Institute Of Cancer Research Research Articles

Adherence to the World Cancer Research Fund/American Institute for Cancer Research recommendations for cancer prevention in adolescent and young adult (AYA) cancer survivors: results from the SURVAYA study.

For adolescent and young adult (AYA) cancer survivors with a good prognosis, having a healthy lifestyle prevents morbidity and mortality after treatment. The aim of this study was to investigate the prevalence of (un)healthy lifestyle behaviors and related determinants in AYA cancer survivors. A population-based, cross-sectional study was performed among long-term (5-20years) AYA cancer survivors (18-39years old at diagnosis) registered within the Netherlands Cancer Registry. Self-reported questionnaires data about health behaviors were used to calculate the 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) adherence score. Associations between the score and clinical/sociodemographic determinants of (un)healthy behaviors were investigated using logistic regression models. The mean WCRF/AICR score was low to moderate, 3.8 ± 1.2 (0.5-7.0) (n = 3668). Sixty-one percent adhered to "limit the consumption of sugar sweetened drinks," 28% to "be a healthy weight," 25% to "fruit and vegetable consumption," and 31% to "limit alcohol consumption." Moderate and high adherence were associated with being a woman (ORmoderate = 1.46, 95% CI = 1.14-1.85, and ORhigh = 1.87, 95% CI = 1.46-2.4) and highly educated (ORmoderate = 1.54, 95% CI = 1.30-1.83, and ORhigh = 1.87, 95% CI = 1.46-2.4). Low adherence was associated with smoking (ORmoderate = 0.68, 95% CI = 0.50-0.92, and ORhigh = 0.30, 95% CI = 0.21-0.44) and diagnosis of germ cell tumor (ORmoderate = 0.58, 95% CI = 0.39-0.86, and ORhigh = 0.45, 95% CI = 0.30-0.69). Adherence to the 2018 WCRF/AICR lifestyle recommendations was low to moderate, especially regarding body weight, fruit, vegetables, and alcohol consumption. Men, current smokers, lower-educated participants, and/or those diagnosed with germ cell tumors were less likely to have a healthy lifestyle. Health-promotion programs (e.g., age-specific tools) are needed, focusing on high-risk groups.

To study the survival analysis and recurrence pattern in women treated for breast cancer: Retrospective study, a tertiary cancer center experience from Sub-Himalayan Region of India.

Breast cancer is a leading health concern in India, comprising 25% of female cancers with significant mortality. This study was conducted at the Cancer Research Institute in the Northern Sub-Himalayan region of India from 2016 to 2021, evaluated 674 breast cancer cases to analyze factors that influence recurrence. Retrospective clinical audit assessing patients' survival outcomes using Kaplan-Meier curves and Cox proportional hazard regression. Factors including age, molecular subtype, TNM staging, and treatment modalities were evaluated. Notable findings include a high occurrence of breast cancer in young patients (24.48% ≤ 40 years) and varying recurrence rates among molecular subtypes withhuman epidermal growth factor receptor 2 neu-enriched (25.24%) and triple‑negative breast cancer (22.58%) being the most common. Advanced T and N stages, neoadjuvant chemotherapy, and the number of nodes dissected showed significant associations with higher recurrence rates. This study sheds light on survival and recurrence patterns in Northern Sub-Himalayan breast cancer patients, emphasizing the need for tailored treatment strategies, comprehensive follow-up care, with improved understanding of regional outcomes. These findings contribute valuable insights for optimizing patient care and improving survival rates in this region.

Comparative Study between Two Fractions of 9Gy & Three Fractions of 7Gy High Dose Rate Brachytherapy Following Concurrent Chemo Radiotherapy in Patients with Locally Advanced Carcinoma of Uterine Cervix

Introduction: Traditionally, a judicious combination of external beam radiotherapy (EBRT) and intracavitary brachytherapy (ICBT) is the widely accepted primary modality of treatment for locally advanced carcinoma of the cervix. Although the recommendation ofAmerican Brachytherapy Society is <7.5 Gyfor individual fraction and four to eight should be the range of fractions; however, literature showed high dose rate (HDR) brachytherapy of two fractions of 9Gyresults in acceptable toxicity without compromising the local control.  Methods: This was a Prospective Quasi-Experimental study, conducted in Department of Radiation Oncology, National Institute of Cancer Research and Hospital, Mohakhali, Dhaka from July 2018 to June 2019. Patients with Clinically diagnosed and histopathologically proven squamous cell carcinoma of uterine cervix in locally advanced stage (FIGO stage IIB to IVA) were selected. Total 60 patients were enrolled according to selection criteria and allocated in to group. Both arm was received 50Gy EBRT in 25 fractions with concurrent inj.Cisplatin 40 mg/m2 weekly. Then Arm A was given HDR Brachytherapy 9Gy in each fraction for 2 fractions and Arm B was given HDR Brachytherapy 7Gy in each fraction for 3 fractions. Then treatment responses, locoregional control of disease and acute toxicities were compared between groups. Result:Follow up at 6 months after completion of treatment, complete remission was 90% and 86% respectively for arm A and arm B. The overall complete response was 88%. The common toxicities associated with treatment were bladder and rectal toxicities, skin reaction, small bowel toxicity and haematologic complications which were managed well. During follow up after 6 months, 3 patients in arm A and 2 patients in arm B developed grade II bladder toxicities and only 2 patients in arm A developed rectal grade II toxicities, but there was no rectal toxicity in arm B. Conclusions: Present study showed that a total dose of 18 Gy ICRT in two fractions of 9 Gy over 2 weeks is equally effective in short term local control with acceptable toxicities in comparison with a total dose of 21 Gy in three fractions of 7 Gy ICRT. J Bangladesh Coll Phys Surg 2024; 42: 49-56

