Understanding and Addressing Cancer Health Disparities in Louisiana

摘要： 癌症健康差距代表着路易斯安那州和墨西哥湾沿岸的一大公共卫生危机。 这一地区的公民必须与癌症发病率和死亡率作斗争，这些癌症发病率和死亡率是 是全国最高的。此外，我们有非常高的特定恶性肿瘤的发病率 不成比例地影响到少数群体和该区域未得到充分服务的公民。三重阴性乳腺癌， 肝细胞癌、子宫内膜癌、晚期前列腺癌、肾细胞癌 其他人则更常见，在少数族裔中似乎更具攻击性。复杂的社会经济 政治原因和肥胖症等并存疾病的增加可能在一定程度上有助于解释 其中一些健康差距。然而，来自基因组学和癌症生物学的越来越多的证据，包括 我们的工作已经开始揭示其中一些不平等的生物学基础，并提出了具体的 帮助减轻这些疾病的影响和改善患者预后的干预措施。我们计划使用 这项P20计划拨款用于建立研究项目，将最好的调查人员和 路易斯安那州正在进行遗传学/基因组学、免疫学和临床研究的机构 和癌症的公共卫生方面，特别强调健康差异。在全国政协主席的领导下 路易斯安那州立大学斯坦利·S·斯科特癌症中心(LSU-CC-NO)与来自 国家的学术和医疗机构，我们已经同意在新的海湾下进行研究 南方癌症健康差异研究和解决方案中心(海湾南-CARE-CHD)。为了确保 作为一项集中和富有成效的努力，这笔P20拨款我们将研究基因组签名和炎症 三重阴性乳腺癌(TNBC)的特征，这种疾病对年轻人的影响不成比例 路易斯安那州的非裔美国女性。我们认为了解基因组学和炎症性疾病 特定癌症的生物学可能为新辅助化疗耐药机制提供洞察力 并帮助确定和测试潜在的干预措施，以提高当前和未来的治疗效果 治疗。除了建立有竞争力的研究团队外，我们还将建立必要的智力和 组织基础设施和开发初步数据，以计划和支持研究项目 有资格申请孢子。我们的综合专业知识、独特的患者群体 路易斯安那州，我们各机构的承诺将使我们能够实现这些目标，这将改善 在路易斯安那州和全球未得到充分服务的人群中预防、诊断和治疗癌症。

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.