The Comprehensive Partnerships to Advance Cancer Health Equity (CPACHE) initiative of the National Cancer Institute (NCI) supports long-standing collaborations between an under-resourced institution and NCI-designated Cancer Centers to strengthen cancer research workforce and advance cancer research capacity. One of the longest continuously funded CPACHE programs is the Morehouse School of Medicine/Tuskegee University/University of Alabama at Birmingham O'Neal Comprehensive Cancer Center tri-institutional partnership. A central component of this partnership is training future generations of investigators, which is accomplished through the research education programs that are designed to build cancer research skills, enhance mentorship, and support career development for all levels from high school students to Early-Stage Investigators (ESIs). This paper evaluates the longitudinal impact of a year-long program for ESIs and postdoctoral fellows since its inception in 2007. The data were extracted from the Research Education Core administrative records about the scholars and mentors and utilized publicly accessible databases Scopus and PubMed for publications, and the NIH RePORTER for grants. Among 89 program scholars, nearly 95% had at least one publication since their program start date. Of these, 70% had a first author, and 62% had a senior author publication. Approximately 20% of scholars obtained NIH funding as principal investigators through grants, core leadership, and/or supplements. This tri-institutional program successfully attracted investigators committed to cancer research. The outcomes suggest that structured training, intensive mentorship, and cross-institutional collaboration can meaningfully support their academic careers. These findings provide insights for strengthening similar programs to continue to meet the evolving professional needs for the development of ESIs and postdoctoral fellows, particularly at under-resourced institutions.

Introduction/Objectives Cancer nutrition education supports cancer prevention and survivorship, yet African American/Black (AA/B) women continue to experience nutrition-related inequities across the cancer continuum. This review examined how qualitative studies describe these inequities and assign responsibility within the literature. Methods PubMed and Scopus were searched in December 2024 and updated in January 2026. Eligible studies involved AA/B women in the United States, addressed cancer-related nutrition experiences, used qualitative methods, and examined nutrition-related inequities across the cancer care continuum. SPIDER-informed criteria guided eligibility, data were synthesized using inductive thematic analysis guided by intersectionality, and study quality was appraised using CASP. Results Fourteen qualitative studies were included. Responsibility for nutrition-related inequities was located within programmatic, institutional, and structural conditions. Five themes were identified: Universal Nutrition Standards, Feasible Nutrition Guidance, Access and Choices, Concordance and Cultural Relevance, and Community-Driven Co-Design. Participants described adapting nutrition guidance to caregiving demands, cultural food practices, survivorship challenges, and access barriers. Race, gender, caregiving, cultural identity, geography, and socioeconomic conditions were reported across studies. Conclusions The literature frames inequities in cancer nutrition education as consequences of programmatic, institutional, and structural conditions. Improving cancer nutrition equity for AA/B women may require culturally relevant, feasible, community-informed approaches and stronger attention to nutrition delivery contexts.

