Health Disparities In Men Research Articles

Abstract 7028: Optimization of DNA extraction methods and DNA methylation array quality from FFPE prostate tumor tissues to identify DNA methylation biomarkers

Abstract Prostate cancer is the second leading cause of cancer related deaths among men in the United States. Health disparities in men diagnosed with prostate cancer are observed between patients of African and those of European ancestry. To elucidate molecular mechanisms behind prostate tumorigenesis and racial disparities, researchers have identified genetic alterations such as gene fusions, deletions, and mutations that occur at varying frequencies among different ethnic groups. However, results are inconsistent across studies, suggesting that racial disparities may be multifactorial. Our approach to further understand the mechanisms underlying racial disparities is to compare DNA methylation profiles between cancers from different ethnic groups using formalin-fixed paraffin-embedded (FFPE) prostate cancer tissue samples. For this study, FFPE prostate cancer specimens from 32 Black men and 30 age-matched White men were obtained in the form of tissue sections on glass slides. To profile DNA methylation in these samples, tumor and normal tissue regions (in a subset of cases) were outlined on a hematoxylin & eosin (H&E) reference slide and the respective regions were macro-dissected off the corresponding unstained slides from the same block. The areas of macro-dissected regions were measured using ImageJ, and the number of slides were taken to normalize DNA yield. Next, we compared magnetic bead and column based DNA extraction methods. We evaluated them on their relative DNA yield per tissue size, and identified that the bead-based extraction method had both higher and more consistent DNA yield. In total, we used 95 unique tissue regions to profile global DNA methylation levels using Illumina Epic array. We found that a subset of samples harbored an aberrant DNA methylation pattern. Therefore, we extracted DNA from additional FFPE tissue slides using the bead-based method and repeated the assay with a larger amount of DNA, successfully rescuing the majority of the aberrant samples. Next, we will evaluate associations between DNA methylation levels in different ethnic groups, clinicopathological features, and follow-up data to help identify potential DNA methylation biomarkers and therapeutic targets linked to prostate cancer from different ethnicities. Citation Format: Colton Duran Stensrud, Leonardo Gonzalez-Smith, Claire Stevens, Huan Cao, Jenaye Mack, Olumide Arigbede, Daniel Weisenberger, Sarah G. Buxbaum, Sara M. Falzarano, Suhn Rhie. Optimization of DNA extraction methods and DNA methylation array quality from FFPE prostate tumor tissues to identify DNA methylation biomarkers [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 7028.

Men's health disparities: Causes and interventions.

According to the existing, extensive scientific evidence in the literature, men on average are living sicker and dying younger at a higher rate compared to women. The causes of men's infirmities are complex and multifaceted, contributing to increased morbidity and mortality rates and decreased life expectancy. Despite the statistics of the doomed health status among men, interests to eliminate their health disparities remain inconsistent and ill-defined. Therefore, efforts to eradicate men's health disparities should be positioned in interdisciplinary health education, research, and policy using sex and gender-based health frameworks. The purpose of this paper is to explore men's health generally by discussing common health disparities, the causes of the gender gap in men's health outcomes, proposing some strategies for advancing men's health, and finally providing nursing implications for education, practice, research, and health/public policy. Notably, interdisciplinary, gender-based health education potentially has significant impacts on men's health. The promotion of such initiatives can consequently address the intricacies of men's health, which will provide future healthcare professionals with the knowledge, attitude, and skills necessary to improve men's health.

Pathological upgrading and upstaging at radical prostatectomy in Jamaican men with low-risk prostate cancer.

Several studies suggest race-based health disparities in men with low-risk prostate cancer (PCa), with African American males having poorer oncological outcomes. We sought to determine the prevalence and predictors of pathological upgrading and upstaging in Jamaican men with low-risk PCa treated with radical prostatectomy (RP). Data on 141 men who met the National Comprehensive Cancer Network criteria for low-risk PCa and underwent RP at a single institution were reviewed. All men had a transrectal ultrasound-guided biopsy. Pre-operative clinical and final pathological data were obtained. Data were summarised as means and standard deviations or percentages as appropriate. Bivariate analyses such as independent samples t-tests and chi-square tables were conducted and logistic regression models were estimated to predict upgrading (>Gleason 6) and upstaging (p ≥ T3).The mean age was 59.5 ± 7.8 years with mean prostate specific antigen (PSA) of 6.6 ± 2 ng/mL. A total of 48.3% of men were upgraded and 11.4% were upstaged. Bivariate analyses indicated that PSA (p = 0.008) and percentage positive cores (p = 0.002) were associated with upgrading. PSA (p = 0.042) and percentage positive cores (p = 0.003) were significantly associated with upstaging. The odds of upgrading increased with increased PSA levels (OR 1.40, 95% CI 1.05–1.87, p = 0.021) or increased percentage positive cores (OR 8.27, 95% CI 2.19–31.16, p = 0.002). The odds of upstaging increased with increased PSA levels (OR 1.4, 95% CI 1.01–1.96, p = 0.046) and with increased percentages positive cores (OR 11.4; 95% CI 2.06–63.09, p = 0.005). Jamaican men with low-risk PCa are at high risk of pathological upgrading and upstaging at RP. These findings should be taken into consideration when discussing treatment options with these patients.