Effect of Pelvic Radiation on Haematopoeitic and Gastrointestinal Syndromes: a Prospective & Observational Study

Radiotherapy may induce irreversible damage on healthy tissues surrounding the tumor. It has been reported that the majority of patients receiving pelvic radiation therapy show early or late tissue reactions of graded severity as radiotherapy affects not only the targeted tumor cells but also the surrounding healthy tissues. This prospective, observational study was conducted to observe the effects of pelvic radiation on haematopoeitic and gastrointestinal syndromes. It was done in Radiation Oncology department of National Institute of Cancer Research and Hospital, Dhaka between July 2011 to June  2012. The study participants were all patients getting pelvic radiation in the concerned department. A blood profile was done before radiotherapy. Clinical evaluation as per RTOG Guideline was done to access the gastrointestinal syndromes. Then, pelvic radiation was started and CBC was done and recorded weekly as well as gastrointestinal toxicity grading. Main outcome measures were hemoglobin, TC of WBC, nausea, vomiting, diarrhea. Before treatment the mean hemoglobin % was 11.0±1.1 mg/dl, during 4th week of treatment it 10.37±0.7 mg/dl.The mean TC of WBC was found 11107.4±13481.4 mm3, during 4th week of treatment the mean TC of WBC was found 7550.6±2514.6 mm3.Nausea and vomiting increased upto 3rd week but decline in subsequent follow-up. 42% patients had diarrhea during 2ndand 3rd week of treatment, 20.0% in 4thweek and only 2.0% found in 5th week. It can be said that hematopoetic and gastrointestinal syndromes are significantly correlated in patients undergoing pelvic radiation following 4th week of follow up reports. J Bangladesh Coll Phys Surg 2024; 42: 31-37

Clinical Audit of Gynecological Cancers at National Institute of Cancer Research and Hospital, Dhaka, Bangladesh

The aim of this audit was to assess the trend of the gynecological cancers for the year of 2022. This is an observational study on retrospectively collected data of gynecological cancer patients at National Institute of Cancer Research and Hospital (NICRH), Dhaka. All cases of cancer seen at the gynecology outpatient department and cases admitted in the gynecological oncology ward at NICRH, between the months of January to December 2022 were audited. The results shown that about 5.8% of all the new cases were young women aged below 25 years. The majority of gynecological cancers were among women aged between 35 and 64 years (73.17%) and only 2.6% patients were aged above 75 years. Cervical cancer (59%) was the leading gynecological cancer among all female cancers attended at NICRH. In ovarian malignancy, most of the patients(61%) had stage lll disease and no patient in stage IV diseases. Due to  improper evaluation of abnormal uterine bleeding, majority of the endometrial carcinoma patients (64%) presented with histopathology reports after hysterectomy. This study might help to get a in depth understanding of the trend of major gynecological cancers. J Bangladesh Coll Phys Surg 2024; 42: 43-48

Assessment of Oncosurgical and Functional Outcomes in Patients undergoing Glossectomy for Advanced Carcinoma Tongue: A Cross-sectional Study at a Tertiary Cancer Care Centre in Northern India

