Abstract The Promise Fund is creating a systemic change in healthcare service delivery through its Continuum of Care model in which patients are provided health education, navigation for breast and cervical health, affordable early detection screenings, diagnostics, treatment, and/or support services through an established network of providers, reducing healthcare costs, alleviating the burden of our complex healthcare system, and improving patient outcomes. This model, established in Palm Beach County, has potential to be scaled across Florida and beyond. The Promise Fund's primary focus is to eliminate preventable deaths and stop the progression of breast and cervical cancer among women in South Florida. The region faces significant healthcare disparities, with over 80,000 uninsured women in Palm Beach County alone. Disproportionately affecting minority groups, these women often experience delayed diagnoses and higher mortality rates compared to White women. Barriers such as transportation, translation, education, and childcare further contribute to suboptimal survival rates, despite high cure rates exceeding 95% for breast and cervical cancer. Through public and private partnerships, the Promise Fund established a Women's Health Center co-located at a Palm Beach County Federally Qualified Health Center (FQHC). FHQCs are community-based facilities that provide comprehensive primary care services to uninsured or low-income individuals in areas of high need. At this strategically selected FQHC, the Promise Fund supplies state-of-the-art equipment for breast and cervical cancer screenings, such as a 3D Genius Mammography Machine, donated by Hologic, Inc., ultrasounds, LEEP, and colposcopy. To facilitate access, the Promise Fund employs over 20 patient navigators positioned in FQHCs, free clinics, and community-based organizations across South Florida. These navigators connect women to resources, engage in outreach, and enroll at-risk individuals into the program. The impact of the navigators is significant, with over 20,000 women engaged, over 80 cancers treated, more than 5,000 women finding medical homes, and over 19,000 women receiving education and outreach. Additionally, the program has facilitated over 4,000 mammograms and 2,000 pap tests, all provided at little to no cost to the patients. Promise Fund Patient Navigators are well-trained, culturally competent, and bilingual. They help patients overcome barriers to care, arranging transportation, childcare, and translation services. Our navigators are carefully selected from the community and undergo rigorous training in breast and cervical health, navigation, and reporting. Moreover, the Promise Fund supports patients throughout their cancer journey by brokering low-cost or free treatment from private hospitals. Despite the prevailing healthcare disparities, the Promise Fund's patient-centered approach has yielded positive outcomes. Over 98% of women navigated by the organization comply with receiving their screening mammogram, drastically surpassing the national average. Research has consistently demonstrated that patient navigators significantly improve patient outcomes by facilitating early screening and timely access to treatment, thus reducing disease progression and healthcare costs. Additionally, the Promise Fund’s expansive Continuum of Care model effectively decreases the time patients have to wait between diagnosis and starting treatment, as well as decreases the overall treatment time for patients. The success of the Promise Fund's inaugural Women's Health Center has led to the replication of this model in three additional FQHCs in Palm Beach and Broward County, ensuring that no woman in these areas should go without essential breast and cervical cancer resources. Citation Format: Nancy Brinker, Donna Shalala, Edith Mitchell, Haywood Brown, Wayne Frederick, Jane Mendez, Deeptee Jain, David Dodson, David Brodsky, Lillie Shockney. Developing a Continuum of Care Model to Address Healthcare Disparities in Breast and Cervical Cancer: The Promise Fund's Approach [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO2-10-10.

PDF file - 73K, Descriptive summary statistics for diagnostic time (in days)

Of the four subtypes of cutaneous melanoma, acral lentiginous melanoma (ALM) is atypical in its presentation. ALM is a rare melanoma subtype that presents on the volar surfaces of the hand and foot. The difficulty of making an early diagnosis of ALM is highlighted by the case seen in our institution. The dire prognosis associated with ALM is postulated to be not only related to its destructive nature, but also due to a lack of patient awareness and vigilance, inadequate physician awareness, and disparity in healthcare access. We present this as a unique account of an ALM lesion in a 76 year old African-American male presenting originally in the left foot that went misdiagnosed for several years. The original lesion was considered to be an ulcerating left great toe lesion with signs typical of osteomyelitis. These clinical findings were corroborated by radiological x-ray evidence. Upon amputation and biopsy for suspected worsening osteomyelitis five years later, the pathological diagnosis of melanoma was finally made.