Microaggressions in Clinical Training and Practice.

Microaggressions in Clinical Training and Practice.

Abstract A33: Population and evolutionary genomics of prostate cancer-associated variants: implications for health disparities in men of African descent

Abstract To determine why African men are more likely to suffer from prostate cancer (CaP), we integrated GWAS results and scans of selection with allele frequency data from 64 global populations. Despite substantial overlap in genetic risk scores across populations, we find that predicted CaP risk is highest in West Africans and that a small number of loci drive these differences in risk. There is a strong concordance between genetic risk scores and clinical estimates of CaP mortality. Although most CaP-associated loci are evolving neutrally, we find multiple instances where alleles have hitchhiked to high frequencies with linked locally adaptive alleles. Citation Format: Joseph Lachance, Ali Berens, Matthew Hansen, Andrew Teng, Sarah Tishkoff, Timothy Rebbeck. Population and evolutionary genomics of prostate cancer-associated variants: implications for health disparities in men of African descent [abstract]. In: Proceedings of the AACR International Conference: New Frontiers in Cancer Research; 2017 Jan 18-22; Cape Town, South Africa. Philadelphia (PA): AACR; Cancer Res 2017;77(22 Suppl):Abstract nr A33.

Biopsychosocial Approaches to Men's Health Disparities Research and Policy

Although a century ago the life expectancies of men and women were about equal,1 the life expectancy at birth between the sexes has grown in the past four decades.2 In most industrialized societies...

Focus on preclinical sex differences will not address women’s and men’s health disparities

Last spring, the US National Institutes of Health (NIH) announced a new policy calling for the use of both male and female materials—animals, tissues, cells, and cell lines—in preclinical research (1). Canada and the European Union have recently instituted similar policies. Advocates argue that requiring analysis of sex in preclinical research will advance scientific understanding of sex differences in human health outcomes, such as higher rates of adverse drug events (ADE) in women compared with men (2). We disagree.

Social Determinants of Men's Health Disparities.

Social Determinants of Men's Health Disparities.

Abstract A23: Addressing men's health disparities in the District of Columbia

Abstract The Georgetown University Lombardi Comprehensive Cancer Center Office of Minority Health and Health Disparities Research is a community based center located in Ward 8 of the District of Columbia, which has some of the highest incidence and death from cancer in the city. Programs addressing men's health are very limited in these communities. Our location is easily accessible to the residents in Wards 6, 7, and 8 which are designated by the Department of Health and Human Services as medically underserved. Our mission is to facilitate, stimulate, and to promote synergy in addressing the biological and environmental basis of cancer health disparities via research, training, communication and education. Current programs include breast cancer prevention studies for African American and Hispanic Women, HPV Education, Environmental Justice, exercise studies to relieve the effects of cancer treatments for men and women. The Health Disparities Initiative also conducts community based boot camps, and regular focus groups to engage community support for our programs, and to give the residents the opportunity to let us know what their community needs are. The nearby Capitol Breast Care Center provides women with mammograms and cervical exams and needed follow-up regardless of a woman's ability to pay. As a Community Health Educator I am a liaison between the residents of these communities and the Health Disparitiess Initiative. I actively participate in community activities that help promote healthy lifestyles and the reduction of chronic diseases. I am actively involved in the recruitment of residents from the community to form our Community Advisory Board and Environmental Justice Advisory Board. And I have accepted the invitation to sit on community boards and committees. Citation Format: Everett Dodson. Addressing men's health disparities in the District of Columbia. [abstract]. In: Proceedings of the Seventh AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 9-12, 2014; San Antonio, TX. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2015;24(10 Suppl):Abstract nr A23.