Introduction: Tongue carcinoma presents a global oncological challenge due to its aggressive nature and late-stage diagnosis. Glossectomy, a key surgical procedure for advanced cases, significantly affects both cancer control and essential functions such as speech and swallowing. Aim: To analyse the impact of different glossectomy types on oncological and functional outcomes in patients with advanced carcinoma of the tongue. Materials and Methods: A cross-sectional study was conducted in the Department of Surgical Oncology, Cancer Research Institute, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Uttarakhand, India over a one-year period from September 1, 2022, to August 31, 2023. The study included 47 patients with squamous cell carcinoma of the oral and posterior tongue who underwent glossectomy. Oncological outcomes (mortality and hospital stay) and functional outcomes (swallowing, speech, dysphagia, and Quality of Life (QoL)) were assessed. The questionnaires used were the EORTC Core Quality of Life questionnaire (EORTC QLQ-C30), EORTC questionnaire for the assessment of QoL in head and neck cancer patients (EORTC QLQ-H&N35), M.D. Anderson Dysphagia Inventory (MDADI), and Speech Handicap Index (SHI). Follow-up was conducted at the 6th week to assess changes in the functional aspects compared to the baseline scores. Data were entered into Microsoft Excel, and the analysis was performed using Statistical Packages for Social Sciences (SPSS) software version 25.0. The data were analysed using the Wilcoxon Signed Rank test. A p-value of <0.05 was considered statistically significant. Results: The study comprised 37 (78.72%) males and 10 (21.28%) females, with a mean age of 47.77±12.6 years. Preoperative staging indicated that 22 (46.81%) patients had T2N0 stage, 16 (34.04%) patients had T3, and 9 (19.15%) patients had T4a disease. Among the patients, 14 (29.79%) underwent partial glossectomy, 27 (57.45%) underwent hemiglossectomy, and 3 (6.38%) underwent subtotal glossectomy, and 3 (6.38%) underwent total glossectomy. The mean duration of hospital stay was 10.09±2.87 days. There were no instances of mortality or tumour recurrence at the 6th week. Regarding the functional outcomes, compared to baseline, at the 6th week, there was a significant decrease in EORTC QLQ-H&N35 median scores from 6.94 to 1.73 (p=0.005), but no significant change in the mean EORTC QLQ-C30 (90±8.22 versus (vs) 89.72±8.52, p=0.368), mean MDADI (4.51±1.2 vs 4.43±1.19, p=0.585), and mean SHI (15.81±25.76 vs 13.43±26.19, p=0.052). Conclusion: It can be inferred that glossectomy for advanced carcinoma of the tongue leads to a significant improvement in symptoms; however, the overall Quality of Life (QoL) and functions of the tongue such as swallowing and speech remain comparable to pre-surgery levels.

Pre and Postoperative Serum miR-21 Expression Levels in Oral Cancer and it’s Association with Clinical and Histological Parameters: An Observational Study

Introduction: The patterns of microRNA (miRNA) expression have opened up new avenues in the search for prognostic biomarkers and potential therapeutic targets for various tumours. In oral carcinogenesis research, analysing microRNAs expressed in Oral Squamous Cell Carcinoma (OSCC) unveils a complex network of interest. miR-21 is known to be overexpressed in numerous solid tumours and is linked to the progression of malignancies in hepatocellular carcinomas, breast cancer, and colon carcinomas. Aim: To determine the impact of surgical excision on serum miR-21 expression levels in OSCC cases and to establish correlations with clinicopathological parameters. Materials and Methods: The study was an exploratory prospective observational study conducted with proper institutional ethical approval at the Cancer Research Institute (CRI), Himalayan Institute of Medical Sciences (HIMS), Jolly Grant, Dehradun, Uttarakhand, India. Fifty-six histologically confirmed OSCC cases were enrolled along with 25 healthy subjects as controls from May 2021 to June 2023. The relative fold expression change was calculated using the Livak method (2-∆∆ct). Data analysis was performed using software such as Statistical Package for Social Sciences (SPSS) version 20.0 and MS Excel. Non parametric statistical tests such as Wilcoxon signed-rank test, MannWhitney test, and Kruskal-Wallis test were utilised. Results: Out of 56 sample included, 28 exhibited high expression of miR-21 (p-value<0.001), while 27 cases showed downregulation postsurgery (p-value<0.001), with one sample showing the same level of expression. In cases where the time difference between pre and postsurgery samples was over 25 days, no significant change was observed (p-value=0.06), and similarly, in cases with a time difference below 25 days, no significant difference was noted (p-value=0.14). A significant negative correlation was found between presurgery serum Albumin to Globulin ratio (A:G ratio) and miR-21 expression (p-value <0.05), while no other parameters showed a significant correlation with miR-21. Conclusion: miR-21 expression decreased significantly in some OSCC cases; however, in the majority of cases, it increased postsurgery. A significant correlation was observed between miR-21 expression and the serum A:G ratio.

Effect of Rhodiola Rosea Supplement on Exhaustive Swimming Test and Physical Fatigue in Male Institute of Cancer Research Mice

Background Fatigue decreases exercise performance, and affects work capacity and quality of life. Functional supplement use is one of the common methods to alleviate fatigue. Rhodiola rosea (RHR) exerts antioxidative and anti-inflammatory effects due to its rich glycosides and has the potential to resist fatigue. Therefore, this study aims to investigate the effects of the RHR supplement on physical fatigue induced by exhaustive swimming exercise. Methods Forty institute of cancer research (ICR) mice were divided and assigned to one of four treatment groups (0, 600, 1200, and 3000 mg/kg body weight), with 10 animals in each group. After four weeks of RHR supplement intervention, swimming tests were conducted to assess exercise endurance, the accumulation of blood fatigue markers, and tissue glycogen storage. Results The results showed that after four weeks of the RHR supplement intervention, the exhaustive swimming time significantly increased in three treatment groups with a dose-dependence effect. The accumulation of blood fatigue substances (lactate, blood urea nitrogen (BUN), creatine kinase (CK) was significantly decreased, and glycogen content in the liver and muscle was elevated. Conclusion RHR supplements possess the capacity to enhance exercise performance and prevent exercise-induced fatigue. It is suitable to develop an RHR supplement as a dietary supplement for anti-fatigue.

