men regarding time to PCA diagnosis. Conclusions Five genetic risk markers at 8q/17q may be useful in tailoring screening approaches in high-risk men, particularly AA men. Further follow-up is needed to firmly determine how these risk markers influence time to PCA diagnosis. Citation Information: Cancer Prev Res 2008;1(7 Suppl):B54.

In the new South Africa gender role constructions are slowly shifting, this article explores early fatherhood as a potential site for the development of alternative masculinities. Existing research tends to cast young men as subjects of risk factor vulnerability and negative outcomes who become uninvolved fathers. The narrative data from young men in this study contradict this view. The analysis reveals that young men deliberately shift their life focus and actively renegotiate their identity through the choice to take responsibility for their children. They structure their personal goals and their relationships with families and partners in terms of providing emotional and financial stability for their child. Fatherhood becomes a highly valorised masculine identity. These young men resolve the tension between the pursuit of hegemonic gender ideals and determination to act as caregivers to their children, thus casting fatherhood as a site to challenge stereotypes of irresponsible young men and absent fathers. This study indicates that young fathers are not invisible and that early fatherhood is a potentially transformative force in the construction of masculinities which include provision, protection and caring.

Background: Men with a family history (FH) of prostate cancer (PCA) and African American (AA) men are at 2 to 7-fold increased risk for the disease. Assessing risk for PCA in these high-risk men has been challenging due to the lack of available genetic testing. The vitamin D and androgen pathways have been studied for years for association to prostate cancer risk with single nucleotide polymorphisms (SNPs) in the vitamin D receptor (VDR) gene and genes encoding enzymes involved in testosterone biosynthesis found to have no substantial association to prostate cancer risk. However, a recent study found an interaction between the FokI SNP in VDR and the V89L SNP in SRD5A2 (converts testosterone to dihydrotestosterone) in non-Hispanic white men. In addition, in Hispanic white men, the V89L SRD5A2 polymorphism and the CDX2 VDR SNP was associated with prostate cancer. We evaluated these particular genetic variants in VDR and SRD5A2 for association to prostate cancer and time to prostate cancer diagnosis in high-risk men enrolled in the Prostate Cancer Risk Assessment Program (PRAP)- a screening and research program with 60% African American participation. Methods: Eligibility for PRAP includes men ages 35–69 years with one first degree relative with PCA, two second degree relatives with PCA on the same side of the family, any AA man regardless of FH of PCA, or men with BRCA1/2 mutations. Current criteria for biopsy include PSA > 2.0 ng/mL, PSA 1.5–2.0 ng/mL with free PSA < 25%, any abnormality on digital rectal examination, or PSA velocity of 0.75 ng/mL/year. All biopsies are 12-core under transrectal ultrasound guidance with additional cores taken at physician discretion. Genotyping of SRD5A2 V89L and VDR CDX2 was performed using the Taqman® SNP Genotyping Assay (Applied Biosystems) per manufacturer's instructions. Pyrosequencing methods were used for the FokI SNP in VDR as Taqman assays did not produce reliable results. Standard statistical methods were used to determine allele and genotype distributions by race. Cox models were used to determine time to PCA diagnosis. Results: 661 PRAP men had genotype data available for FokI and V89L, while 380 men had genotype data for CDX2 and V89L. Among 236 AA men with at least one follow-up visit included in the FokI-V89L analysis, a significant interaction was seen between FokI and V89L genotypes after adjusting for age and PSA at entry (p=0.01). Hazard ratio estimates for AA men with the FokI CC genotype and V89L LV/LL genotypes vs. VV was 2.51 (95% CI 1.07–5.90). No interaction was seen between FokI and V89L genotypes among 194 Caucasian men, where FokI genotype alone was found to have a significant association to PCA (Hazard Ratio for FokI TT/CT vs CC = 0.29, 95% CI 0.14–0.62). No significant association to PCA was seen for CDX2 either alone or in combination with V89L for AA and Caucasian men in this analysis. Conclusions: FokI CC in VDR and V89L LV/LL in SRD5A2 appear to be informative of time to PCA diagnosis and risk for PCA in AA men undergoing PCA screening. FokI TT/CT genotype appears to have a protective effect in Caucasian men for PCA. Further study is warranted. Citation Information: Cancer Prev Res 2010;3(1 Suppl):A9.

