Health Outcomes Research Articles

Association of Cardiovascular Health With Brain Volume and White Matter Integrity: Results of the SOL-INCA MRI Study.

Better cardiovascular health (CVH), measured using the Life's Simple 7 (LS7) score, is associated with improved cognitive function. However, its effect on brain imaging in Hispanics/Latinos has not been reported. We investigated the association of LS7 score with brain MRI outcomes in a diverse Hispanic/Latino population. Hispanic Community Health Study/Study of Latinos (HCHS/SOL) is the largest prospective cohort study of diverse Hispanic/Latino adults in the United States. LS7 score was assessed at baseline (2008-2011). The SOL-Investigation of Neurocognitive Aging (SOL-INCA) MRI ancillary study recruited HCHS/SOL participants who underwent neuroimaging approximately 10 years (2017-2022) later. Main outcomes include standardized residuals for total brain, total and lobar gray matter (frontal, temporal, parietal, and occipital), total white matter, total CSF, lateral ventricle (LV), and white matter hyperintensity (WMH) volumes and diffusion tensor imaging (mean free water fraction, peak width skeletonized mean diffusivity, and mean fractional anisotropy). MRI outcomes across continuous LS7 scores were investigated using adjusted linear regression models. We performed an interaction analysis by age and sex. All analyses accounted for complex sample design. The study included 2,659 participants (weighted %female = 56%). The mean age (95% CI) was 54 (53-55) years, and the mean LS7 score was 7.2 (7.1-7.3). In the fully adjusted model, higher LS7 scores were associated with larger total and lobar brain volumes (βTotal Brain = 0.03 [0.002 to 0.06], βTotal White = 0.05 [0.03 to 0.08], βTotal Gray = 0.04 [0.01 to 0.06], βFrontal Gray = 0.04 [0.02 to 0.07]); smaller total CSF (β = -0.06 [-0.08 to -0.03]), LV (β = -0.03 [-0.06 to -0.004]), and WMH (β = -0.05 [-0.07 to -0.03]) volumes; and better measures of microstructural integrity (βFW = -0.002 [-0.003 to -0.001], βPSMD = -0.01 [-0.01 to -0.003], and βFA = 0.001 [0.001 to 0.002]). In interaction analysis by age, the benefits of CVH on magnetic resonance volumes and microstructural integrity were more pronounced in older patients. No interaction was observed by sex. We found that better CVH is associated with better brain-based volumes and microstructural integrity and that the effects of LS7 score on brain health are age dependent. Additional studies are needed to assess the longitudinal effect of CVH on MR-based brain health outcomes.

Abstract 3610: Healthcare segregation experienced by colorectal cancer patients residing in high-poverty areas and its impact on health outcomes

Background: Existing evidence indicates that colorectal cancer (CRC) patients from high-poverty areas (HPA), defined as areas with 20% or more residents living below federal poverty level, are more likely to receive surgery at low-volume, non-accredited hospitals than those from low-poverty areas (LPA). The systematic difference in surgical care location between patients from HPAs and LPAs, healthcare segregation, could represent a structural equity through which disparities in health outcomes arise. We sought to determine the existence of healthcare segregation and assess its impact on patient health outcomes. Methods: We identified patients undergoing surgery for non-metastatic CRC diagnosed in 2009-2019 from SEER-Medicare. Patients living in a county which had been an HPA for at least 30 years were classified as living in a persistent-poverty area (PPA). Patients living in a county which was an HPA during the year of cancer diagnosis but not a PPA were classified as living in a current-poverty area (CPA). Otherwise, they were classified as living in an LPA. Experiencing healthcare segregation was defined as being treated at a poverty-area-serving (PAS) hospital where ≥50% of the patients were from HPAs. We examined the association between area-level poverty, treatment at PAS hospitals, and health outcomes (postoperative adverse events, 30-day readmission, long-term all-cause mortality (ACM), and cancer-specific mortality (CSM)) using logistic and Cox regression. We performed a subgroup analysis for metropolitan, urban, and rural areas. Results: We included 81,767 patients (7.5% from PPAs, 8.4% from CPAs) with a median age of 78 (IQR: 73-84) years. 53.9% of patients were females, 14% were non-White, and 1.5% lived in rural areas. 81% of the hospitals (180/991) were PAS hospitals, which treated 64% of patients from PPAs and CPAs vs. 3% from LPAs. Compared with patients from LPAs treated at non-PAS hospitals, those treated at PAS hospitals who were from PPAs (ACM HR=1.17(1.08-1.26), CSM HR=1.23(1.11-1.37)) and CPAs (ACM HR=1.15(1.08-1.22), CSM HR=1.23(1.13-1.35)) had worse short and long-term outcomes. Patients from CPAs treated at non-PAS hospitals also had worse outcomes, to a lesser degree (ACM HR=1.12(1.05-1.19), CSM HR=1.16(1.06-1.28)). Among rural residents, being treated at PAS-serving hospitals but not area-level poverty was independently associated with worse outcomes. Conclusions: Patients living in HPAs experience healthcare segregation in CRC treatment, contributing to their worse health outcomes. Healthcare segregation reflects systemic inequities and structural barriers limiting access to resources that patients from HPAs may deploy to mitigate consequences of cancer. Understanding healthcare segregation and factors shaping it can help identify areas for intervention to reduce associated health disparities. Citation Format: Xinyan Zheng, Laura C. Pinheiro, Parisa Tehranifar, Erica Phillips, Rulla M. Tamimi, Steven Y. Chao, Maria Pisu, Chuxuan Gao, Andrew G. Rundle, Jialin Mao. Healthcare segregation experienced by colorectal cancer patients residing in high-poverty areas and its impact on health outcomes [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 3610.