Enhanced anti-fatigue and exercise performances due to Huáng qí polysaccharide supplementation in mice

In modern society, people have busy and competitive lives, with different stresses causing fatigue and overwork, which may ultimately harm their health. We investigated the beneficial effects of Astragalus polysaccharide (rAPS) on fatigue and exercise performance. Forty male Institute of Cancer Research (ICR) mice were randomly divided into four groups according to body weight (BW): control group (distilled water), 1-fold dose group (0.70 g rAPS/kg BW/day), 2-fold dose group (1.40 g rAPS/kg BW/day) and a 5-fold dose group (3.50 g rAPS/kg BW/day). In terms of exercise performance, rAPS supplementation significantly improved grip strength performance and time to exhaust-loaded swim times when compared with controls (p < 0.05). Moreover, rAPS supplementation significantly reduced fatigue-related biochemical parameters, including blood lactate and BUN levels, while significantly improve muscle strength and swimming endurance times t(p < 0.05). Hence, we recommend that rAPS elicit antifatigue and performance-enhancing health benefits.

Toxicologic effect and transcriptome analysis for sub-chronic exposure to carbendazim, prochloraz, and their combination on the liver of mice.

Carbendazim (CBZ) and prochloraz (PCZ) are broad-spectrum fungicides used in agricultural peat control. Both fungicides leave large amounts of residues in fruits and are toxic to non-target organisms. However, the combined toxicity of the fungicides to non-target organisms is still unknown. Therefore, we characterized the toxic effects of dietary supplementation with CBZ, PCZ, and their combination for 90days in 6-week-old male Institute of Cancer Research (ICR) mice. CBZ-H (100mg/kg day), PCZ-H (10mg/kg day), and their combination treatments increased the relative liver weights and caused liver injury. The serum total cholesterol (TC), triglyceride (TG), glucose (Glu), pyruvate (PYR), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) levels were reduced, and synergistic toxicity was observed. Hepatic transcriptome revealed that 326 differentially expressed genes (DEGs) of liver were observed in the CBZ treatment group, 149 DEGs in the PCZ treatment group, and 272 DEGs in the combination treatment group. According to KEGG enrichment analysis, the fungicides and their combination affected lipid metabolism, amino acid metabolism, and ferroptosis. In addition, the relative mRNA levels of key genes involved in lipid metabolism were also examined. Compared with individual exposure, combined exposure to CBZ and PCZ caused a more obvious decrease in the expression of some genes related to glycolipid metabolism. Furthermore, the relative mRNA levels of some key genes in the combination treatment group were lower than those in the CBZ and PCZ treated groups. In summary, CBZ, PCZ, and their combination generally caused hepatotoxicity and glycolipid metabolism disorders, which could provide new insights for investigating the combined toxicity of multiple fungicides to animals.

Daily low-dose aspirin and incident type 2 diabetes in community-dwelling healthy older adults: a post-hoc analysis of efficacy and safety in the ASPREE randomised placebo-controlled trial

Inflammation has been implicated in the pathogenesis of diabetes. This study investigated the randomised treatment effect of low-dose aspirin on incident type 2 diabetes and fasting plasma glucose (FPG) concentrations among older adults. ASPREE was a double-blind, placebo-controlled trial of daily oral low-dose aspirin. The study population included community-dwelling individuals aged 70 years or older (≥65 years for US minority ethnic groups) in the USA and Australia who were free of cardiovascular disease, independence-limiting physical disability, or dementia. For the post-hoc analysis, we excluded participants with diabetes at baseline or with incomplete or missing incident diabetes data during follow-up. Participants were randomly assigned 1:1 to oral 100 mg daily enteric-coated aspirin or placebo. Incident diabetes was defined as self-reported diabetes, commencement of glucose-lowering medication, or a FPG concentration of 7·0 mmol/L or more assessed at annual follow-up visits among participants with no diabetes at baseline. We used Cox proportional hazards models and mixed-model repeated measures to assess the effect of aspirin on incident diabetes and FPG concentrations in the intention-to-treat population. We assessed major bleeding in participants who had taken at least one dose of study medication. Between March 10, 2010, and Dec 24, 2014, a total of 16 209 participants were included (8086 [49·9%] randomly assigned to aspirin and 8123 [50·1%] randomly assigned to placebo). During a median follow-up of 4·7 years (IQR 3·6-5·7), 995 (in 6·1% individuals) incident cases of type 2 diabetes were recorded (459 in the aspirin group and 536 in the placebo group). Compared with placebo, the aspirin group had a 15% reduction in risk of incident diabetes (hazard ratio 0·85 [95% CI 0·75 to 0·97]; p=0·013) and a slower rate of increase in FPG concentration at year 5 (between-group difference estimate -0·048 mmol/L [95% CI -0·079 to -0·018]; p=0·0017). Major bleeding (major gastrointestinal bleeding, intracranial bleeding, and clinically significant bleeding at other sites) occurred in 510 (3·2%) of 16 104 participants (300 [3·7%] in the aspirin group and 210 [2·6%] in the placebo group). Compared with placebo, the aspirin group had a 44% increase in risk of major bleeding (hazard ratio 1·44 [95% CI 1·21 to 1·72]; p<0·0001). Aspirin treatment reduced the incidence of type 2 diabetes and slowed the increase in FPG concentration but increased major bleeding among community-dwelling older adults. Given the increasing prevalence of type 2 diabetes among older adults, the potential for anti-inflammatory agents such as aspirin to prevent type 2 diabetes or improve glucose levels warrants further study with a comprehensive assessment of all potential safety events of interest. US National Institute on Aging, US National Cancer Institute, National Health and Medical Research Council of Australia, Monash University, and the Victorian Cancer Agency.