Abstract Background: Lung cancer exhibits disparities in incidence, disease prevalence, and treatment outcomes. Chemokines and their corresponding receptors have been shown to be associated with these observed disparities within different ethnic groups. In this study, we have demonstrated that the differential signaling of chemokine receptor CCR6 and its natural ligand is associated with the observed disparity, and this differential CCR6 signaling is primarily due to the diversity in CCL20. Methods: Bulk RNA-seq data (BioProject ID: PRJNA1039495) from lung cancer cell lines derived from African American (AA) and European American (EA) individuals were analyzed to identify and quantify different isoforms of CCL20. MD simulations were performed to evaluate the binding affinity of CCL20, hydrogen-bond stability, and conformational behavior upon interaction with the CCR6 receptor. Downstream pathway activation potential was inferred by comparing the expression of signaling molecules that support oncogenic pathways and are associated with poor therapeutic outcomes. Furthermore, smoking habits, including higher nicotine intake, distinct metabolite patterns, and alterations in basic cytokine levels, were incorporated into the model as external factors that may influence CCL20 isoforms and CCR6 signaling. Results: Out of 5 CCL20 isoforms, Isoform-1 (24 TPM) and Isoform-2 (36 TPM) showed stronger interactions with CCR6 compared to EA cells (Isoform-1: 7.5 TPM; Isoform-2: 11.2 TPM). Across smoking groups, AA cells showed higher Isoform-2 levels than EA cells, increasing from non-smokers (Isoform-1: 18 TPM; Isoform-2: 18 TPM) to smokers (Isoform-1: 24 TPM; Isoform-2: 40 TPM), while EA cells showed lower increases from non-smokers (Isoform-1: 18 TPM; Isoform-2: 19 TPM) to smokers (Isoform-1: 24 TPM; Isoform-2: 30 TPM). MD simulations revealed that lung-cancer-cell CCR6 binds both CCL20 Isoform-1 & 2 from AA-derived cell lines with significantly stronger affinity compared to EA-derived cells, reflected by lower binding free energies, more stable hydrogen-bonds, and longer ligand-receptor contact durations. Isoform-2 showed the strongest overall binding affinity, indicating that it may be the dominant activator of CCR6 signaling. Population-level behavioral data, including All of Us cohort metrics, showed that AA smokers tend to use cigarettes with higher nicotine content, inhale more deeply, and exhibit slower nicotine and cotinine clearance, which corresponded with increased Isoform-2 expression. Conclusion: Lung cancer cells derived from AA exhibit a ligand-rich and affinity-enhanced CCL20-CCR6 signaling axis driven primarily by Isoform-2. Isoform-specific expression, receptor affinity, and smoking-associated inflammation together highlight the significance of Isoform-2 in disparity observation in Lung cancer, as a key player in contributing to disparity. Citation Format: Murugesh Eswaran, Briana Alicia Brock, Hina Mir, Sejong Bae, Gabriella M. Oprea-Ilies, Eric L. Flenaugh, Sanjay R. Jain, Brian M. Rivers, Rick A. Kittles, James W. Lillard, Rajesh Singh, Shailesh Singh. Health behavior associated CCL20 ligand variation contributes to the disparity in non-small cell lung cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2026; Part 1 (Regular Abstracts); 2026 Apr 17-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2026;86(7 Suppl):Abstract nr 1507.

Abstract Breast cancer (BrCa) is the most common cancer among women. Although there has been progress in early detection and specific therapies, long-term success is still limited, especially for triple-negative breast cancer (TNBC). This challenge arises from issues such as recurrence, drug resistance, and side effects associated with treatments. Chemoprevention, which involves using natural compounds to delay, suppress, or prevent cancer development in individuals at high risk, shows promise, but clinical success is limited by poor bioavailability. Hedgehog (Hh) signaling pathways are being studied for the growth and metastasis of BrCa; thus, targeting Hh represents a promising therapeutic strategy. To address these challenges, we studied the effects of combining two drugs: honokiol (HNK), a natural compound derived from Magnolia officinalis, alongside the chemotherapy drug docetaxel (DTX) for treating TNBC. For this purpose, we employed gold nanoparticles (AuNPs). Our results show that dual drug delivery (HNK+DTX), combined with sonic hedgehog (Shh) DNA aptamer (AP32)- conjugated AuNPs, effectively targets the Hh pathway in TNBC cells that express it at high levels. We characterized the formulated AuNPs, including a Zetasizer for charge and size analysis, Transmission Electron Microscope (TEM), Fourier-Transform Infrared Spectroscopy (FTIR), Nuclear Magnetic Resonance (NMR), and Nanoparticle Tracking Analysis (NTA), before applying them to TNBC cells (MDA-MB-468 and MDA-MB-231). A cell viability/ cytotoxicity assay was performed to determine the IC50 values and assess drug combination synergy. Additionally, 3D cell models confirmed the internalization of AuNPs and the efficacy of combination AuNPs compared to single-drug or scramble aptamer AuNPs (control). Mechanistic studies using immunofluorescence, flow cytometry, qRT-PCR, and Western blot analysis show that Shh-targeted delivery suppresses the expression of downstream signaling molecules, Gli1 and Ptch1, induces cell cycle arrest at the G0/G1 phase, and triggers apoptosis. Furthermore, results from molecular dynamics simulations suggest that HNK influences both NF-κB-driven transcription and Shh-mediated signaling, subsequently affecting tumor cell-environment interactions. These findings highlight the potential of combination AuNPs for pathway-specific intervention in addressing TNBC, providing a foundation for further research in this area. Citation Format: Santosh K. Singh, Melad Dababneh, Brian M. Rivers, Rajesh Singh. Enhanced therapy for triple-negative breast cancer (TNBC) using combinatorial drug delivery [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2026; Part 1 (Regular Abstracts); 2026 Apr 17-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2026;86(7 Suppl):Abstract nr 6371.

