Understanding the role of structural racism on racial/ethnic inequities in lung cancer risk

了解结构性种族主义对种族/民族不平等在肺癌风险中的作用

基本信息

批准号：
10450374
负责人：
Iona C Cheng
金额：
$ 71.46万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-07-01 至 2027-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10450374
关键词：
Address Adult African American population Age Air Pollution American Biological Biological Factors Biological Markers Biometry Blood Cohort Studies Communities DNA DNA Methylation Development Dose Economics Ensure Epidemiology Epigenetic Process Ethnic Origin Ethnic group European Exposure to Genetic Genetic Predisposition to Disease Geographic Locations Geography Health Benefit Histology Incidence Individual Intervention Japanese American Knowledge Latin American Lead Leukocytes Light Malignant Neoplasms Malignant neoplasm of lung Mediating Modification Molecular Molecular Epidemiology Molecular Genetics Native Hawaiian Neighborhoods Nested Case-Control Study Participant Pathway interactions Policy Maker Poverty Prevalence Prospective Studies Public Health Questionnaires Race Reporting Resources Risk Role Sampling Scientist Shapes Site Smoker Smoking Smoking Behavior Smoking Status Socioeconomic Status Structural Racism Testing Tobacco Tobacco-Associated Carcinogen Tumor stage cancer epidemiology cancer health disparity cancer risk cigarette smoke cigarette smoking cohort environmental stressor epidemiology study epigenome epigenome-wide association studies ethnic bias ethnic difference experience follow-up former smoker health care availability health equity health inequalities high risk high risk population lifestyle factors multi-ethnic multidisciplinary population based racial and ethnic recidivism residential segregation rural setting sex smoking intervention social factors social health determinants socioeconomics surveillance data urban setting urinary

项目摘要

ABSTRACT Despite the overall progress in lowering the prevalence of cigarette smoking and incidence rates of lung cancer in the U.S., the persistent racial/ethnic and socioeconomic (SES) inequities in the burden of lung cancer are major public health problems. Over decades, African Americans and Native Hawaiians have suffered a disproportionate incidence of lung cancer in comparison to other racial/ethnic groups. The concerning observation that African Americans and Native Hawaiians experience a higher risk of lung cancer, compared to European, Japanese, and Latin Americans, for the same lifetime exposure to smoking has fueled molecular epidemiology studies of smoking and lung cancer to investigate racial/ethnic differences in genetic susceptibility, biomarkers of smoking, and epigenetics. While these studies have shed light on the contribution of molecular factors to racial/ethnic differences in lung cancer risk, both molecular, genetic and individual-level lifestyle factors are unable to account fully for the racial/ethnic differences in lung cancer risk. Thus, there is a clear need to address how upstream factors of social determinants of health, including structural racism, influence lung cancer inequities. To address this gap, we will leverage the unique epidemiological resources of the Multiethnic Cohort Study and Southern Community Cohort Study. These two large cohorts include over 272,000 well-characterized adult participants with up to 27 years of follow-up and high-quality cancer surveillance data. Specifically, we will assess the impact of structural racism and neighborhood disinvestment on: change in smoking status and internal smoking dose (Aim 1); racial/ethnic and SES inequities in lung cancer risk (Aim 2); and DNA methylation in blood leukocytes (Aim 3). In addition, we will evaluate whether air pollution mediates the relationships between structural racism and lung cancer inequities. We will also assess whether DNA methylated sites and epigenetic age mediate the association between structural racism and lung cancer risk (Aim 3). The strengths of this proposal include: 1) the integration of two population-based cohorts, statistically powered to study five racial/ethnic groups from urban and rural settings, ensuring the representation of understudied high-risk populations; 2) the public health significance of addressing the influence of structural racism on smoking and lung cancer inequities; 3) the assessment of the biological pathways by which structural racism is embodied and leads to lung cancer inequities. Findings from this proposal will expand our understanding of the contribution of structural racism to lung cancer development and the underlying biological pathways by which structural racism may operate. This knowledge has translational relevance in providing empirical evidence for community stakeholders, policy makers, and implementation scientists to develop interventions for smoking and lung cancer that also may have broad health benefits.

抽象的尽管在降低吸烟率和肺癌发病率方面取得了总体进展在美国，肺癌负担中持续存在的种族/民族和社会经济 (SES) 不平等是重大公共卫生问题。几十年来，非裔美国人和夏威夷原住民遭受了与其他种族/族裔群体相比，肺癌的发病率不成比例。有关的观察发现，与其他人相比，非裔美国人和夏威夷原住民患肺癌的风险更高欧洲、日本和拉丁美洲，在一生中接触吸烟的情况加剧了分子吸烟与肺癌的流行病学研究，以调查遗传中的种族/民族差异易感性、吸烟的生物标志物和表观遗传学。虽然这些研究揭示了贡献分子因素对肺癌风险种族/民族差异的影响，包括分子、遗传和个体水平生活方式因素无法完全解释肺癌风险的种族/民族差异。因此，有一个显然需要解决健康问题社会决定因素的上游因素，包括结构性种族主义，影响肺癌的不平等。为了解决这一差距，我们将利用独特的流行病学资源多种族队列研究和南方社区队列研究。这两个大群体包括超过 272,000 名特征明确的成人参与者，拥有长达 27 年的随访和高质量的癌症监测数据。具体来说，我们将评估结构性种族主义和社区投资减少的影响关于：吸烟状况和内部吸烟剂量的变化（目标 1）；肺部的种族/民族和社会经济地位不平等癌症风险（目标 2）；和血液白细胞中的 DNA 甲基化（目标 3）。此外，我们将评估空气是否污染调节了结构性种族主义与肺癌不平等之间的关系。我们还将评估 DNA甲基化位点和表观遗传年龄是否介导结构性种族主义与肺之间的关联癌症风险（目标 3）。该提案的优点包括：1）整合两个基于人群的队列，统计上有能力研究来自城市和农村的五个种族/族裔群体，确保未被充分研究的高风险人群的代表性； 2) 解决这一问题的公共卫生意义结构性种族主义对吸烟和肺癌不平等的影响； 3）生物学评价结构性种族主义的体现和导致肺癌不平等的途径。由此得出的结论该提案将扩大我们对结构性种族主义对肺癌发展的贡献的理解，结构性种族主义可能发挥作用的潜在生物学途径。这些知识具有可翻译性为社区利益相关者、政策制定者和实施提供经验证据的相关性科学家们正在开发针对吸烟和肺癌的干预措施，这些干预措施也可能具有广泛的健康益处。