Introduction Thyroid cancer incidence has increased substantially in the past 4 decades, estimated at 3.5% annually. Incidence is highest in white patients, yet black patients have the worst survival. Racial/ethnic differences in presentation and outcomes are hypothesized to be a result of differences in access to care. Analyses delineating the relative contribution of access to racial/ethnic survival disparities are scarce. We aimed to explore the association of delay in access to care and early/increased detection with racial/ethnic disparities in thyroid cancer survival. Methods The Surveillance, Epidemiology, and End Results (SEER) database was queried from 2007 to 2011 for patients with a first primary thyroid cancer diagnosis and up to 5 years of follow-up. Composite scores were generated from county-level variables to capture socioeconomic status and screening habits. Kaplan-Meier analysis and Cox proportional hazards models were utilized for survival analysis. Results We identified 46,970 patients (67% white, 7% black, 15% Hispanic, 10% Asian or Pacific Islander, and 1% unknown/other). Compared to white patients, black, Hispanic, and Asian or Pacific Islander patients were more likely to present with distant disease (3% vs 5%, 5%, and 6%, respectively; P < .001). After adjusting for sex, age, stage, subtype, tumor size, surgery, radiation, socioeconomics, and screening habits, black patients were the only race/ethnicity found to have increased odds of 5-year mortality compared to white patients (24%, P < .001). Conclusion Thyroid cancer survival is worst for black patients regardless of socioeconomic status or screening habits. Racial/ethnic disparities in survival are not attributable to early detection alone.

Howard University students are the embodiment of everything that is right about America. They exemplify the University's unwavering commitment to providing access to quality education for all regardless of race, economic background, or gender. I am certainly honored to be the 17th President of this storied University. The opportunity to lead a team at an institution that produces the trailblazers, and social engineers of our time is humbling.

The objective of this study was to identify predictors of self-reported family health history of breast cancer in an ethnically diverse population of women participating in a breast cancer screening program. Participants completed a self-administered questionnaire about their demography, health, breast health and family health history of breast cancer. The association between family health history of breast cancer and categorical variables were analyzed using the T test, chi square, and multi-nominal logistic regression. Those who were least likely to report a family history of cancer were African Americans (p = 0.02), and immigrant women from South America (p < 0.001) and Africa (p = 0.04). However, 34.4 % reported having a second-degree maternal relative with breast cancer compared to 6.9 % who reported having a second degree paternal relative with breast cancer. Therefore, there is a need to increase efforts to educate families about the importance of collecting and sharing one’s family health history.

OBJECTIVES Obesity is a risk factor for many cancers and obese cancer patients have a poorer prognosis. This study aimed to evaluate the prevalence of obesity and attempts to lose weight among cancer survivors. The effects of cancer treatment and time since cancer treatment were also evaluated. METHODS The 2007 Health Information National Trends Survey data were analysed between 2011 and 2013; respondents with (n = 966) and without (n = 6,093) a personal history of cancer were identified. Each respondent's body mass index (BMI) was calculated using self-reported height and weight measurements and categorised as normal (<25 kg/m(2)), overweight (25-29.9 kg/m(2)) or obese (≥30 kg/m(2)). RESULTS Cancer survivors were older (mean age = 63.4 versus 44.7 years for those with no history of cancer). Overall, there were similar percentages of overweight (37.6% versus 34.1%; relative risk ratio [RRR] = 0.99; 95% confidence interval [CI]: 0.75-1.31) and obese (31.4% versus 27.5%; RRR = 1.04; 95% CI: 0.79 1.39) respondents among both cancer survivors and those without a history of cancer. Among overweight and obese participants, cancer survivors did not demonstrate increased weight loss attempts compared to those without a history of cancer (61.6% versus 66.3%; odds ratio = 0.94; 95% CI: 0.73 1.20). CONCLUSION A high prevalence of overweight and obese cancer survivors were identified without any association with cancer treatment. However, cancer survivors did not demonstrate increased attempts to lose weight in comparison to those without a history of cancer despite awareness of their degree of body fatness. Increased efforts to promote the maintenance of a healthy weight among cancer survivors are needed.