Abstract Non-small cell lung cancer (NSCLC) contains a highly diverse immune landscape, making it challenging to identify markers that truly reflect how the tumor interacts with the immune system. Recent research has identified CCR8 as a key marker for a particularly suppressive group of regulatory T cells (Tregs) that accumulate within tumors. In this study, we aimed to investigate the impact of CCR8+ Tregs on disease outcomes in NSCLC and to deepen our understanding of their role in facilitating tumor evasion of the immune response. We employed various techniques, including multiparametric flow cytometry, RNA sequencing, and spatial immunohistochemistry, using NSCLC cell lines (H1299 and H1573) and patient-derived tumor samples to assess their effects. We observed that CCR8+ Tregs were significantly enriched within tumor tissue compared to adjacent normal lung tissue. These CCR8+ Tregs expressed higher levels of potent immunosuppressive molecules, including CTLA-4, TIGIT, and IL-10, as well as genes associated with TGF-β signaling, distinguishing them from CCR8- Tregs. Tumors with a high density of CCR8+ Tregs had fewer CD8+ T cells, reduced effector cytokine production, and lower levels of granzyme B, indicating weakened antitumor immunity. Additionally, patients with elevated CCR8+ Treg infiltration tended to have more advanced diseases and shorter progression-free and overall survival, even after adjusting for standard clinical factors. Statistical modeling confirmed that CCR8+ Treg levels independently predict patient outcomes. Further analysis and in vitro assays using NSCLC cell lines revealed that CCL1-CCR8 interactions likely drive the recruitment and retention of these cells within tumors. Overall, our findings show that CCR8+ Tregs represent a uniquely suppressive immune population and a strong prognostic marker in NSCLC, supporting the development of therapies that specifically target CCR8 to enhance antitumor immunity. Citation Format: Santosh K. Singh, Manoj K. Mishra, Eric Flenaugh, Gabriella M. Oprea-Ilies, Brian M. Rivers, James W. Lillard, Shailesh Singh, Rajesh Singh. CCR8+ regulatory T cells represent a promising prognostic marker for non-small cell lung cancer (NSCLC) [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2026; Part 1 (Regular Abstracts); 2026 Apr 17-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2026;86(7 Suppl):Abstract nr 5369.

Honokiol (HNK), a bioactive compound found in Magnolia species, is a promising, multifunctional agent with therapeutic effects on breast cancer (BrCa). Preclinical evidence, including in vitro and in vivo studies, suggests that HNK inhibits essential oncogenic pathways and reduces oxidative stress, inflammation, metabolic reprogramming, and cancer stemness. HNK demonstrates synergistic activity with chemotherapy, endocrine therapy, targeted therapy, and immune checkpoint inhibitors, increasing sensitivity to treatment across models of ER+, PR+, and HER2+ BrCas, as well as triple-negative breast cancers (TNBC). Nanotechnological delivery systems enhance the solubility, bioavailability, and intratumoral accumulation of HNK, increasing its translational capacity. Although clinical data remain very limited, current evidence in humans is insufficient to draw definitive conclusions regarding the safety and efficacy of HNK. This review summarizes mechanistic, preclinical, and emerging clinical data, highlights challenges in formulation and pharmacokinetics, and anticipates future trends in incorporating HNK into multimodal therapy for BrCa.

Lung cancer remains the leading cause of cancer-related morbidity and mortality worldwide. African Americans (AA) are disproportionally affected by the disease, and mortality is higher in AA compared to European Americans (EA). The mortality rate among AA is higher than EA even when diagnosed at an early stage, implying biological differences associated with health behaviors such as smoking and its impact on microbial dysbiosis. A higher mortality rate in AA diagnosed at an early stage compared to EA highlights the biological differences in AA are primarily due to health behaviors such as smoking and its impact on microbial dysbiosis, making AA predisposed to higher risk and mortality. Microbial dysbiosis in lung cancer was analyzed using GEO and All of Us data repositories. Our analysis provides compelling evidence of the interplay between microbial dysbiosis, health behaviors, and racial disparities in lung cancer outcomes. Our study shows that smoking exacerbates microbial imbalances, particularly with the prevalence of Streptococcus and its differential impact on AA and EA. Dysbiosis correlates strongly with lung cancer pathogenesis, particularly the abundance of Streptococcus, Haemophilus, Neisseria, and Pseudomonas. AA participants show higher susceptibility to Streptococcus invasion, with detectable levels in the blood at just 7 cigars daily compared to 23 cigars in EAs. Urine samples of AAs smoking only 17 cigars per day are positive for streptococcus, while for EAs the bacteria is detected only when they smoke 20 cigars daily. These findings underscore a biological predisposition that amplifies cancer risk for AAs at lower smoking intensities. The lower thresholds for Streptococcus detection among AA populations suggest a heightened biological vulnerability, emphasizing the need for tailored public health interventions and early screening programs in these communities. These results underscore the importance of integrating microbial profiling in personalized medicine approaches and addressing underlying health inequities to improve lung cancer outcomes across diverse populations. Murugesh Eswaran, Briana A. Brock, Hina Mir, Gabriela Oprea-Ilies, Eric Flenaugh, James W. Lillard, Brian M. Rivers, Rajesh Singh, Shailesh Singh. The role of health behaviors in microbial dysbiosis and lung cancer inequities [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 6528.