The status of African American boys and men is of significant concern. This article reviews the literature on African American males within the field of the psychology of men and masculinity. We focus on theory and research that describe African American men's masculinity, and how traditional masculinity and racial identity relate to the health and well-being of African American men. The article provides a context for introducing this special series of articles on African American men that advance our understanding of psychosocial factors associated with the health and well-being of African American men. Gibbs's classic 1988 book, Young, Black, and Male in America: An Endangered Species, brought much needed attention to the status of young African American males and suggested that there had been marked deterioration compared with past generations. Compared with earlier cohorts, young African American males were more likely to be unemployed, involved in the criminal justice system, unwed fathers, and victims of homicide and sui- cide. Almost 25 years later the status of African American boys and men continues to be an issue of significant concern. For example, African American men have the shortest life expectancy of all race/gender groups (National Center for Health Statistics, 2005). In 2006, the rate of new HIV infection for African American men was six times higher than European American men, nearly three times that of Hispanic/Latino men and twice that of African American women (Centers for Disease Control & Prevention, 2010). Further, African American men are six times more likely than European American men to be incarcerated (National Urban League, 2007). Lastly, the growth rate of African American men enrolling in college is the lowest among minority groups in the United States (Harvey, 2003). While these data are discouraging, other research has high- lighted strengths, progress, and psychosocial patterns character- ized by resilience. Compared with the national averages, African American men had lower rates of alcohol use and binge drinking from 2004-2008 (Substance Abuse & Mental Health Service Administration, 2010), and lower rates of mood disorders than both African American women and Whites (Breslau, Su, Kendler, Aguilar-Gaxiola, Kessler, 2005; Brown & Keith, 2003; Robins et

Background: Secondary to their comparable racial and socio-demographic background, African American (AA) men and women with breast cancer are expected to have similar outcomes. However, there is a paucity of data demonstrating gender-specific differences in breast cancer across racial/ethnic groups. Our objective is to investigate potential differences between AA men, AA women and White men with breast cancer by evaluating risk factors using a population-based tumor registry. Methods: A retrospective review of the Surveillance Epidemiology and End Results (SEER) database from 1988 to 2008 was conducted. We identified AA men and AA women aged 20 years or older with a primary breast cancer diagnosis or in whom the index breast cancer is the first cancer. A similar group of White men were included to serve for comparison. All available treatment modalities were reviewed. Bivariate analysis of patient characteristics, tumor grade, stage, hormonal assay, and treatment modality was performed using Chi squared test. Survival was estimated and Cox proportional model was used to investigate survival differences comparing AA men, AA women and White men (with AA men as reference), adjusting for age, year of diagnosis, tumor characteristics, as well as treatment received. Subset analyses were done within stage strata. Results: We reviewed 62 758 patient records comprising 506 (0.81%) AA male, 59 234 (94.38%) AA female and 3 018 (4.81%) White males. Most were 50 years or older (57.5%), married (39.4%), had invasive ductal carcinoma (61.9%) and localized disease (42.5%). Mean age at diagnosis was 59 (±11), 55 (±12) and 63 (±11) years for AA males, AA females and White males, respectively. Men were more likely to have moderately differentiated tumors (37.6% and 40.4% for AA males and White males, respectively) compared to AA women who were more likely to have poorly differentiated tumors (39.2%) (p<.001). AA males had more regional disease (39.5%) compared to AA females and White males who had more localized disease (42.6% and 41.5%, respectively). Incidence of distant metastasis was highest among AA men (10.9%) compared to their AA female (6.10%) and White male (5.8%) counterparts (p<.001). Men received more modified radical mastectomies (61.2% and 62.6% for AAs and Whites, respectively) and women had more partial mastectomies (56.4%). The 5- and 10-year survival was 78% (95% CI .73-.82) and 66% (95% CI .59-.72) for AA men, 80% (95% CI .80-.81) and 73% (95% CI .72-.73) for AA women, 88% (95% CI .86-.89) and 79% (95% CI .77-.81) for White men. Overall, White men were 24% less likely to die from breast cancer compared to AA men (HR 0.76; 95% CI .62-0.94), while the survival difference was not significant when compared to AA women (HR: 0.98; 95% CI: 0.81-1.19). Similarly, among patients with regional disease, White men had significantly better survival (HR: 0.63; 95% CI: 0.46-0.48) compared to AA men. Conclusion: Using a large population-based database, our study demonstrates absence of gender specific difference in breast cancer survival among African Americans. However, AA men were found to have larger tumors, worse stage, and despite presenting with similar grade and receiving similar treatment as White males, had worse outcome. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P5-12-05.