Feasibility of correcting defects in the pronunciation of posterior lingual sounds resulting from oral cavity and oropharyngeal cancer surgery

BACKGROUND: Speech dysfunction is noted in patients who have undergone hemiglossectomy or glossectomy for cancer of the oral cavity and oropharynx, including the pronunciation of sounds [k], [k’], [g], and [g’].&#x0D; AIMS: To evaluate the effectiveness of correction of the pronunciation of posterior lingual sounds in patients with oral cavity and oropharyngeal cancers after surgical treatment.&#x0D; MATERIALS AND METHODS: The objective and subjective assessments of speech allowed speech therapists to examine defects in the pronunciation of posterior lingual sounds [k], [k’], [g], and [g’] in patients with oral cavity and oropharyngeal cancer who underwent surgery. The effectiveness of correcting defects in the pronunciation of posterior lingual sounds was evaluated considering the extent of surgery. The study included 171 patients with stage II–IV oral cavity and oropharyngeal cancers. The age of the patients ranged from 24 to 70 years. The patients underwent hemiglossectomy, hemiglossectomy with reconstruction, or glossectomy with reconstruction. Combined modality treatment and postoperative speech rehabilitation were performed at the Department of Head and Neck Tumors of the Cancer Research Institute.&#x0D; RESULTS: In all patients before starting the combined treatment, the pronunciation of posterior lingual sounds [k], [k’], [g], and [g’] corresponded to the norms in the Russian language. After surgery, the pronunciation of these sounds was impaired in most patients. In group III (after glossectomy with reconstruction), pronunciation defects were observed in 100% of the cases. The corrective speech therapy included a set of breathing and articulation exercises for the muscles of the cheeks, lips, and tongue using passive motor gymnastics as the basis for activating and coordinating the patient’s articulation apparatus.&#x0D; CONCLUSION: The presented system of subsequent correction and automation of posterior lingual sounds allowed the correction of the pronunciation of these sounds in most patients.

Association of genetic risk and lifestyle with pancreatic cancer and their age dependency: a large prospective cohort study in the UK Biobank

BackgroundPancreatic cancer (PC) is influenced by both genetic and lifestyle factors. However, further research is still needed to comprehensively clarify the relationships among lifestyle, genetic factors, their combined effect on PC, and how these associations might be age-dependent.MethodsWe included 340,631 participants from the UK Biobank. Three polygenic risk score (PRS) models for PC were applied, which were derived from the previous study and were categorized as low, intermediate, and high. Two healthy lifestyle scores (HLSs) were constructed using 9 lifestyle factors based on the World Cancer Research Fund/American Institute of Cancer Research (WCRF/AICR) lifestyle score and the American Cancer Society (ACS) guidelines and were categorized as unfavorable, intermediate, and favorable. Data were analyzed using Cox proportional hazards models.ResultsThere were 1,129 cases of incident PC during a median follow-up of 13.05 years. Higher PRS was significantly associated with an increased risk of PC (hazard ratio [HR], 1.58; 95% confidence intervals [CI], 1.47–1.71). Adhering to a favorable lifestyle was associated with a lower risk (HR, 0.48; 95% CI, 0.41–0.56). Participants with an unfavorable lifestyle and a high PRS had the highest risk of PC (HR, 2.84; 95% CI, 2.22–3.62). Additionally, when stratified by age, a favorable lifestyle was most pronounced associated with a lower risk of PC among participants aged ≤ 60 years (HR, 0.35; 95% CI, 0.23–0.54). However, the absolute risk reduction was more pronounced among those aged > 70 years (ARR, 0.19%, 95% CI, 0.13%–0.26%). A high PRS was more strongly associated with PC among participants aged ≤ 60 years (HR, 1.89; 95% CI, 1.30–2.73). Furthermore, we observed a significant multiplicative interaction and several significant additive interactions.ConclusionsA healthy lifestyle was associated with a lower risk of PC, regardless of the participants' age, sex, or genetic risk. Importantly, our findings indicated the age-dependent association of lifestyle and genetic factors with PC, emphasizing the importance of early adoption for effective prevention and potentially providing invaluable guidance for setting the optimal age to start preventive measures.