Expression of estrogen receptor (ER), progesterone receptor (PR), and the human epidermal growth factor receptor 2 (HER2) can subdivide breast carcinomas into clinically meaningful classes. Cancers lacking expression of all three of these receptors (triple-negative breast cancer; TNBC) is of particular interest for molecular research because these tumors currently have no effective targets for therapy. Furthermore, TNBCs are relatively more prevalent among African-American women and can account for some of the health disparities associated with breast cancer. We approached a molecular understanding of how TNBC differs from ER(+) breast cancer through a comprehensive gas chromatography (GC)-mass spectrometry (MS) and liquid chromatography (LC)/MS/MS-based and unbiased metabolomic analysis of a series of breast carcinomas from African-American patients. Remarkably, global metabolomic profiling of tumor tissues identified a total of 418 distinct metabolites, out of which 133 (31.8%) were shown to differ between the ER(+) and TNBC tumors with statistical probability of p<0.05. Specific biochemical pathways affected included those reflecting general increases in energy metabolism and transmethylation in the TNBC tumors when compared to ER(+) tumors. Additionally, biochemicals associated with increased proliferation, redox balance and the recently proposed oncometabolites, sarcosine and 2-hydroxyglutarate, were also detected at higher levels in the TNBC versus ER(+) tumors. These studies demonstrate that TNBC tumors have metabolic signatures that distinguish them from ER(+) tumors and suggest that distinctive metabolic characteristics of these tumors might offer new targets for treatment.

Background Fascin, an actin bundling protein, plays a critical role in cell motility due to formation of actin rich protrusions called filopodia, important in cell migration, invasion and metastatic spread. Fascin overexpression has been associated with epithelial to mesenchymal transition and correlates with progression and unfavourable prognosis in breast carcinoma. Objective To evaluate fascin expression by immunohistochemistry and correlate the expression pattern with clinicopathological parameters in breast cancer in African-American (AA) women, in whom triple negative breast cancer (TNBC), an aggressive subtype, is more prevalent. Methods Tissue microarrays were constructed from formalin-fixed, paraffin-embedded blocks of tumour tissue from primary breast carcinomas in 202 AA women. Immunohistochemical detection of fascin was correlated with four major subtypes of breast carcinoma (luminal A, luminal B, human epidermal growth factor receptor 2 and triple negative (TN)) and other clinicopathological factors, including age, grade, tumour size, stage, regional lymph node status and survival. Results We observed a significant association between fascin expression and TN subtype, oestrogen receptor (ER) negativity, progesterone receptor (PR) negativity, Elston–Nottingham (EN) grade 3 and decreased overall survival. There was also a significant association between expression of CK 5/6, a marker of basal-like phenotype, and fascin expression. Conclusion These results suggest that fascin is a marker for TN subtype having a basal-like phenotype and decreased overall survival. Fascin may represent a target for therapy in TNBC in AA women.

endoscopy with gastric biopsies and sPGI and sG 17 determination at baseline.All patients underwent eradication therapy.Serum sPGI and sG 17 were measured againa after 6 months, and at 1, 2, 3, 5 and 6 yrs after eradication therapy.RESULTS: Mean sPGI levels prior to eradication were 13,4 microgr/L (range: 1,5-24 microgr/L).6 months after eradication therapy, mean sPGI levels significantly increase to 16,6 microgr/L (p=0.05).At the completion of the study, 6 yrs after eradication, sPGI levels increased to 27,3 microgr/L (p=0.01).Conversely, the sG 17 dropped out from 84,8 at baseline to 67,6 pmol/L after the 6 yrs follow up period (p,0.01).5 patients (4 female, mean age 56, range 49-66 yrs) out of the 74 sample atrophic gastritis subjects experienced a 3 month period of treatment with Acetium 100 mg at dosage of 3 capsules daily before eating.In all, both sPGI and sG 17 were reduced at baseline and after 3 months period of treatment.The mean levels of sPGI increases from 5,3 microgr/L at baseline to 7,8 after 90 days of Acetium intake as well as sG 17 drop out from 74,6 to 79,8 pmol /L.CONCLUSION: After H.Pylori eradication subjects with body atrophic gastritis showed long-lasting improvement of physiological gastric function, reflected by significantly and stabile increasing of sPGi levels and a parallel decreased of sG 17 over a 6-year period of follow up.

