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NCI awards $19.3m for multisite investigation of cancer disparities

Why are African-American women more likely than those of European descent to be diagnosed with breast cancer at a young age, and with poor prognoses? It's a provocative question, and one that a multidisciplinary team from the Slone Epidemiology Center at Boston University (BU), the University of North Carolina Lineberger Comprehensive Cancer Center (UNC) and Roswell Park Cancer Institute (RPCI) are coming together to address, supported by a five-year, $19.3 million award from the National Cancer Institute (NCI).

This "team science" effort to better understand a significant health disparity will be led by Co-Principal Investigators Julie Palmer, ScD, from BU, Robert Millikan, PhD, from UNC's Lineberger Comprehensive Cancer Center and Christine Ambrosone, PhD, from RPCI. They will collaborate with a team of researchers in a national study investigating the causes of breast cancer among African-American women. For reasons that are not clear, African-American women are more likely than women of European descent to be diagnosed before age 45, and are also more likely to be diagnosed with aggressive types of breast cancer that are linked to more deaths.

The study, the largest to date on breast cancer in African-American women, will involve 5,500 African-American women from four ongoing studies the Carolina Breast Cancer Study (CBCS), the Women's Circle of Health Study (WCHS), the Black Women's Health Study (BWHS) and the Multiethnic Cohort Study (MEC) as well as 5,500 controls, or healthy women. Until now, studies on breast cancer in African-American women have been hampered by not having a large population to investigate risk factors for specific subtypes of breast cancer and for breast cancer diagnosed at an early age.

The investigation will be the first to develop comprehensive models for contributions of genetic and non-genetic risk factors for breast cancer subtypes in African-American women. The collaborators' goal is to discover genetic, biologic, reproductive and behavioral risks for breast cancer subgroups defined by tumor biology and age at onset of disease.

"We've known about these disparities for years, but not what's causing them," said Dr. Ambrosone, Professor of Oncology and Chair of the Department of Cancer Prevention and Control, Division of Cancer Prevention and Populations Science, RPCI. "Drs. Millikan, Palmer and I are passionate about this work, and we're joining forces in an effort to identify factors that can ultimately be used to prevent this deadly disease."

The researchers will apply a multi-faceted approach, investigating genetic susceptibility; reproductive history, lactation, and hormonal factors; body size, early life and adult physical activity; gene/environment interactions; and other risk factors in relation to breast cancer subtypes.

African-American women under age 45 have a 76 percent five-year survival rate from breast cancer, while young white women have an 88 percent survival rate (statistics for 2001-2007, the most recent period for which data are available).

The studies that form the foundation for this Program Project, or P01, award have been funded by a number of sources: the NCI (BWHS, CBCS, MEC and WCHS); NCI Specialized Program of Research Excellence in Breast Cancer (SPORE) and the North Carolina University Cancer Research Fund (CBCS); and the Department of Defense Breast Cancer Research Program, the Breast Cancer Research Foundation and a gift from the Philip H. Hubbell family (WCHS).


Contact: Jenny Eriksen
Boston University Medical Center

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