Abstract 3616: Cultural racism as a driver of health disparities

Abstract Background: Cultural racism (CR), which refers to ideologies, values, belief systems, and tangible manifestations that enable racial oppression, is a distinct component of systemic racism with hypothesized links to health disparities. However, relative to other more widely recognized components of systemic racism— interpersonal and structural racism— CR is poorly studied with sparse epidemiological evidence on its direct relationship with health outcomes and contributions to disparities. Methods: To bridge this gap, we developed the cultural racism factor (CRF), a latent measure derived using confirmatory factor analysis to model interrelationships among seven indicators that are hypothesized to reflect CR: i) anti-immigrant sentiments, ii) racial resentment, iii) online racial animus, iv) number of public symbols of the confederacy/100, 000, v) aggregate implicit racial bias for White residents, vi) lack of White support for Medicaid expansion, and vii) lack of community-oriented policing. These indicators were quantified at the state level, given that data was consistently available at this level, and states are influential political actors that shape population health and allocate resources. Associations between the CRF and a variety of health outcomes (four mortality outcomes, life expectancy at birth, and two mental health outcomes) were evaluated using demographics-adjusted regression models. Results: In analysis of US mortality data between 2018 and 2021 obtained from CDC Wonder, each unit increase in the CRF was associated with ∼136 (95% confidence interval (CI): 90-182) all-cause deaths per 100, 000, ∼40 (21-59) cardiovascular-specific deaths per 100, 000, ∼6 per 100, 000 (3-9) diabetes-specific deaths per 100, 000, and ∼11 per 100, 000 (5-17) cancer-specific deaths per 100, 000. Also, the CRF was associated with a one-year decline in life expectancy at birth (∼ -1 (-2 - -1); National Center for Health Statistic data). Overall, these associations were consistent for both Black and White adults. Also, CRF’s association with all-cause mortality appeared to be independent of structural racism. Further, CRF showed significant associations with mental health outcomes including a higher risk for depression history ranging from 3% overall to 25% among Native Hawaiian/PI and higher risk for poor mental health days ranging from 3% overall to 14% among Hispanics, in CDC’s Behavioral Risk Factor Surveillance System data (2018-2021). Conclusion: In sum, CRF was adversely associated with numerous health outcomes, overall and by racialized groups. These findings highlight cultural racism’s role as a contemporary, consistent, and universally harmful social exposure for US adults that critically needs to be addressed. Further, the CRF makes it possible to advance the science of racism and health and provides an empirical basis for efforts to address US health inequities that result from cultural racism. Citation Format: Oyomoare L. Osazuwa-Peters, Tyson Brown, Nancy Krieger, Tomi Akinyemiju. Cultural racism as a driver of health disparities [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 3616.

Abstract 4976: Examining the association between chronic inflammation, stress, and resilience factors among diverse breast cancer survivors using the NIH All of Us dataset