The Hallmarks of Cancer in 2023

CURRENT cancer hallmarks, their capabilities, and potential targeted therapies were the focus of the presentation given by Douglas Hanahan, Ludwig Institute for Cancer Research, Lausanne, Switzerland, at the European Society for Medical Oncology (ESMO) Congress 2023, held in Madrid, Spain. Hanahan began by defining hallmarks as acquired functional capabilities that contribute to the manifestation of the disease, which are a “conceptual framework for rationalising the daunting complexity of cancer.”

Abstract B058: Positive changes in diet quality among African American breast cancer survivors from Moving Forward, a weight loss intervention program

Abstract Background: African American breast cancer survivors (AABCS) experience higher rates of all-cause mortality and recurrence risk compared to survivors of other races/ethnicities. Although disparities are multi-factorial, lifestyle is a key factor in cancer survivorship, comorbidity burden and quality of life. The American Cancer Society (ACS) and American Institute for Cancer Research (AICR) have set nutrition and physical activity guidelines for cancer survivors. This study examines the between and with-in group differences of diet quality and related outcomes among AABCS enrolled in Moving Forward (MF).  Methods:  MF was a 6-month, community-based, weight-loss intervention trial for AABCS. Participants were randomized to either an Interventionist-Guided (IG) or Self-Guided (SG) group. Both groups received educational materials to promote lifestyle changes. The IG group also received twice weekly group sessions with supervised exercise and group support. Participants completed surveys on diet quality (Block 2005 Food Frequency Questionnaires (FFQ)) and related outcomes, and fitness assessments at baseline, post-intervention and at a 12-month follow-up. Diet quality was scored using the Healthy Eating Index (HEI-2010) range 0-100, Alternative Healthy Eating Index (AHEI-2010) range 0-110, and ACS/AICR guidelines range 0-21 to measure adherence pre- and post-intervention. Results: 180 AABCS completed the FFQ at all 3 timepoints and were included in these analyses. Participants had a mean age of 57.6 ± 10.6, 40.2% were married/living with a partner, and had varied income and education levels. Participants were an average of 7.2 years from diagnosis (range 0.8-35.1 years), 99% had surgery, 78% had radiation and 74% had chemotherapy. At baseline, mean diet scores were 65.3 for HEI-2010, 56.7 for AHEI-2010, and 12.7 for ACS/AICR guidelines. Although results varied among the 3 diet indices, participants in the IG group saw significant improvements in fruit, vegetable, and whole grain consumption with decreased sugar, empty calorie, and trans fat consumption from baseline to 6 and 12 months. Both groups saw improvements in total scores for all 3 diet indices from baseline to 6 and 12 months. The SG group improved in limiting sugars and empty calories from baseline to follow-up timepoints. The IG group saw greater improvements in fruit and vegetable consumption compared to SG group in all 3 diet indices. Body Mass Index and physical activity were significantly improved in both groups but social support, self-efficacy, and perceived barriers to healthy eating were significantly improved in the IG group only. Conclusion: Overall diet quality scores were suboptimal at baseline showing a need for positive dietary change among AABCS, and a need for more evidence considering diet quality and social predictors of dietary intake in this community. Data from culturally tailored and community-based interventions like MF can be used to develop effective, sustainable strategies to improve diet quality and related outcomes in AABCS even after an intervention ends. Citation Format: Margaret Y. Tovar, Sparkle Springfield, Melinda Stolley. Positive changes in diet quality among African American breast cancer survivors from Moving Forward, a weight loss intervention program [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B058.

Abstract A124: NICRAT: The institute pioneering a new approach to cancer research and treatment in sub-Saharan Africa