With the rapid advancements in human genetics and genomics research, it is crucial to build genomics capacity at minority-serving institutions (MSIs), which play a key role in developing diverse workforce in genomics and precision medicine, driven by their commitment to educating and training underrepresented students and trainees. Moreover, MSIs are instrumental in tackling chronic diseases, including cancer, that disproportionately affect minority and underserved populations. A comprehensive cross-sectional survey was conducted from August to October 2024 across six MSIs within the Diversity Centers for Genome Research (DCGR) Consortium, established by the National Human Genome Research Institute (NHGRI), to assess their genomic infrastructure and capacity. The surveyed institutions included the Pacific Center for Genome Research at the University of Hawai’i at Mānoa, the University of Texas Rio Grande Valley, Florida International University, Morehouse School of Medicine, Meharry Medical College, and the Carver Genomic Research Center at Tuskegee University, with the last three being Historically Black Colleges/Universities (HBCUs). These MSIs serve diverse and historically underrepresented minority populations, including Native Hawaiian and Pacific Islander, Asian Americans, Hispanic/Latino communities, and African Americans. The survey consisted of 32 questions covering a wide range of topics, including DCGR budget allocations, available sequencing equipment, proteomics instruments, biorepository sample collection and management, etc. An important aspect of the survey is MSIs’ access to cutting-edge next-generation sequencing technologies, a critical component of genomic research infrastructure. Among the six MSIs surveyed, four currently have Illumina short-read sequencers, and three have long-read sequencers, either Nanopore or Ion Torrent. However, none of the institutions owns a PacBio long-read sequencer, an increasingly popular platform for applications where accuracy, read length, and the ability to resolve complex genomic regions outweigh throughput needs. The six MSIs also vary in their computing infrastructure, proteomics instruments, and mass spectrometers, among other resources. Furthermore, all six MSIs own or plan to establish human tissue biorepositories. The survey reveals two common challenges regarding biorepositories across these institutions: (1) effective biorepository management and (2) securing sustainable funding. These results provide valuable insights into the genomic infrastructure and capacity of the six MSIs in the DCGR Consortium. The data collected and insights gained lay a strong foundation for supporting MSIs and fostering future collaborations among them to tackle the common challenges they face in building robust genomics programs. Xuexia Wang, Francisco A. Fernandez-Lima, Zoran Bursac, Stephen Black, Marianna Baum, Jeremy W. Pettit, Deepa Bedi, Honghe Wang, Balasubramanyam Karanam, Melissa B. Davis, Martini Rachel, Erica L. Johnson, Brian Rivers, Anderson Winkler, Jacob Galan, John Blangero, Sarah Williams-Blangero, Maarit Tiirikainen, Lang Wu, Youping Deng, Grace Pan, Olga Korolkova, Alla Ivanova, Harshana Rajakaruna, Thanigaivelan Kanagasabai, Dorin B. Borza, Rajbir Singh, Sanika Chirwa, LaMonica Stewart, Stephania T. Miller-Hughes, Aramandla Ramesh, Ebony Madden, Anil Shanker, Qingguo Wang. A cross-sectional survey of genomics infrastructure at six NHGRI-funded Diversity Centers for Genome Research [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 7111.

African American women face disproportionately higher rates of breast and endometrial cancer recurrence compared to their Caucasian counterparts, highlighting an urgent need to explore the role of stress in cancer progression and recurrence. This study conducts a systematic review of the literature to evaluate the efficacy of stress and anxiety interventions in reducing cancer risk among African American survivors. By analyzing 25 articles from 2014-2024, this review examines the correlation between psychological stress, biological stress markers, and cancer outcomes. The findings emphasize the significant impact of stress on health outcomes, particularly in the context of cortisol's role in metabolism and immune response. The review also explores coping mechanisms, including social support, diet, and exercise, tailored to African American women's cultural and socioeconomic needs. The results underscore the critical need for targeted interventions to address stress in this population, with implications for improving cancer survivorship and advancing healthcare equity. Gabrielle Ford, Zakirah L. Abdul-Hameed, Amirah Burton, Brian M. Rivers, Desiree Rivers. Review of literature on the effect of stress and anxiety among African-American breast and endometrial cancer patients [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 4020.