Abstract Breast cancer disparities exist by race and ethnicity, including disparities in age at diagnosis, quality of life, and health outcomes. These disparities may be influenced by chronic stress, exacerbated by unique challenges that extend beyond disease management, such as the effects of psychosocial stress and social determinants of health (SDOH) on chronic inflammation. Elevated C-reactive protein (CRP) levels, a marker of chronic inflammation, are implicated in worse health outcomes. Understanding how stress and SDOH interact to influence CRP and other inflammatory biomarkers is critical for addressing disparities in survivorship care. However, most studies lack adequate representation of racial and ethnic minorities; thus, factors associated with chronic inflammation among diverse breast cancer survivors remain unknown. This study aims to investigate factors associated with chronic inflammation among diverse breast cancer survivors using the NIH All of Us research dataset. Using Python, a programming language available within the NIH All of Us research program dataset, we examined CRP and additional inflammatory biomarkers and their relationships with stress, economic, social, and environmental factors. Economic and environmental factors included income, housing security, and neighborhood characteristics. Social and psychological factors included social support, the Perceived Stress Scale (PSS), and the Everyday Discrimination Scale (EDS). Multivariate analyses were conducted to evaluate associations between stress, resilience, SDOH, and inflammation, with stratification by age, BMI, and allostatic load. Preliminary findings reveal significant racial and ethnic disparities in CRP levels. Black and Hispanic breast cancer survivors exhibited the highest CRP levels. We identified 3,110 participants with breast cancer in the All of Us research program dataset. Of those, 7.2% were African American or Black, 2.2% were Asian, and 6.7% were Hispanic. We hypothesize that inflammation will be higher among racial and ethnic minorities, as well as among women with higher levels of stressors, such as low income and increased PSS and EDS scores. Furthermore, we expect inflammation to be negatively associated with resilience factors, such as increased social support and greater neighborhood safety. This study will identify factors associated with chronic inflammation among diverse breast cancer survivors and provide a deeper understanding of the biological mechanisms driving breast cancer health inequities. Citation Format: Bathsheba Aklilu, Erica Tate, Cathy Samayoa. Examining the association between chronic inflammation, stress, and resilience factors among diverse breast cancer survivors using the NIH All of Us dataset [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 4976.

From Eugenics to Evidence: A Historical Perspective on Prenatal Physical Activity Guidelines and Their Present Impact on Maternal Health

This article, "From Eugenics to Evidence: A Historical Perspective on Prenatal Physical Activity Guidelines and Their Present Impact on Maternal Health," traces the evolution of prenatal physical activity guidelines from their origins in eugenics to contemporary evidence-based practices. The review highlights how long-standing medical caution and cultural norms have shaped perceptions of pregnancy and exercise, often leading to low participation rates and inconsistent provider guidance. By examining historical influences and current maternal health outcomes, the author recommends better alignment between evidence-based recommendations and clinical practice to improve health outcomes for mothers and their babies. The article highlights the importance of incorporating historical context into modern healthcare practices to improve maternal health and well-being.

Abstract 6183: Social determinants and survivorship care among Black women breast cancer survivors in Maryland

Abstract Purpose: Limited research has examined the impact of social determinants of health (SDOH) on survivorship care experiences exclusively among Black breast cancer (BC) survivors who face survival disparities due their high prevalence of obesity, comorbidities, and inequities in access and quality of care. Survivorship care experiences among Black BC survivors should be examined to identify potential interventions to improve health outcomes. The goal of this study is to test the feasibility of establishing a state-wide cohort study of Black BC survivors residing in Maryland to address this research gap. Methods: This study will recruit 350 Black women BC survivors, aged ≥18 years, and diagnosed with stage I-III primary BC who have completed recommended adjuvant treatment including surgery, chemotherapy, and/or radiation. Recruitment approaches include targeted Facebook ads, outreach to previous study participants, and mailed recruitment letters from the Maryland Cancer Registry (MCR). Participants complete a 30-40-minute online survey, covering demographic and lifestyle factors, clinical and SDOH characteristics, and survivorship care questions. The study also pilots medical record abstractions with the MCR for cancer characteristics and the state designated health-information exchange, Chesapeake Regional Information System for Patients (CRISP), for follow-up care. Results: Recruitment began in July 2024, and by September 2024, 61 self-reported Black participants with a prior diagnosis of BC have completed the survey. The average age at survey is 58.96 (standard deviation (SD)= 11.84)) years, with an average age at diagnosis of 46.42 (SD=13.35) years. 40% are married/living as married, 36.7% are college graduates, all have health insurance, and only 20% reported household incomes <$40, 000/year. Almost half of the survivors self-reported being diagnosed with stage 1 BC (45.9%), followed by 31.1% stage 2, 18% stage 3, and 4.9% unknown stage. The most common self-reported comorbidities include hypertension (39.3%), diabetes (16.7%), and obesity (12.3%). Related to care, 83.3% have a family doctor, and 73.8% received a treatment summary. Additionally, 56.1% and 54.4% consented to medical record linkages with MCR and CRISP, respectively. Recruitment is ongoing. Conclusion: This study will inform future interventions by identifying disparities in survivorship care experiences among Black BC survivors and evaluating the impact of this care on health outcomes. Citation Format: Lensa S. Keno, Camryn Mae Cohen, Kate E. Dibble, Kala Visvanathan, Avonne E. Connor. Social determinants and survivorship care among Black women breast cancer survivors in Maryland [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 6183.