e13552 Background: African American (AA) males have disproportionately high prostate cancer (PCA) incidence and mortality rates compared to men of other races. While genetic testing for PCA is rapidly expanding, AA men represent fewer than 10% of those who undergo genetic counseling and testing. Barriers for AA males may include a lack of awareness or understanding, cultural beliefs, financial and access-to-care limitations, fear of discrimination, and mistrust in the healthcare system. These issues may be exacerbated among low-income, urban AA males. Methods: We conducted two focus groups with AA males who live in a low-resource neighborhood in a major US city to explore their understanding about PCA, challenges in obtaining and discussing family health history, and attitudes towards genetic counseling and testing. Prior to the start of the focus groups, men provided informed consent and completed a brief survey to capture demographic and health history information. Focus groups were moderated by a male member of the community, were audio and video recorded, and transcribed verbatim. Transcripts were analyzed using NVivo 12 to deduce themes within the discussions. Results: Seventeen men participated in one of two focus groups. The mean age was 54 years old (range: 40-66). Only 5 men (30%) were married. Ten men (60%) did not report a family history of PCA, while the remaining 7 reported that their father, grandfather, brother or uncle had PCA. All men had a primary care visit in the past 3 years, but only 13 out of 17 men (76%) reported discussing PCA. Focus group discussions and analyses revealed multiple key themes. Men had limited understanding of the prostate and PCA, with somewhat fatalistic views toward cancer. Family history was recognized as an important risk factor for cancer; talking about family history has become easier and more widely accepted. However, there was mixed reaction to genetic testing: most men were unfamiliar with it but were in favor of learning more, while a few did not see the utility of genetic information. Conclusions: AA men continue to have knowledge deficits about PCA. While there is strong understanding that cancer may be hereditary, there is less awareness about PCA genetic testing. Targeted genetic education and addressing access and cost barriers to genetic testing among AA males is needed to increase uptake of genetic testing and participation in genetic trials.

Being an African American man is a risk factor for prostate cancer, and there is little consensus about the use of screening, early detection, and the efficacy of treatment for the disease. In this context, this systematic review examines the roles women, particularly wives, play in African American men's prostate cancer screening and treatment decision making. We searched OVID Medline (R), CINAHL (EBSCO), PsychInfo (EBSCO), PubMED, Cochrane Library, ERIC (Firstsearch), and Web of Science to identify peer-reviewed articles published between 1980 and 2016 that reported qualitative data about prostate cancer screening, diagnosis, or treatment in African American men. We conducted a systematic review of the literature using study appraisal and narrative synthesis. Following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines for identifying and screening 1425 abstracts and papers, we identified 10 papers that met our criteria. From our thematic meta-synthesis of the findings from these publications, we found that women played 3 key roles in African American men's decision making regarding prostate cancer screening, diagnosis, or treatment: counselor (ie, offering advice or information), coordinator (ie, promoting healthy behaviors and arranging or facilitating appointments), and confidant (ie, providing emotional support and reassurance). Women are often important confidants to whom men express their struggles, fears, and concerns, particularly those related to health, and they help men make appointments and understand medical advice. Better understanding women's supportive roles in promoting positive mental and physical outcomes may be key to developing effective interventions to improve African American men's decision making and satisfaction regarding prostate cancer screening and treatment.

Stress is a key factor that helps explain racial and gender differences in health, but few studies have examined gendered stressors that affect men. This study uses an intersectional approach to examine the sources of stress in African American men's lives from the perspectives of African American men and important women in their lives. Phenomenological analysis was used to examine data from 18 exploratory focus groups with 150 African American men, ages 30 years and older, and eight groups with 77 African American women. The two primary sources of stress identified were seeking to fulfill socially and culturally important gender roles and being an African American man in a racially stratified society. A central focus of African American men's daily lives was trying to navigate chronic stressors at home and at work and a lack of time to fulfill roles and responsibilities in different life domains that are traditionally the responsibility of men. Health was rarely mentioned by men as a source of stress, though women noted that men's aging and weathering bodies were a source of stress for men. Because of the intersection of racism and economic and social stressors, men and women reported that the stress that African American men experienced was shaped by the intersection of race, ethnicity, age, marital status, and other factors that combined in unique ways. The intersection of these identities and characteristics led to stressors that were perceived to be of greater quantity and qualitatively different than the stress experienced by men of other races.