Liver cancer (LC) is one of the most devastating malignancies. Low socioeconomic status (SES), especially poverty, negatively affects HCC outcomes. Poverty is a risk factor in cancer incidence, late-stage diagnosis, and mortality for all racial/ethnic groups. This study aims to evaluate the correlation between LC incidence and Social Determinants of Health (SDOH), focusing on major ethnic groups (African American (AA) and European Americans (EA)) in Georgia (GA). We utilized Geospatial Technology (GT) to analyze the connection between SDOH and LC prevalence in AA and EA populations in GA. This study incorporated county-level LC prevalence and association with SES and health disparities. The robust data mining (All of Us, NCI Cancer Atlas, and SEER) enabled us to explore the association between SDOH and LC in the spatial context. Integrating spatial and non-spatial data on LC prevalence to SES will help predict and formulate LC prevention methods. The GT's secondary data analysis revealed that LC affects minority communities in GA. The GT analysis further demonstrates poverty, uninsured rates, and food insecurity were positively correlated with higher LC incidence, reflecting the impact of economic instability on health outcomes. Limited access to exercise and higher crime rates in some counties further compounded risks, likely through indirect effects on stress and health behaviors. Racial disparities were prominent, with AA populations experiencing a disproportionately higher burden of LC compared to EA. The analysis highlighted that GA counties with elevated poverty rates (20-33%) and higher uninsured percentages (18-26%) exhibited increased LC incidence, particularly within AA populations. In these communities, the LC rates reached 20-24 cases per 100, 000 for AA males and 15-20 for AA females, which is significantly higher compared to the rates for EA males at 10-16 cases and EA females at 6-12 cases. The study underscored notable racial disparities, revealing that AA populations bear a disproportionate burden of LC, linked to a complex interplay of socioeconomic, behavioral, and systemic influences. Additionally, the findings indicated that AA individuals had lower levels of educational attainment, with 10-20% holding a bachelor's degree, alongside higher rates of smoking (20-30%) and alcohol use (15-25%). Conversely, EA populations demonstrated more favorable SES indicators, including lower unemployment rates (6-12%) and a greater percentage with higher education (20-25%). These findings underscore the intricate interplay of socioeconomic, behavioral, and systemic factors driving LC disparities. Our finding demonstrates that SES is an essential factor that modulates LC incidences in underserved minority populations in GA. Hence, understanding the association between socioeconomic disparities will help predict and prevent LC more effectively. Amit Kumar Srivastav, Manoj Kumar Mishra, Shailesh Singh, Brian Rivers, James W. Lillard, Rajesh Singh. Changing landscape of liver cancer disparity due to the impact of social determinate of health in Georgia [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 4972.

The construct of ‘Trust’ is a critical factor influencing participation in genomic research, particularly among minority populations who have historically faced systemic discrimination in healthcare. Investigating cultural and social determinants of trust is essential to inform public health interventions aimed at improving representation in genomic studies. Through the Clinical Trials and Genomic Education Program (CTC-GEP), a NCI-funded initiative, purposed to address the barriers and facilitators to research participation, recruited 250 Black and Hispanic cancer patients receiving care at a safety-net hospital. Participants engaged in a three-month navigator-guided educational program on clinical trials and genomic research, including an informational video and pre- and post-education surveys at baseline, one month, and three months. Key measures included trust in healthcare providers, perceptions of clinical trial ethics, and confidence in research oversight. Descriptive and inferential statistics were generated using SAS software. Preliminary analysis at baseline revealed significant mistrust among participants, with 38.7% expressing skepticism toward information provided by researchers and 21.5% indicating fears of being exploited in research. Post- intervention, trust in healthcare providers increased by 15%, with 62.5% of participants agreeing that the reputation of the treatment center positively influenced their willingness to participate. Public health initiatives that address historical inequities and foster cultural competence are vital for building trust in genomic research. This study demonstrates the potential of tailored interventions to promote equitable participation and highlights the importance of embedding trust-building efforts in broader public health frameworks addressing research participation among Black and Hispanic populations. Future research should explore long-term effects of trust-building strategies. Christina Wilkerson, Osato Eke, Naaja Davis, Nayya Jamison, Victoria Churchill, Amirah Burton-Obanla, Desiree Rivers, Brian M. Rivers. Cultural and social determinants of trust in clinical trials and genomic research among Black and Hispanic cancer patients treated in a safety-net hospital [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 2 (Late-Breaking, Clinical Trial, and Invited Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_2):Abstract nr LB147.