Physiological and Psychological Impacts of Shift Work Among Student Pharmacists: Sex Differences in Stress and Health Outcomes

Shift work is prevalent among healthcare professionals and associated with significant health risks, including stress, sleep disturbances, and mood disorders. Despite known sex differences in stress responses, their impact on shift workers, particularly student pharmacists, is understudied. The objective of this study was to explore sex-specific differences in psychological and physiological stress responses among pharmacy students engaged in shift work. Psychological stress was assessed using validated scales like the Perceived Stress Scale (PSS), Shift Work Disorder Index (SWDI), Ford Insomnia Response to Stress Test (FIRST), and Positive and Negative Affect Schedule (PANAS). Additionally physiological stress was assessed using salivary biomarkers like cortisol, DHEA-S, IL-6, and alpha-amylase. Females reported significantly higher perceived stress (p = 0.0004), SWDI (p = 0.0302), insomnia (p = 0.0111), and negative affect (p = 0.0171) compared to males. Rotating shift workers showed elevated scores across all measures (p = 0.0005–0.0381). Female rotating shift workers exhibited higher alpha-amylases (p = 0.0191) and lower DHEA-S levels (p = 0.0176) than males. Strong correlations emerged between perceived stress and insomnia (r = 0.40, p = 0.0001) and between insomnia and negative affect (r = 0.55, p < 0.0001). Findings highlight females’ vulnerability, underscoring the need for sex-specific interventions and the early identification of stress biomarkers.

Abstract 7477: Conquering overtreatment of ductal carcinoma in situ through integrative team science

Abstract Ductal carcinoma in situ (DCIS), often misclassified as early-stage breast cancer, rarely progresses to invasive disease. Yet, the inability to distinguish between indolent and aggressive DCIS leads to widespread overtreatment, burdening thousands of women globally. Addressing this, the PRECISION team, under the Cancer Grand Challenges initiative, has achieved remarkable advancements, driving a paradigm shift in DCIS management. PRECISION exemplifies next-level team science, merging expertise from 10 institutions across the USA, UK, and the Netherlands. Spanning disciplines such as epidemiology, molecular biology, AI, pathology, clinical expertise, health outcomes, and patient advocacy, the team’s interdisciplinary approach enabled transformative breakthroughs. Key achievements include: 1. Understanding DCIS Biology: Using innovative patient-derived DCIS-MIND models and single-cell genomic techniques, PRECISION revealed that genetic changes alone do not dictate progression. These findings challenge long-held assumptions, emphasizing the need for comprehensive approaches to assess risk. 2. Risk Stratification Methodologies: Novel biomarkers, AI-driven morphometric analyses, and an RNA-seq classifier reliably differentiate high-risk from low-risk DCIS. For example, the RNA-seq classifier identified low-risk DCIS with a 98% negative predictive value, paving the way for treatment de-escalation. 3. Testing Active Surveillance: Clinical trials embedded in PRECISION’ (COMET, LORD, LORIS) explored the safety of active surveillance, potentially replacing invasive treatments for low-risk DCIS with cost-effective outcomes. Patient engagement and shared decision-making tools further enhance personalized care strategies. PRECISION’s success stems from dynamic international collaborations and integration of advanced technologies. Its findings not only redefine DCIS management but also establish a blueprint for addressing other low-risk malignancies. By focusing on biology-based, patient-centered solutions, PRECISION ensures that treatment aligns with the true nature of the disease, paving the path to transform DCIS care worldwide. To do so, the team aims to develop dynamic risk forecasting techniques, powered by evolutionary AI, drawing inspiration from geoscience methodologies. The team also plans to establish a Global Virtual DCIS Monitoring Clinic, enabling worldwide participation. This initiative will support personalized care, foster shared decision-making, and minimize clinic visits through standardized data collection and seamless online follow-ups. Citation Format: Jelle Wesseling, Proteeti Bhattacharjee, Esther H. Lips, Elinor J. Sawyer, E. Shelley Hwang, Alastair M. Thompson, Grand Challenge PRECISION Consortium. Conquering overtreatment of ductal carcinoma in situ through integrative team science [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 7477.

Culturally appropriate patient-provider communication methods for Black women with breast cancer: a scoping review.