Abstract Background: Cancer is a major public health challenge in several sub-Saharan African countries, and some of these nations have established their national cancer institutes as a focal point to address this threat. Similarly, the Nigerian government founded the National Institute for Cancer Research and Treatment (NICRAT) in 2017. The purpose of this report is to provide an understanding of the opportunities in establishing a new cancer institute in Nigeria, the most populous Black country in the world and the most populous country in Africa. We reviewed the history, mission and strategy of the National Institute for Cancer Research and Treatment (NICRAT). Methods: The data sources reviewed were publications in professional journals, government reports, news articles, and the NICRAT website. Results: Some of the concerns that justified the establishment and initiation of a national cancer institute in Nigeria include the lack of a coordinated effort to study and combat the disease in Nigeria. The NICRAT was created to centralize cancer research efforts, provide funding for cancer research, and coordinate research activities across the country. These institutes are a science-based governmental institutions dedicated to cancer research, prevention, and treatment. Accordingly, the institution will promote the fight against cancer, providing a centralized focus for cancer research and treatment efforts, and facilitating collaboration between researchers, healthcare providers, and patients, as well as guidance for cancer policy formulation and implementation for decision-makers. Modelled on the US National Cancer Institute (NCI), the NICRAT has institutionalised Nigeria’s capacity to coordinate research efforts to support the use of evidence-based practices in designated Cancer Centers to reduce the impact of cancer. The NICRAT is also the focal point for the implementation of the National Cancer Control Plan (NCCP), and will coordinate the National System of Cancer Registries and the Cancer Health Fund. Discussion: Cancer institutes in sub-Saharan Africa are currently in early stages of evolution. Over the next 5 years, NICRAT’s mission is to work in partnership with other arms of Government and partners to continue its efforts in advancing cancer research, prevention, and treatment. The NICRAT will also focus on improving cancer care delivery and access to care, enhancing cancer prevention and education efforts, and strengthening collaborations with international partners to address the cancer challenge. How successful the institute becomes in its mission will be determined by its capacity to develop the right partnerships, including with the private sector, adopting innovative approaches, and mobilising adequate resources. Building a national cancer institute requires strong commitment, planning and action. The experience of setting up the NICRAT can inform similar efforts in other African countries. Citation Format: Sani A. Malami, Usman M. Aliyu, Uchechukwu E. Nwokwu, Waziri U. Mohammed. NICRAT: The institute pioneering a new approach to cancer research and treatment in sub-Saharan Africa [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A124.

Abstract A089: Examining the role of Social Determinants of Health (SDoH) on adherence to cancer prevention recommendations: Evidence from a national representative sample

Abstract The role of Social Determinants of Health (SDoH)  on adherence to cancer prevention recommendations has not been systematically examined among adults in the United States adults despite  the influential role of SDoH in shaping individuals' health behaviors and outcomes. Our purpose was to  explore the effects of SDoH on adherence to cancer prevention recommendations among  adults in the United States Methods: We used data from the Health Information National Trends Survey (HINTS), 6 cycle (2022).  Adults aged 18 years and above were included. Adherence to cancer prevention recommendations was measured with the 2018 World Cancer Research Fund (WCRF)/American Institute for Cancer Research (WCRF/AICR) Cancer Prevention Recommendations Score.  SDoH was measured based on the American Cancer society's five core SDOH domains (economic stability, social and community context, neighborhood and built environment, education access, and healthcare access). Weighted hierarchical multiple regression models were conducted using each domain of SDOH as a block, controlling for age, gender, race, selfcare efficacy, cormorbidity, cancer risk perception and  belief about cancer,  Jackknife replicate weights were incorporated into the analyses. Results: The sample consisted of 6252 respondents with a mean age of 55.6 (SD, 17.4) years,  The  estimated mean adherence rate  to cancer prevention recommendations among adults in the United States was  40.4% (SD 21.8) .Adherence to  cancer prevention recommendations was positively associated with  having a college education compare to less than high school education (Odd Ratio [OR], 6.29, P = .019),  combined household income of $75,000 and above compare to combined household income of less than $20,000 ( OR, 5.11 , P= .014) , retired compared to full-time employement ( OR, 4.87, P &amp;lt; .001), access to health insurance compared to lack of health insurance  (OR, 4.01, P= .020). These findings suggest that  interventions targeting  the effects of SDoH on cancer on adherence to cancer prevention recommendations may consider the  socioeconomic context of targeted individuals. Such interventions should focus on addressing barriers related to education access, income stability, employment status  and healthcare access.   Citation Format: Adaeze Aroh, Ifeanyi N. Madujibeya. Examining the role of Social Determinants of Health (SDoH) on adherence to cancer prevention recommendations: Evidence from a national representative sample [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A089.

Abstract A068: Educating the next generation of cancer researchers: Evaluation of a cancer research partnership training program