Abstract BACKGROUND: There are racial/ ethnic disparities in breast cancer survival rates in the US. Tumor stage at diagnosis has long been a prognostic factor in breast cancer. Our objective was to determine whether there are racial disparities in tumor stage at diagnosis of breast cancer in pre-menopausal women, using a large national cancer registry. METHODS: We conducted a retrospective analysis using data from the Surveillance Epidemiology and End Results database for 1996-2006. Premenopausal (≤50 years) women with primary diagnosis of breast cancer were identified using appropriate ICD-O-3 codes (C500-C509). Comparing racial/ethnic groups, with white race as the reference, multivariate logistic regression was used to assess the odds of late stage (stage III or IV) versus early stage (stage I or II) diagnosis at presentation, adjusting for prognostic factors, tumor characteristics, and year differences. All statistical tests were two-sided. RESULTS: A total of 86,570 women met our inclusion criteria. Of those, 56,811 (65.62%) were White, 10,789 (12.46%) were Hispanic, 9,896 (11.43%) were Black, 8,115 (9.37%) were Asian or Pacific Islanders, 544 (0.63%) were Native American and for 415 (0.48%) women the race was unknown. A majority of patients were 46-50 years old (43%) and married (65%) at the time of diagnosis. Most were diagnosed with stage II (46%), invasive ductal (93%) histology, 1.1-2cm (36%) in size, poorly differentiated (45%), and without distant metastasis (96%). On multivariate analysis, compared to white women, Black women had 58% higher adjusted odds (OR: 1.58; 95% CI: 1.49-1.68) and Hispanic women had 37% higher odds (OR: 1.37; 95%CI: 1.29-1.46) of having late stage versus early stage breast cancer at time of diagnosis. Figure 1 shows the race specific percent of women diagnosed with late stage cancer across the years. Cancer-specific mortality rates were 10.1% for whites, 21.1% for blacks, 13.4% for Hispanics, 17.6% for Native Americans, and 9.6 % for Asians (p value <.001). CONCLUSIONS: Utilizing a large cohort of premenopausal women diagnosed with breast cancer our study showed African-American and Hispanic women have higher incidence of diagnosis of late stage breast cancer as compared to their white counterparts. They as well as Native Americans also have higher cancer specific mortality rates as compared to their white and Asian counterparts. This study provides evidence that premenopausal African-American and Hispanic women represent a high-risk group that will benefit from identification of factors that contribute to late stage at presentation. Figure 1: Percent of women in each race diagnosed with late stage breast cancer over time. Citation Format: Namita Akolkar, Augustine Obirieze, Wayne Frederick, Lori Wilson. Racial differences in stage at diagnosis and survival for premenopausal breast cancer patients. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 170. doi:10.1158/1538-7445.AM2013-170