Black women with breast cancer experience a 40% higher mortality rate compared to white women, and this disparity may be influenced by suboptimal patient-provider communication. Evidence has suggested that Black patients with breast cancer have unique informational needs, yet few studies focus on patient-provider communication for this community. The aim of this scoping review was to identify best practices for communicating breast cancer diagnosis and treatment options with Black women. Following PRISMA-ScR, a search strategy was developed and implemented in 4 databases and grey literature. Coders achieved reliability and independently screened articles by title and abstract, then full-text. Articles were included if they studied Black patients with breast cancer and reported on patient-provider communication. Outcomes of interest included patients' appraisals of their communication, and associated health outcomes. A final sample of 27 studies were included. Black patients' positive appraisal of their providers was based on their interactions, rather than providers'perceived expertise. Patients had negative appraisal of communication when they received limited information regarding their treatment plan, side-effects, or possibility of disease recurrence. High-quality communication was associated with adherence to adjuvant therapy; low-quality communication was associated with treatment discontinuation or delay, and lower self-rating of physical well-being. Patients' perceptions of their quality of communication with their healthcare providers was associated with their treatment decisions and health outcomes. Future research is needed to test interventions that optimize communication between Black breast cancer patients and their providers, including discussing navigating barriers to care.

Abstract 4020: Review of literature on the effect of stress and anxiety among African-American breast and endometrial cancer patients

Abstract African American women face disproportionately higher rates of breast and endometrial cancer recurrence compared to their Caucasian counterparts, highlighting an urgent need to explore the role of stress in cancer progression and recurrence. This study conducts a systematic review of the literature to evaluate the efficacy of stress and anxiety interventions in reducing cancer risk among African American survivors. By analyzing 25 articles from 2014-2024, this review examines the correlation between psychological stress, biological stress markers, and cancer outcomes. The findings emphasize the significant impact of stress on health outcomes, particularly in the context of cortisol's role in metabolism and immune response. The review also explores coping mechanisms, including social support, diet, and exercise, tailored to African American women's cultural and socioeconomic needs. The results underscore the critical need for targeted interventions to address stress in this population, with implications for improving cancer survivorship and advancing healthcare equity. Citation Format: Gabrielle Ford, Zakirah L. Abdul-Hameed, Amirah Burton, Brian M. Rivers, Desiree Rivers. Review of literature on the effect of stress and anxiety among African-American breast and endometrial cancer patients [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 4020.

Abstract 3614: Examining social networks within public housing to better direct cancer screening interventions for Pacific Islanders

Background: Social networks and social interactions play an important role in an individual’s health and cancer screening behaviors. We examined the relationship between types of social interactions to better understand where to direct efforts for cancer screening interventions for Pacific Islanders (PIs) in Hawaiʻi (Native Hawaiians, Chuukese, and Marshallese adults) in public housing communities where PIs are often overrepresented. Methods: We utilized a mixed methods research design, examining an existing survey dataset of 1,010 PIs and 16 semi-structured interviews from the same sites where we surveyed individuals, to determine the role of social networks on health outcomes within PIs living in public housing. As a measure of social networks, we formed a social network index from three survey items, including, the number of individuals a person knows personally, interacts with, and discusses personal matters with utilizing a range of 0-9 for each item. Findings from the 16 semi-structured interviews regarding social networks used by individuals for information sharing and with whom participants discussed personal health matters provided qualitative data used for examining the social network index. We applied means testing between the groups (515 Native Hawaiians, 305 Chuukese, 180 and Marshallese) to determine if there were differences in the groups’ social networks, and grounded theory to extract the major themes from the narratives. Results: Interviewees discussed the role of small social circles consisting of their families and households for information and health resource sharing. Within the dataset, Chuukese had significantly smaller personal networks (x̅= 4.05, p=.003); however, they had significantly more individuals (x̅= 4.90, p=.04) with whom they would discuss personal matters, more than Native Hawaiian and Marshallese adults. Marshallese indicated significantly more individuals (x̅= 5.10, p=.04) that they have interacted with over the past two weeks. Conclusions: Chuukese adults have small personal networks; however, their small social circles used to discuss personal and important matters is larger than the other groups, Marshallese and Native Hawaiian. This thus indicates more meaningful social networks for this group. Marshallese adults may interact with more people; however, they did not indicate more close relationships than Chuukese to discuss personal matters. These findings indicate social networks and the type and frequency of social interactions have meaningful roles in health and cancer information sharing for PIs. Future interventions must recognize the frequency and types of meaningful social networks within PIs to potentially change cancer screening behaviors by increasing resource sharing within the most valuable networks. Citation Format: Mark L. Willingham, Kevin Cassel, Ian Pagano, Grazyna Badowski. Examining social networks within public housing to better direct cancer screening interventions for Pacific Islanders [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 3614.