Background/Significance- Scientific literature continues to demonstrate the beneficial impact of lifestyle modifications, such as diet, on overall health and in reducing recurrence of breast and endometrial cancers. However, more research is needed to identify and understand how certain structural and social barriers impede cancer survivors’ ability to maintain a healthy diet. The purpose of this study is to examine 1) the prevalence of nutrition insecurity and 2) how food cost and accessibility influence food choices and nutrition security status among low-income postmenopausal African American breast and endometrial cancer survivors. This sub-study is part of a larger study funded by the ACS Research Scholar grant. Sixteen postmenopausal (50+ years of age) African American women diagnosed with breast or endometrial cancer before 2020 completed cross-sectional surveys assessing nutrition security status and healthfulness choice (ability to meet dietary needs by having control over food options), food accessibility (Neighborhood Environment Walkability Scale), and food expenditures. Nutrition security and healthfulness choice assessment tools were from the Center for Nutrition and Health Impact. Descriptive statistics and univariate analyses were performed to determine nutrition security status, healthfulness choice, average walking distance to food retailers, and food expenditures. Forty-two percent of participants were nutrition insecure, while 5.3% scored low for household healthfulness choice. Most participants are in closer walking distance to fast food restaurants compared to a supermarket or fruit/vegetable market and purchase most of their food at a supermarket (75%), supercenter (25.8%), or small grocery store (6.3%). Sixty-two percent of participants rated the price of fresh fruits and vegetables as somewhat expensive, 12.5% not expensive, 18.8% very expensive, and 6.3% very inexpensive. Although many participants experience nutrition insecurity, few participants feel constrained in their ability to meet their dietary healthfulness needs and control their food options. Despite living in closer proximity to fast food restaurants, participants spend more money on food at supermarkets or supercenters. Additional studies are needed to further explore the multi-level factors impacting nutritious food access, diet quality, and health status of African American breast and endometrial cancer survivors. Amirah Burton, Zakirah Abdul-Hameed, Mohamed Mubasher, Brian Rivers, Desiree Rivers. Examining the impact of food cost and accessibility on nutrition insecurity and food choice among postmenopausal African American breast and endometrial cancer survivors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 6197.

Research advances on effective methods to prevent, diagnose, and treat cancer continue to emerge through clinical and genomic research. Most clinical trial and genomic research participants identify as White which limits the generalizability of research findings to non-White populations. With the development and access to technology, digital delivery of salient and tailored health education may provide innovative pathways to increase representation of African Americans (AA) and Hispanics in research. This project focused on the creation of a bioethical sensitive education video aimed at increasing participation in clinical trials and genomic research by bringing together experts from the community, healthcare, biomedical research, and public health. The goal was to utilize existing educational resources to create a tailored message to address AA/Hispanics' beliefs, values, and bioethical concerns related to participation in clinical and genomic research. Models of behavior change and communication theories were leveraged to frame key components of the message, which then informed the framework for the animated video. Development of the video consisted of six iterative phases: 1) writing sessions; 2) storyboarding; 3) animating; 4) screening/revisions; 5) acceptability testing; 6) finalization. The final animated video is approximately 5 min in length and covers several topics including the goal of clinical research, disparities in research participation, bioethical concerns, and genomic research regulations. Increasing AA and Hispanic participation in clinical and genomic research is imperative to achieving health equity. Tailored messages via short videos may assist in addressing the barriers and facilitators towards research participation and increase intentions to enroll in trials.

PURPOSE:The CDC's Diabetes Prevention Program (DPP) is an effective lifestyle intervention to prevent type 2 diabetes (T2D). However, DPP implementation in rural areas is limited. This study sought to address this gap by implementing DPP in rural church settings through a community-academic partnership and identifying implementation facilitators and barriers. METHODS:This was a cross-sectional qualitative study. Semistructured interviews guided by the Consolidated Framework for Implementation Research (CFIR) assessed church leaders' and lifestyle coaches' perceptions of implementing DPP in rural churches. Thematic analysis was used to identify key themes through an inductive approach; then, these emergent themes were deductively linked to CFIR constructs. COREQ guidelines were used to report study findings. FINDINGS:Twenty-five stakeholders participated. Facilitators to implementing DPP included its evidence-based effectiveness in preventing T2D, as well as support from the academic partner in terms of funding, training, and communication. Additionally, DPP's alignment with community needs, along with the active engagement of pastors in participant recruitment, supported implementation. Several barriers hindered DPP implementation, including transportation and childcare issues, as well as program participants' medical conditions/disabilities limiting their participation. Furthermore, rural residents' reluctance to adopt lifestyle changes and loyalty to family churches posed challenges to their engagement in DPP. CONCLUSIONS:This study identified contextual factors influencing DPP implementation in rural communities. Findings highlight the importance of tailored strategies that leverage facilitators while proactively addressing barriers, including rural residents' reluctance to attend programs outside their church, resistance to lifestyle changes, and transportation issues to ensure successful DPP implementation in rural areas.