ABSTRACTDespite the recognized importance of fathers to children’s well-being, there is a lack of research exploring the impact of parenting interventions on young fathers. Further, little work has been done to identify whether fatherhood interventions differentially benefit specific subgroups of fathers, including Hispanic subgroups.This research examines a 15-week fatherhood intervention for African American, Puerto Rican, and non-Puerto Rican Hispanic young fathers. Data were collected from 312 fathers ages 15-24 at baseline, post-intervention (15 weeks), and at 8 months, 12 months, and 16 months post-baseline follow-up. Latent growth models were used to examine differential shapes of change for the three groups. Results suggest different intervention responses across the three groups on risky parenting attitudes, African American fathers in the study indicated more risky parenting attitudes than Hispanic and Puerto Rican fathers. The practice and research implications of disaggregating data for minority fathers, particularly for Latino subgroups, are discussed.

Fatherhood is a turning point in the life of many men, but for men who lacked a father figure while growing up, the birth of a child may be the catalyst for a fresh start. Researchers have called for qualitative investigations into African American fathers’ parenting beliefs and practices that consider their social contexts within the broader research discourse on parenthood. Such investigations can inform the way we frame African American fathers in research, thereby improving theoretical suggestions for better supporting Black men in their roles as caretakers. The present case study details the experiences of a young African American man, Tron, who was participating in a larger church-based intervention program focused on strengthening father–child relationships among African American families. Findings highlight how Tron’s story serves as a positive counternarrative against the prevailing negative stereotype of African American men as absentee parents. Thematic coding analysis revealed several major themes, and the current article focuses on Tron’s decisions to transform his experience growing up without a father into a dedicated resolve to remain actively present in his son’s life, a process that the author refers to as “intergenerational change.” Finally, this case study helps to mitigate the dearth of positive research on African American fathers by challenging deficit-based research narratives.

Much of the literature on African American fathers has tended to perpetuate a stereotype of absent and unsupportive parenting. This study employs a life course perspective to investigate the extent and predictors of involvement by young fathers. Data come from the Rochester Youth Development Study, a longitudinal study that has followed a representative sample of urban youth since they were in the seventh or eighth grade. Analysis is based on the young men in the sample who became fathers by age 22, of whom 67% are African American. Results suggest that African American fathers do not differ significantly from other young fathers in their contact with and support provided to their eldest biological child. For African American fathers, fulfilling a father role is, as hypothesized, related to the success of transition to adult roles and relationships and to prosocial behavior and problem behavior.

Colorectal cancer (CRC) is the third most common cancer, for both incidence and mortality, in the United States 1 Although incidence and mortality are decreasing for all races and ethnicities in the U.S., African American (AA) males continue to disproportionately bear the burden of this disease. Socioeconomic status (SES) accounts for some of this disparity as AAs, like many underserved populations, are impacted by low socioeconomic status. Individuals with the lowest SES are 40% more likely to be diagnosed with CRC than those with the highest SES. However, SES doesn't account for all of this disparity. Significant differences in the transcriptomes of AA and Caucasian American (CA) CRC tumors have been reported (UNC reference). Publicly available databases house large numbers of previously analyzed and published studies that can be analyzed again on the background of accumulated knowledge of genes and pathways and provide new insights into the biology of those tumors that may reveal new targets for therapy. With this idea in mind, GSE28000, stored in the NCBI GEO database, was identified for further analysis. The transcriptomes had been characterized using the Agilent-014850 Whole Human Genome Microarray 4 × 44K G4112F platform. The transcriptomes for 24 AA males and 16 CA males were compared using the Biostatistical analysis performed using GEO2R. This resulted in the identification of 2150 differentially expressed, annotated, genes (p≤0.05). The differentially expressed genes were uploaded into Webgestalt and an over-representation analysis for diseases was performed using the OMIM database. A statistically significant (Benjamini & Hochberg FDR p≤0.05) group of four genes associated with CRC was identified. These genes, with log2 differential expression and p-value respectively, were PIK3CA (-0.36861932), FGFR3 (-0.83181818), DCC (0.32934659), and SRC (0.37958239). A positive log difference indicates higher expression in the tumors of AA patients. Although these data are intriguing, the inability to generalize these results from this single study were clear, so we sought to validate these results in other publicly available databases. These validation efforts are ongoing but the difficulty in drawing strong conclusions about this outcome is in the underrepresentation of AA patients in cohorts and clinical trials. African American males' high incidence and mortality rate in CRC and their low presence in clinical trials embellishes the lack of racial equity in clinical trials. A study by the Mayo Clinic in 2013 pointed out of 14,232 CRC trials enrolled, only 746 were African American (11,850 CA). These inequitable results press for the need of an increase in African Americans and other disproportionately affected groups through the cooperation amongst researchers, doctors, minorities, and cancer institutes. Citation Format: Darryl A. Sams, Dana R. Marshall. Gene expression levels correlation to colon cancer disparities amongst African and Caucasian American men [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-226.