Study Protocol: Assessing Anemia, Obesity, and Associated Risk Factors Among Health Sciences University Students in Wardha District: A Cross-Sectional Study for Healthcare Policy Development

ABSTRACT Background: This study, conducted in the Wardha district, investigates the connection between obesity and anemia in health sciences students. Both conditions present significant public health challenges and may be linked through mechanisms such as inflammation and iron deficiency. Methodology: A total of 108 students aged 20 to 30 years with body mass indices (BMI) greater than 30 will participate in the study. Anthropometric measurements, hemoglobin levels, and structured questionnaires covering lifestyle, medical history, and demographics will be collected. Anemia will be defined according to World Health Organization (WHO) guidelines. IBM SPSS Statistics version 21.0 (IBM Corporation 1 New Orchard Road, Armonk, New York, 10504-1722, United States.) will be used for statistical analysis to explore potential associations between obesity and anemia. Findings: The study will aim to find that both obesity and anemia will be prevalent in this demographic, suggesting a potential link through factors like inflammation, iron deficiency, and dietary habits. These insights could help shape targeted public health interventions to improve the health outcomes of young adults in India. Conclusion: The findings of this study will provide important insights into the relationship between obesity and anemia, supporting the development of healthcare interventions and public health strategies for young adults in India aimed at improving their health outcomes.

Abstract 3628: Associations between per and polyfluoroalkyl substances (PFAS) and inflammatory markers in a racially diverse cohort of breast cancer patients

Background: Per- and polyfluoroalkyl substances (PFAS) are persistent environmental pollutants known for their resistance to degradation and their potential to accumulate in biological systems. These compounds have been associated with various adverse health effects, including promoting cancer progression. Aim: This study aimed to examine the associations between plasma PFAS levels and inflammation-related proteins identified through targeted proteomics in a racially diverse cohort of menopausal women and breast cancer patients. Methods: Three PFAS compounds—perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA), and perfluorobutane sulfonic acid (PFBS)—were quantified in plasma samples from both cancer-free individuals and breast cancer patients using targeted liquid chromatography-mass spectrometry (LC-MS). Results: We found higher levels of PFBS in African American patients with breast cancer compared to Non-Hispanic White patients. Analysis of variance (ANOVA) revealed marginal differences in PFAS levels between racial groups for PFBS (p=0.056p) with no significant differences for PFOA or PFOS (p>0.05). Logistic regression models showed no significant associations between normalized PFAS levels (PFOA, PFOS, and PFBS) and health outcomes (tumor grade or status) in the overall cohort or within racial subgroups. Lastly, Among African American patients, PFBS levels were strongly associated with inflammatory and cancer-related markers including CASP8, CCL3, MMP10 and TRANCE, which are implicated in immune regulation tissue remodeling and cancer progression. These findings highlight the potential role of PFAS in contributing to inflammation and cancer progression, particularly among African American breast cancer patients, emphasizing the need for further research on PFAS exposure and its impact on cancer disparities. Citation Format: Alicia Arredondo Eve, Ashlie Santaliz Casiano, Haihley Connors, Oana Danciu, Garth Rauscher, Natalie Pulliam, Elona Liko-Hazizi, Sarah Friedewald, Seema Khan, Julie Kim, William Gradishar, Kent Hoskins, Zeynep Madak-Erdogan. Associations between per and polyfluoroalkyl substances (PFAS) and inflammatory markers in a racially diverse cohort of breast cancer patients [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 3628.

The Potential Health Economic Value of Adding Magnetomotive Ultrasound to Current Diagnostic Methods for Detecting Lymph Node Metastases in Rectal Cancer.

Local resection of early rectal cancer (RC) is a desirable treatment option compared with surgery, offering reduced morbidity, mortality, health care costs and avoidance of stoma. However, local resection is restricted to cases without suspicion of lymph node metastases (LNM). Current methods to diagnose LNM and risk estimations based on histopathology cannot reliably identify patients eligible for local resection. The NanoEcho diagnostic system is based on a novel method for lymph node staging in RC. The aim of this study was to perform a health economic analysis at an early stage of clinical development to estimate the potential value of adding NanoEcho diagnostics to current diagnostic methods in RC. A Markov model for RC diagnosis was developed where the costs and health outcomes, including quality-adjusted life years (QALYs), for adding the NanoEcho diagnostics to current diagnostic methods were compared with current diagnostic methods alone. The diagnostic performance of the NanoEcho diagnostic system is still unknown and the base-case analysis was performed at an assumed 85% sensitivity and 85% specificity. Two testing strategies corresponding to two alternative ways of implementing the diagnostic test in clinic were evaluated: (1) examine all patients diagnosed with RC and (2) examine only patients diagnosed with clinical stages T1 and T2. Adding the NanoEcho diagnostic system resulted in a gain of 0.032 life years and 0.124 QALYs per patient in the target population compared with current diagnostic methods alone. At a cost-neutral level, the estimated justifiable price of NanoEcho diagnostics was SEK6995 in the first testing strategy and SEK50,658 in the second testing strategy. The justifiable price of the NanoEcho diagnostics at a willingness to pay of 500,000SEK/QALY was SEK10,654 in the first testing strategy and SEK65,132 in the second testing strategy. The results indicate that adding NanoEcho diagnostics to standard of care can potentially reduce healthcare costs and increase quality of life in RC patients, assuming a sensitivity and specificity of 85%.