Economic Burden of Men's Health Disparities in the United States

Very little is known about the economic consequences of men’s health disparities. Using data from the 2006 through 2009 Medical Expenditure Panel Survey and the National Vital Statistics Reports, we estimated the potential cost savings of eliminating health disparities for racial/ethnic minority men. The total direct medical care expenditures for African American men were $447.6 billion of which $24.2 billion was excess medical care expenditures. With regard to indirect costs to the economy, African American and Hispanic men incurred $317.6 and $115.0 billion respectively. These findings indicate that we cannot afford to overlook the disparities that exist, particularly among African American and Hispanic men. Failure to do so is both socially and morally wrong and carries huge economic consequences.

Practical Solutions to Addressing Men's Health Disparities: Guest Editorial

In men’s health research, an important gap exists in how we explain differences in health among men. Though scholarly contributions to men’s health disparities are growing, there continues to be a lack of discourse around concrete solutions that can be applied to reducing or eliminating differences in health outcomes between groups of men. This is the first special issue dedicated to describing strategies for addressing men’s health disparities globally and across racial and ethnic groups in the U.S. Collectively, these papers represent a range of efforts to not simply explain men’s health disparities, but to describe interventions or findings in such a way that they inform strategies to reduce or eliminate men’s health disparities. This body of work uses a variety of research methods, captures global, social and economic developmental issues, and provides practical solutions that can be implemented by various stakeholders at various levels.

Developing the Discipline and Practice of Comprehensive Men’s Health

Men of all ages in the United States experience disproportionately higher rates of morbidity and premature death than females. The reasons for this are complex and include biological, sociological, and health system-related issues, but this is also in part due to the fact that men and boys tend to lead more risky lifestyles and generally avoid preventive care when compared with women and girls. These disparities not only affect males but also their loved ones and can adversely affect their participation in the workforce and in their communities. Better understanding of the drivers of men's health disparities is needed to enable health professionals to more effectively address this problem. One of the fundamental building blocks for changing health care delivery to males is to provide a core curricular framework for education and training of health professionals related to the specific health issues of men and boys. This article will present a study assessing what men's health courses are available in the United States and identifying the content within such courses that will prepare health care professionals to deliver programs and care to this demographic. The study identified that as of 2012, there were only 21 courses in 18 institutions that address gender-appropriate health care for boys and men. The authors conclude that developing and incorporating an expert, consensus-based men's health core curriculum in universities and colleges, particularly in health professional programs, is an extremely important cornerstone in advancing the science and practice of true and balanced gender-based care delivery.

Population-Based Approaches to Inform Policy: Men's Health Disparities and Opportunities for Nonprofits and Philanthropy to Leverage Change

Certain racial, ethnic, and economic groups, specifically men of color and men with low incomes, experience disproportionately high rates of chronic illness and of diseases and conditions that are leading causes of death in the United States. The dismal rates of morbidity and premature death among poor men and men of color in the United States underscore societal inequities and exacerbate health disparities among these populations. As the evidence of disparities continues to compound, the need for many-layered responses to address complex and intractable health inequalities becomes more obvious. Detailing the actual utilization of health services in specific populations by gender, race, ethnicity, and income can contribute to a wider understanding of health disparities and the costs of inadequate access to quality health care. Such population-based approaches to data collection and health service delivery within a community context can both ameliorate health disparities and suggest novel interventions to inform policy decisions. Nontraditional collaborations that create broad community coalitions around population-based approaches and join nonprofits with philanthropy, academe, and local, state, and federal governmental entities hold the greatest potential for lever-aging change.

ENVISIONING AND ADVANCING MARGINALIZED MEN'S HEALTH DISPARITIES SCHOLARSHIP: THE MARGINALITY-CULTURAL COMPETENCE INTEGRATIVE FRAMEWORK (M-CCIF)

Given the current focus of the National Institutes of Health (NIH) on eliminating health disparities among minority populations, a substantive body of culturally competent scholarship about marginalized men's health disparities is needed to add knowledge about the complex features, processes, and relationships underlying health disparities, marginality, men's health, interventions, and clinical outcomes. Marginalized men in the United States suffer disproportionately from mental and chronic health problems. Historically disadvantaged, their voices have not been privileged in health care and clinical discourses. Utilizing the concepts of marginalization and culturally competent scholarship, an integrative framework has been created to facilitate clinicians and scholars in envisioning and advancing critical scholarship related to marginalized men's health disparities.