Abstract Background: Several driver mutations have been discovered in colorectal cancer (CRC) progressions including KRAS and BRAF that has a practical significant therapeutic and prognostic value. Sequencing technology has advanced and now provides a tool for the discovery of novel driver mutations. In addition, sequencing technologies now provide a tool for whole genome methylation analysis. Here, we performed whole exome sequencing (WES) and whole genome methylation analysis to elucidate the involvement of novel candidate genes the KRAS pathway that may effect colorectal carcinogenesis. Patients and Methods: WES was carried out on genomic DNA extracted from 8 normal-tumor pairs of frozen biopsies from African Americans patients with CRC. WES and Reduced Representation Bisulfite Sequencing (RRBS) were performed. Pyrosequencing and sanger sequencing used for validation of methylation and single nucleotide variants (SNV) respectively. For WES, base call quality recalibration, realignment around indels, SNV calling and variant call recalibration were carried out using Genome Analysis Tool Kit. Variants were then annotated using Annovar. Results: WES uncovered somatic mutations alteration in many genes that are known be mutated in CRC including APC, BRAF, KRAS, Notch1, PIK3C2A, and NDRG4. We discovered a number of Novel SNVs in EID3, RGS3, HNRNPF, and GNAS in tumor samples. One GNAS missense mutation was discovered among KRAS mutated tumors. In addition, the tumor with the GNAS mutation was significantly hypomethylated (P<0.05) in the CpG sites of GNAS promoter as compared with paired normal tissue. The tumor was located in the cecum and identified to be invasive adenocarcinoma with stage IV1b (T4b, N2a, M1). Ingenuity pathway analysis (IPA) showed that GNAS were involved in CRC metastasis signaling via APC, BRAF, GSK3A, KRAS, MLH1, MLH2, MLH3, Notch family, and PIK3C family. Conclusion: This work provides insight into identification of novel somatic mutations in GNAS coupled with promoter hypomethylation at the same locus using WES and RRBS. GNAS SNV resulted in gain of function of G-protein signaling that may play a pivotal role in CRC Identification the biological significance of GNAS in CRC may introduce a new target for colorectal cancer diagnosis and treatment. Citation Format: Hamed Rahi, Sohaila Soltani, Mohammad Daremipouran, Hassan Brim, Eward L. Lee, Alfreda Woods, Wayne Frederick, Adeyinka O. Laiyemo, Joe Devaney, Ron Leavitt, Xueguang Sun, Hassan Ashktorab. Novel mutation and hypomethylation define distinct biological subgroups of altered KRAS colon tumors. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 1934. doi:10.1158/1538-7445.AM2013-1934

Abstract Background: Whole Exome sequencing (WES) is a tool that is revolutionizing screening for pathogeni single nucleotide variations (SNV) in complex disorders such as cancers. Using matched normal-tumor pairs, it is possible to identify exome-wide germline and somatic variant alterations that may have an effect on disease progression or response to different interventions. The existing analysis pipelines are under continuous enhancements. In analyzing matched pairs, there is a critical assumption that the sequenced data are matched, without any quality check. Identification of germline and rare somatic variants depend on the normal sample being the qualified matched pair. Our aim was to determine if Identity By State (IBS), a genetics concept on measuring relatedness between individuals (matched tumor-normal pairs) can assess somatic landscape between individual using WES data. Materials and Methods: Genomic DNA was extracted from 8 normal-tumor pair tissues from African Americans (males n=3, females n=5) with colorectal cancer (CRC). WES was performed for identification of SNV according to manufacturer recommendations (Illumina HiScan SQ). The low quality reads were discarded and the clean reads were aligned against the human reference genome (HG19) and base quality calibration was completed using SAMTools, and GATK for variant calling and annotation. Pairs with no shared allele, one shared allele, and two shared allele assigned as IBS 0, IBS 1, and IBS 2 respectfully. Alleles in the dataset were coded using A and B and pairwise IBS was computed between all samples. Display of the IBS landscape was done using GenomeRelator. Results: The frequency of IBS from WGS data sets showed that most of the changes were IBS-1 which were heterozygous variants; i.e. AA/BB>AB (somatic) or AB>AA/BB (LOH). Frequency of LOH varied from 4.36% to 73.61%. Homozygous variant (i.e. IBS-0, AA>BB) on the other hand was not common, from 0.00% to 4.17%. Distribution of IBS across genome for matched pairs reveals that most of the IBS were IBS-2, indicating that both alleles between matched normal and tumor were similar. Frequency of IBS-1 and IBS-0 varied amongst the samples. Sample CC1053 had the most allele changes in chr1-22, and Xq, and sample CC1054 showed the second highest allele changes in chr1,3,4,6,8,9,10,11,13, 16, 17,19,20 and 22. Conclusion: Our results showed that the SNV difference between normal-tumor matched pair is relatively small consistent with the assumption of low mutation rate in cancer. IBS approach provides the tumor contents as well as assurance in the selection of samples for sequencing using SNP data. In our samples 88% similarly was found, as shown in IBS landscape across the chromosomes. We concluded that our matched pair samples are appropriately selected and are suitable for analysis of mutation across the samples. Citation Format: Mohammad Daremipouran, Hassan Hassanzadeh Namin, Sohaila Soltani, Joe Devaney, Wayne Frederick, Edward L. Lee, Hassan Brim, Hassan Ashktorab. Paired analysis of matched colon normal and tumor using whole exome sequencing. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 5307. doi:10.1158/1538-7445.AM2013-5307

