Understanding and Addressing Cancer Health Disparities in Louisiana

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ABSTRACT: Cancer health disparities represent a major public health crisis in the state of Louisiana and the Gulf Coast. The citizens of this region have to contend with cancer incidence and mortality rates that are among the highest in the nation. In addition, we have a very high incidence of specific malignancies that disproportionately affect minorities and the underserved citizens of the region. Triple negative breast cancer, hepatocellular carcinoma, endometrial cancer, advanced prostate cancer, renal cell carcinoma, among others, are more common and appear to be more aggressive among minorities. Complex socio-economic and political reasons and an increase in co-morbidities, such as obesity, may in part help explain the origin of some of these health disparities. However, increasing evidence from genomics and cancer biology, including our work, has started to shed light on the biological basis for some of these inequities, and suggests specific interventions to help ameliorate the impact of these diseases and improve patient outcomes. We plan to use this P20 planning grant to establish research projects that bring together the best investigators and institutions in Louisiana who are conducting research on the genetics/genomics, immunology, and clinical and public health aspects of cancer with special emphasis on health disparities. Under the leadership of the LSU Stanley S. Scott Cancer Center in New Orleans (LSU-CC-NO) and in partnership with investigators from academic and medical institutions in the state, we have agreed to conduct research under the new Gulf South Center for Research and Solutions in Cancer Health Disparities (Gulf South-CARES-CHD). To ensure a focused and productive effort, this P20 grant we will study the genomic signature and inflammation characteristics of triple negative breast cancer (TNBC), a disease that disproportionately affects young African-American women in Louisiana. We believe that understanding the genomics and inflammatory biology of specific cancers may provide insights into mechanisms of resistance to neoadjuvant chemotherapy and help identify and test potential interventions for improving the therapeutic efficacy of current and future treatments. Besides creating competitive teams of researchers, we will build the necessary intellectual and organizational infrastructure and develop the preliminary data to plan and support research projects that qualify for a SPORE application. Our combined expertise, the unique patient populations available in Louisiana, and the commitment of our institutions will enable us to achieve these goals, which will improve prevention, diagnosis and treatment of cancer in underserved populations, both in Louisiana and globally.