Abstract Introduction: The underrepresentation of minorities in cancer research hampers efforts to address disparities among minority populations. To tackle this issue, early mentorship of emerging scientists from underrepresented communities is crucial. The Synergistic Partnership for Enhancing Equity in Cancer Health (SPEECH) is a collaboration between Temple University/Fox Chase Cancer Center, Hunter College (TUFCCC/HC), and funded by the National Cancer Institute. SPEECH aims to reduce cancer health disparities through research, community outreach, and support for underrepresented investigators and students. The Research Education Core (REC) within SPEECH focuses on enhancing training and mentorship, including the Summer Cancer Research Institute (SCRI), providing opportunities for underrepresented minority students in cancer research. Procedures: We conducted a cross-sectional survey with accepted SCRI applicants (i.e., participants) and their peers whose applications to the SCRI were not accepted (non-participants) from four cohorts (2019–2022). Email invitations with a link to a REDCap survey were sent to 51 SCRI participants and 488 non-participants with the goal of investigating any differences between the two groups in knowledge and career goals. In total, 32 SCRI participants and 47 non-participants responded to the survey. One SCRI participant was excluded due to missing data, yielding 31 SCRI participants. About 70% of the participants identified as Asian, Black/African American, or multi-racial. Results: SCRI participants had significantly higher knowledge scores in health disparities (p &amp;lt; 0.001), cancer biology (p &amp;lt; 0.001), and cancer prevention (p &amp;lt; 0.05) than non-participants. SCRI participants also had slightly higher levels of interest in pursuing a graduate-level degree in cancer biology or cancer health disparities-related discipline (41.9% reporting “very interested”) and in pursuing a career in cancer biology or cancer health disparities (41.9% “very interested”), than the non-participants (36.2% and 36.2%, respectively), but the differences were not statistically significant. The two groups had similar rates of pursuing a career in cancer biology, cancer health disparities research, or teaching in academia. In addition, over 90% reported Of those who participated in the SCRI  that they “agreed” or “strongly agreed” that the SCRI experience had a positive influence on their plans for continued education (90.3%), increased skills in cancer or cancer health disparities research (93.6%), increased skills on scientific writing (93.6%), increased skills on presenting at a conference (100%), and had a positive influence on their future career plans (90.3%). Summary: Our findings indicate that an intensive 8-week training institute can increase students’ knowledge and capacity in cancer research, demonstrating an overall positive influence of the program on students’ perceived scientific skills and future career plans.   Citation Format: Lin Zhu, S.J. Dodd, Yuku Chen, Emily R. Kaminsky, Zhiqing Elaine Liu, Grace X. Ma, Olorunseun O. Ogunwobi, Carolyn Y. Fang. Educating the next generation of cancer researchers: Evaluation of a cancer research partnership training program [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A068.

Abstract A022: Assessing, understanding, and addressing social determinants of cancer health disparities through patient navigation among rural Arkansans

Abstract The Winthrop P. Rockefeller Cancer Institute at the University of Arkansas for Medical Sciences (UAMS), Office of Community Outreach and Engagement has developed a Cancer Patient Navigation Program dedicated to improving cancer care for everyone in Arkansas. The team includes nurse navigators and community health workers that help bridge the gap between cancer patients, and financial resources in the community, and health care providers. The Cancer Patient Navigation Program emphasizes patient empowerment through prevention, screening, and treatment for rural and underserved populations across the state. The aim of the program is to help eliminate barriers to health care by providing resources for cancer treatment to rural and underserved populations across Arkansas. Navigators and community health works are located throughout every geographic region of Arkansas and are representative of the diversity in the communities they serve. Navigators and community health workers use the Protocol for Responding to and Assessing Patients’ Assets, Risks, and Experiences (PRAPARE®) to identify cancer patients’ barriers to care. PRAPARE® is a standardized patient risk assessment tool consisting of a set of national core measures as well as a process for addressing the social drivers at both the patient and population levels. Since May 2022, the Cancer Patient Navigation program has assessed and addressed the needs of 350 cancer patients. The data collected by navigators and community health workers has improved care coordination services, increased collaborations with local community partners with similar goals, and provided a unique opportunity for UAMS to better understand challenges of cancer patients and provide more appropriate services and care that is needed on a community level. The PRAPRE data has allowed the Office of Community Outreach and Engagement to understand the number of social determinants risks as well as the most common social determinant risks in our patient population. The risk tally score established a baseline to determine who might be more “at risk” by both geographic location and cancer diagnosis. To date, the data collected has been analyzed to track referrals and interventions. The data will further be used to ensure community-engagement priorities and resources are integrated into all Winthrop P. Rockefeller Cancer Institute research cores and clinical enterprises. Addressing the adverse social drivers of health will ultimately allow UAMS to improve patient well-being, facilitate access to prevention, screening, and treatment. Citation Format: Valandra L. German. Assessing, understanding, and addressing social determinants of cancer health disparities through patient navigation among rural Arkansans [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A022.

Dietary intake and cancer incidence in Korean adults: a systematic review and meta-analysis of observational studies.

Cancer is a major health burden in Korea, and dietary factors have been suggested as putative risk factors for cancer development at various sites. This study systematically reviewed the published literature investigating the associations between dietary factors and cancer incidence among Korean adults, following the Preferred Reporting Items for Systematic Reviews and Meta- Analyses guidelines. We focused on the 5 most studied cancer sites (stomach, colorectum, breast, thyroid, and cervix) as outcomes and dietary exposures with evidence levels greater than limited-suggestive according to the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) panel's judgment for any of the cancer sites. This resulted in the inclusion of 72 studies. Pooled estimates of the impact of dietary factors on cancer risk suggested protective associations of fruits and vegetables with risks for gastric cancer (GC), colorectal cancer (CRC), and breast cancer (BC) and dietary vitamin C with the risk of GC, as well as a harmful association between fermented soy products and the risk of GC. Despite the limited number of studies, we observed consistent protective associations of dietary fiber with GC and dietary fiber, coffee, and calcium with CRC. These findings are largely consistent with the WCRF/AICR expert report. However, pooled estimates for the associations of other salt-preserved foods with GC, meat with CRC, and dietary carotenoids and dairy products with BC did not reach statistical significance. Further studies with prospective designs, larger sample sizes, and diverse types of dietary factors and cancer sites are necessary.