Connectedness to Humanity and Nature: Common Source but Distinct Mental Health and Mindfulness Outcomes – Validation of the Connectedness to Humanity Scale

Connectedness to Humanity and Nature: Common Source but Distinct Mental Health and Mindfulness Outcomes – Validation of the Connectedness to Humanity Scale

Abstract 3602: The association between longitudinal lipid trajectories and all-cause mortality in breast cancer survivors: A population-based study

Abstract Background: Given breast cancer is the second leading cause of cancer-related death in women, it is important to identify breast cancer patients at high risk of mortality. Lipid levels before and after diagnosis may be key indicators for overall health and prognostic outcomes for breast cancer patients. This study aimed to identify distinct lipid trajectories in those diagnosed with breast cancer and examined their association with all-cause mortality. Methods: This population-based retrospective cohort study included females diagnosed with incident breast cancer who survived at least five years after diagnosis (i.e., breast cancer survivors). Total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides (mmol/L) were used to develop trajectory patterns for each lipid through group-based trajectory modelling. Cox proportional hazards models estimated hazard ratios (HR) and 95% confidence intervals (CI) of all-cause mortality by lipid trajectories. Results: The study included 32, 537 female breast cancer survivors. Approximately 30% of the study population lipid levels within recommended ranges before and after a breast cancer diagnosis (moderate-stable trajectory). Nearly 10% of the population had very low lipids before and after a breast cancer diagnosis (very low-stable trajectory); this pattern was associated with an increased risk of all-cause mortality for total cholesterol (HR 1.38, 95%CI 1.16, 1.66), LDL (HR 1.24, 95%CI 1.04, 1.49), and HDL (HR 1.20, 95%CI 1.02, 1.40), compared to the moderate-stable trajectory. Approximately 5-6% had very high total cholesterol or LDL that rapidly declined after a breast cancer diagnosis (very high-declining trajectory); this pattern was associated with an increased risk of all-cause mortality compared to a moderate-stable trajectory (HR 1.59, 95%CI 1.23, 2.05; HR 1.40, 95%CI 1.09, 1.81, respectively). The association between lipid trajectories and all-cause mortality did not significantly differ by lipid-lowering agent use, suggesting pharmacologic management did not impact the findings. However, those not on a lipid-lowering agent had a mortality risk of higher magnitude than those on pharmacologic intervention. Conclusions: Breast cancer patients with very low lipids before and after diagnosis, and patients with very high lipids that rapidly decline to low levels after diagnosis were identified as subgroups at high risk of mortality. These findings highlight the importance of considering longitudinal, repeat lipid measures to improve long-term outcomes in this population. Citation Format: Shana Jean Kim, Vanessa De Rubeis, Brendan T. Smith, Husam Abdel-Qadir, Jennifer D. Brooks. The association between longitudinal lipid trajectories and all-cause mortality in breast cancer survivors: A population-based study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 3602.

Abstract 2214: Inhibiting the mevalonate pathway with atorvastatin alters gut microbiota and has potential as an anti-cancer treatment for ovarian cancer

Abstract Statins, a mevalonate (MVA) pathway antagonist, are widely used to treat and prevent hypercholesterolemia by blocking cellular production of cholesterol. However, new research has uncovered that statins exhibit pleotropic anti-tumor and immune modulating effects, as downstream metabolites from the MVA pathway have been linked to several cellular systems commonly dysregulated in cancer patients. Furthermore, statins have been shown to induce significant changes in intestinal enterotypes in both humans and mice. This is uniquely important as studies on the intestinal microbiota have shown a strong correlation between gut health and cancer outcomes. Therefore, we hypothesized that statins could be utilized to therapeutically target pre-clinical models of ovarian cancer by modulating the systemic and tumor immune landscape as well as the intestinal microbiome. Female C57BL/6 mice injected with 5x105 ID8-BRCA1null cells received low-dose atorvastatin (5mg/kg/day, n=14) or DMSO (<2%(v/v)/day, n=14) control for 5 weeks. Histopathology was performed on necropsy tissues, and immune profiling via flow cytometry was performed on splenocytes and cells isolated from ascites to examine the impact of statins on immune cell populations. In a separate study, we administered to female C57BL/6 mice atorvastatin (5mg/kg/day, n=5) or DMSO (<2%(v/v)/day, n=5) control for 4 weeks and sequenced 16S ribosomal RNA in their stool to determine how statin affected intestinal flora. Lastly, to determine if host genetics affect statin-mediate microbial changes, we simultaneously administered atorvastatin (5mg/kg/day) or DMSO (<2%(v/v)/day) control to three commonly used inbred mice strains (C3H/He, n=3; BALB/c, n=3; C57BL/6, n=5) and compared 16S sequencing results across all three strains. Conclusion: We found that statins, in the absence of standard of care regimens, are able to elicit immune modulatory effects in an aggressive ascitic model of ovarian high-grade serous carcinoma thereby offering moderate improvements to tumor outcomes. Furthermore, we found that statins favorably alter the intestinal microbiome, increasing microbial diversity within the gut and increasing the abundance of beneficial microbiota. Importantly, our data emphasize the role of host genetics in shaping microbiome responses to statin therapy, which could have implications for patient-specific treatment strategies. Overall, these results support further research to evaluate statins' use as a therapeutic or preventive agent for ovarian cancer. Citation Format: Juliane M. Liberto, Emily Ke, Daniel Labbe, Sabrene Mechergui, Kala Visvanathan, Ie-Ming Shih, Tian-Li Wang. Inhibiting the mevalonate pathway with atorvastatin alters gut microbiota and has potential as an anti-cancer treatment for ovarian cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 2214.