Abstract Introduction: Patient Navigators (PNs) have have proven to be effective along the cancer care continuum. However, emerging data suggest that the scope of patient navigation should be expanded to include other contexts such as the recruitment of racial/ethnic minorities for cancer clinical trials. Because the processes of recruitment and retention are often linked, the same barriers hindering minority recruitment often hinder minority retention. The potential benefits of studying generalizability and statistical power for subgroup analyses may be lost with disproportionately high attrition among the enrolled minorities. The dual focus of the training curriculum on both recruitment and retention distinguishes it from the few previous efforts focused on the traditional PN model for minority recruitment in clinical trials and genomic research studies. Methods: A two-phased navigator training program was implemented. Components of the training program was adapted in collaboration, with the Joint Cancer Advisory Council and Bioethics Co-Leaders, from the existing UAB IMPACT Patient Navigation Training Curriculum. A systematic literature review will be conducted to identify the most salient genomic educational and resource needs and concerns of AAs and Hispanic populations regarding participation in genomic-focused research and clinical trials. These findings informed the adaptation of the training curriculum based on principles of adult education. Results: We conducted a joint training for the Clinical Trials and Genomic Navigators at each Partnership institution (MSM, TU, UAB) for the proposed project. The Co-Leaders from the Partnership Outreach Cores, the Bioethics Shared Resource, and the Joint Cancer Advisory Council planned and assigned responsibilities and dates for completion of the training activities. The initial training was the GW Navigator On-line Training Program. A supplemental training was held at one of the partnering sites, a safety-net hospital (Grady Cancer Center for Excellence). The in-person training featured an overview presentation on Genetic Risk Assessment in Oncology by a licensed genetic counselor, followed by a case study approach to enrollment and the implementation of a research study with training materials such as tablets provided by the training conductors. An evaluation was completed by the team for training conductors. The third training was held at Tuskegee University and ttopics included the importance of consent training. For this presentation, we will present the qualitative and quantitative findings. Conclusions: The training outcomes were standardized and included input from the Bioethics Co-Leaders and JCAR members. We measured changes over time (pre vs. posttest) in: 1) knowledge and skills of clinical trials and genomic research; 2) ability to identify barriers and solutions to participation in research, 3) ability to implement the two toolkits, and 4) level of ease in identifying open protocol research studies and clinical trials. Citation Format: Osato Eke, Makeeta Rayton, Teresa Hall, Lleana Barrios-Zermeno, Jennier Culbertson, Angela Morris, Vivian Carter, Yu-Mei Schoenberger, Victoria Churchill, Desiree Rivers, Stephen Sodeke, Mohamed Mubasher, Roland Matthews, Brian Rivers. Evaluation of a navigator training program to increase clinical trials and genomic research participation among adult African Americans and Hispanics residing in the Southern United States [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B119.

Prostate cancer is the second most commonly diagnosed non-skin malignancy and the second leading cause of cancer death among men in the USA. However, the mortality rate of African American men aged 40–60 years is almost 2.5-fold greater than that of European American men. Despite screening and diagnostic and therapeutic advances, disparities in prostate cancer incidence and outcomes remain prevalent. The reasons that lead to this disparity in outcomes are complex and multifactorial. Established non-modifiable risk factors such as age and genetic predisposition contribute to this disparity; however, evidence suggests that modifiable risk factors (including social determinants of health, diet, steroid hormones, environment and lack of diversity in enrolment in clinical trials) are prominent contributing factors to the racial disparities observed. Disparities involved in the diagnosis, treatment and survival of African American men with prostate cancer have also been correlated with low socioeconomic status, education and lack of access to health care. The effects and complex interactions of prostate cancer modifiable risk factors are important considerations for mitigating the incidence and outcomes of this disease in African American men.