Abstract Background: The identification and validation of genes that are frequently methylated in CRC will have potential value for both diagnostic and therapeutic implications. However, the DNA methylation patterns in CRC especially in African Americans have not been well investigated. Here we aimed to determine the methylation status of CpG islands of candidate genes in critical pathways important in the initiation and development of CRC. Materials and Methods: Genomic DNA from 7 individuals (1 normal, 2 adenomas, and 4 adenocarcinomas) was used for global methylation analysis using Reduced Representation Bisulfite Sequencing (RRBS). Based on literature review, differential methylation ratio, gene ontology, WNT, Notch, EGFR, RAS-MPK, PI3K, TGF-b, and P53 pathways analysis, RGS3, EID3, GNAS, ATXN7L1, GAS7, HNRNPF, GPR7, SOX15, and TNFAIP2 genes were selected for methylation validation . Established methylation status of NDRG4, BMP3, Septin 9, Vimentin, and B-Actin were used as validation controls. Forty-four paired colorectal tumors and normal adjacent colonic tissue samples were used for validation. Samples were first bisulfite converted and then amplified at specific loci using 48.48 Access Array (Fluidigm). Amplicon pools were barcoded and adapterized prior to 150-bp paired-end sequencing on the Illumina MiSeq Reads were de-multiplexed using the Fluidigm indexes and mapped back to the reference genome (Hg18). A paired t-test was used for p-value and meth-diff estimation. Results: We validated the methylation status of 355 CpG sites located in 16 gene promoter regions associated with CpG islands. Fifty-nine CpG sites located on CpG islands of ATXN7L1 (2), BMP3 (7), EID3 (15), GAS7 (1), GPR75 (24), NDRG4 (2), Sept9 (6), and TNFAIP2 (1), were significantly methylated in tumor vs. normal (p<0.05). Most of these genes showed significant hypermethylation in tumors compared to normal mucosa, According to gene ontology analysis, GAS7 methylation is associated with the cadherin signaling (WNT) pathway. Conclusion: Methylation profiling based on RRBS is an effective method for screening aberrantly methylated genes in CRC. We identified novel methylated genes that are potential biomarkers for CRC. In consistence with other reports, our study showed that GAS7 is also hypermethylated in African American CRC patients. Investigations into the possible roles of this gene as a potential biomarker in the context of early diagnosis and prognosis of CRC are underway. Citation Format: Hassan Ashktorab, Mohammad Daremipouran, Hamed Rahi, Eward L. Lee, Wayne Frederick, Adeyinka O. Laiyemo, Ron Leavitt, Xueguang Sun, Sudhir Varma, Hassan Brim. Identification of new hypermethylated candidate genes in colorectal cancer using reduced representation bisulfite next generation sequencing. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 4247. doi:10.1158/1538-7445.AM2013-4247