Effects of aerobic exercise of different intensities on the social, emotional, and financial functioning of healthy older adults: results from a 16-week exercise randomized control trial

Abstract Better social, emotional, and financial functioning are associated with improved health outcomes in older adults. While the literature supports a positive relationship between physical activity and increased functional ability in older adulthood, the intensity of physical activity necessary to achieve these gains remains uncertain. To address this gap, the current analysis uses data collected as part of a larger randomized controlled trial to examine the effects of a supervised exercise intervention on measures of social, emotional, and financial functioning. Healthy older adults (n = 211) completed baseline assessments including cardiovascular fitness and health and functioning measures and were randomly assigned to 16 weeks of either: (1) low intensity continuous training (LICT); or (2) moderate intensity continuous training + interval training (MICT + IT). Participants across exercise conditions reported a significant decrease from baseline to post-intervention in depression [F(1, 158) = 22.17, p < .001] and instrumental risk taking [F(1, 157) = 6.72, p < .05]. Further, participants assigned to the MICT + IT condition showed significantly greater improvements in loneliness relative to those in the LICT condition [F(1, 157) = 5.99, p < .05]. By and large, healthy older adults experienced some improvements in functional ability after 16 weeks of exercise. Though most changes were not related to the intensity of exercise condition, associations between increased cardiovascular fitness and both depression and anxiety suggest that exercising at an intensity that improves fitness may confer greater benefits in some domains. Trial registration: ClinicalTrials.gov, NCT02068612.

Plea Bargains as Drivers of Incarceration-Related Health Outcomes.

The discipline of public health has begun to recognize the structural inequities of the carceral system as drivers of poor individual and population health. The number of people incarcerated and the length of their incarceration determine the scope and gravity of their exposure to these individual and public health effects. Plea bargains all but guarantee a period of incarceration, often for many years, because prosecutors have significant bargaining power against defendants who often do not fully understand their rights or the likelihood of receiving the sentences that prosecutors would be seeking in trial. I propose and analyze several pathways through which to eliminate or severely restrict the practice of plea bargaining to minimize the health effects associated with incarceration. I conclude that state legislation would be most feasible and effective at eliminating plea bargains but, without concurrent interventions addressing mandatory minima and/or bail, would not fundamentally address the primary concerns of sentence length and overcrowding.

Exploring the Psychosocial Benefits of Medicinal Plants in HIV Care

The intersection of medicinal plants and psychosocial well-being in HIV care represents an emerging area of interdisciplinary research. While antiretroviral therapy (ART) remains the cornerstone of HIV management, individuals living with HIV (PLWH) face significant psychosocial challenges, including stigma, discrimination, and mental health distress. Traditional healing systems have long incorporated medicinal plants, not only for their pharmacological properties but also for their role in emotional and community support. This paper explores the historical, cultural, and psychosocial dimensions of medicinal plant use in HIV care, highlighting their potential in alleviating psychological distress and enhancing social cohesion. A mixed-methods approach integrating ethnobotanical research with biomedical studies is recommended to validate the efficacy of medicinal plants in this context. Incorporating traditional healing knowledge into modern healthcare strategies may provide a more holistic approach to HIV care, fostering better mental health outcomes and improved quality of life for PLWH. Keywords: Medicinal plants, Psychosocial well-being, HIV/AIDS care, Traditional medicine, Ethnobotany, Holistic health, Stigma and discrimination.