Abstract Introduction: TikTok is a widely used social media platform that allows users to post original short-form videos, typically under three minutes long. Of the 121 million TikTok users in the United States, the majority fall in the 18-34 age range. While most videos are classified as “entertainment” users can explore an array of hashtags, including health-related messages. Given its potential to disseminate information on cancer prevention, our project explored the content of #CancerPrevention videos on TikTok. Methods: Using a naïve TikTok account via a web browser, the team extracted the URLs of the top 157 TikTok videos tagged with “CancerPrevention”. We simultaneously collected analytics of the number of likes the videos received, comments, bookmarks, shares, length of video, and upload date. We developed a content codebook that was refined over several sessions to enhance agreement. The team double-coded the top 60 videos that were available and in English. The remaining videos were not double-coded before the URL linking to the video expired, thus limiting our sample to 60. Average coder agreement was 89%. New data: The 60 videos included in the analysis totaled 679,346 likes, 12,567 comments, 180,151 bookmarks, and 69,300 shares. The median length of a video was 53 seconds (range 5 seconds to 7 minutes 24 seconds). The oldest video was posted in March 2021 and the newest in October 2023. Nearly half of the videos appeared to be from health professionals (43.5%), while a quarter were from lay individuals (22.6%). However, most videos were not affiliated with medical organizations, non-profits, or other reputable organizations (93.5%). As the hashtag suggested, most videos targeted a general audience (86.4%) and focused on cancer prevention (68.3%). Half of the videos discussed diet and nutrition as cancer prevention strategies (51.7%), while very few emphasized exercise (13.3%), tobacco use (6.7%), or alcohol use (8.3%). Most videos addressed general cancer prevention (69.5%), with colon cancer being the most frequently specified type (13.6%), followed by breast cancer (5.1%). Very few discussed pharmacology or industry-related topics (6.7%). More than half (56.7%) promoted unconventional cancer prevention strategies, such as avoiding sugar consumption, which is claimed in some videos “to feed cancer cells” and eating specific foods to prevent cancer. Conclusions: Despite uncertainties about its future, TikTok remains a highly popular social media platform among youth and young adults in the U.S., with the ability to rapidly disseminate messages to a wide audience. However, our project revealed that TikTok content often lacks evidence-based information, which can potentially lead to the spread of misinformation. Public health practitioners can use this opportunity to evaluate which messages garner the most engagement and develop research-based content that is relevant and accurate, countering the spread of inaccurate or harmful information. Citation Format:Victoria Churchill, Anika Jaiswal, Robert T. Fairman, Osato Eke, Brian M. Rivers. TikTok and #CancerPrevention: A content analysis [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B026.

Abstract The persistent gap in cancer incidence and outcomes between African American (AA) and European American (EA) populations remains a significant public health challenge. Understanding these discrepancies is pivotal for crafting targeted interventions to mitigate health disparities. To comprehensively assess these inequalities, this study delves into the association between smoking and lung cancer incidence within a diverse cohort of 5270 participants, comprising both AA (868 participants) and EA (3137 participants) individuals. Among the 2901 lung cancer patients identified in our analysis, diagnoses ranged from Malignant Tumors of the Lung to various subtypes of Non-Small Cell and Small Cell Lung Cancer. Surprisingly, only a significant subset of these patients were smokers, with statistical analysis indicating a p<0.001, pointing to other influential demographic factors. Employing the Chi-Square Test of Independence, Logistic Regression, and Multivariate Analysis, we evaluated the impact of smoking alongside additional variables on lung cancer incidence. Factors such as Age, Gender, Socioeconomic Status, Occupational Exposures, Geographic Location, Family History of Cancer, Comorbidities, and Lifestyle Factors were considered in the multivariate analyses to ascertain their contribution to lung cancer risks. Our findings from Relative Risk (RR) and Attributable Risk (AR) assessments suggest that while smoking constitutes a notable risk factor, a substantial proportion of lung cancer cases in this cohort were not linked to smoking. Stratified and Sensitivity Analyses further unveiled nuanced risk profiles within subgroups, elucidating the intricate interplay between lifestyle factors and genetic predispositions. Our study highlights that a significant portion of lung cancer cases, particularly among EA and AA populations, occur in non-smokers, with smoking often associated with other comorbidities rather than solely lung- specific diseases. This underscores the multifaceted nature of lung cancer risk factors across different racial groups, advocating for public health strategies that address a broader spectrum of influences beyond smoking to combat cancer disparities within these communities effectively. Citation Format: Murugesh Eswaran, Briana A Briana A Brock, Hina Abdulrehman Mir, Eric L. Flenaugh, Oprea M. Gabriela, Brian Rivers, Rajesh Singh, Shailesh Singh. Influence of Socio-Demographic and Lifestyle Factors on Lung Cancer Incidence Among African American and European American [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C173.