Background. The problem of obesity has risen to epidemic levels in the United States. A subset of patients with obesity will have metabolic syndrome. We sought to examine the impact of metabolic syndrome on the risk of morbidity and mortality among a large cohort of patients who underwent hepatic resection.Methods. Patients included in the National Surgical Quality Improvement Program (NSQIP) dataset who underwent hepatic resection between January 2005 and December 2008 were identified. Data on clinical characteristics, comorbidities, operative details, as well as postoperative complications and mortality were collected and analyzed. Patients with BMI > 30 kg/m(2) who also had hypertension and diabetes were defined as having metabolic syndrome.Results. A total of 3,973 patients who underwent a liver resection were identified. Overall mean body mass index was 28 kg/m(2); 31.7% patients were obese (> 30 kg/m(2)). Of the patients who were obese, 256 (20%) had metabolic syndrome. Patients with metabolic syndrome were less likely to have had a major hepatectomy hemi-hepatectomy, 36% vs 43%; P = .01) but had a greater mean number of red blood cell transfusions (1.6 vs 1; P = .02). The incidence of postoperative complications alter hepatectomy was 23%. Patients with metabolic syndrome had a greater risk for reintubation (odds ratio [OR] 1.9; P = .02), > 48 hours ventilator dependence (OR 2.0; P = .003), myocardial infarction (OR 5.5; P = .01) and superficial surgical-site infections (OR 1.7; P = .02) compared with nonmetabolic patients. Overall postoperative mortality was 3%. Metabolic syndrome was associated with an increased risk of postoperative death (OR 2.7; P = .001).Conclusion. The presence of metabolic syndrome was associated with a greater risk of pen operative complications. In addition, patients with metabolic syndrome had greater than a 2-fold increased risk of death after hepatic resection. (Surgery 2012;152:218-26.)

Purpose: To determine the relationship between being overweight or obese and being up-to-date with CRC screening. Methods: We used the 2007 Health Information National Trends Survey (HINTS) to evaluate participants' compliance to CRC screening guidelines for fecal occult blood test (FOBT) and endoscopy (sigmoidoscopy or colonoscopy). Our analytic cohort included 4,234 respondents without a personal history of CRC who were at least 50 years old, reported their current weights and heights and answered questions regarding their use of CRC screening modalities. We used logistic regression analyses to examine the association of being overweight or obese with being current with CRC screening (FOBT within one year, sigmoidoscopy within five years, or colonoscopy within 10 years). We used survey weights and variance estimation procedures to account for the complex survey design. We calculated odds ratios (OR) and 95% confidence interval (CI). Results: The mean age of participants was 65.1 years, 59.6% female, 81.6% white, 8.6% black, 92.8 % had health insurance and 65.9% were overweight or obese. Overall, 65.3% of participants were up-to-date with CRC screening regardless of the screening modality. After adjusting for age, sex, income, health insurance, marital status and education level, BMI was not associated with being up-to-date with CRC screening (Table).Table: Up to date with CRC screening by modalityConclusion: Colorectal cancer screening compliance does not explain the greater risk of CRC associated with being overweight or obese. Maintenance of healthy weight should be recommended for all.

Abstract Background: Studies have suggested that obesity is a risk factor for many common cancers and has a negative impact on the prognosis of those with cancer. Aim: To determine the prevalence of overweight and obesity among cancer survivors. Methods: We used the 2007 Health Information National Trends Survey (HINTS) data and identified those with (n = 966) and without (n = 6,093) a personal history of cancer. We calculated responders’ body mass index (BMI) using self-reported height and weight data and formed 3 categories: BMI < 25 kg/m*2 (normal); BMI 25 - 29 kg/m*2 (overweight); and BMI ≤ 30 kg/m*2 (obese). We used multinomial regression models to evaluate the association of personal history of cancer with BMI categories and calculated risk ratios (RR) and 95% confidence interval (CI). Results: The mean age of responders was 54.2 years and 60.5% were females. Cancer survivors were older (65.4 versus 52.4 years; P value <0.001), but there were no differences by sex or education level. After adjusting for age, sex, education, smoking, race, income, marital status and health insurance status, cancer survivors were as likely to be obese as responders without a history of cancer (Table). Conclusion: In this nationally representative sample of US adults, there is a high prevalence of obesity among cancer survivors. Maintenance of healthy weight should be an integral part of routine care of cancer survivors. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 2660. doi:1538-7445.AM2012-2660