Abstract Purpose: Triple negative breast cancer (TNBC) is a subtype of breast cancer (BC) characterized by the absence of estrogen, progesterone, and HER2 receptors, accounts for 10-15% of all BC cases, and is associated with poor clinical outcomes. Environmental factors such as residential proximity to major transportation infrastructure may influnce disease severity, yet evidence and molecular mechanism remain fragmented. MicroRNAs (miRNAs) regulate tumor growth and treatment response, acting as either tumor suppressors or oncogenes. Here, we investigated miRNA expression across varying environmental exposure groups in TNBC, aiming to evaluate the impact of proximity to high volumes of transportation infrastructure on clinical outcomes in TNBC patients. Methods: Total 434 TNBC patients diagnosed between 2009 and 2019 in Louisiana were included. Clinical and environmental data were integrated from Louisiana Tumor Registry (LTR) and Environmental Justice Index (EJI). RPL_EBM_DOM4 is the environmental variable representing the percentile rank of domain consisting of proximity to high volume roads, railways, and airports, and is categorized into 4 groups. TNBC stages were categorized as early or advanced. All of their Formalin-Fixed, Paraffin-Embedded (FFPE) TNBC tumor specimens were collected. MiRNA expression was profiled using high-throughput sequencing and normalized via the TMM method. Differentially expressed (DE) miRNAs were identified using edgeR, adjusting for plate effects. Shared DE miRNAs across TNBC stage and RPL_EBM_DOM4 were visualized using a Venn Diagram. All the analysis were performed using R.4.5.0. Statistical significance was considered as p<0.05. Results: Advanced TNBC patients resided closer to major transportation infrastructure. There was a statistically significant association between RPL_EBM_DOM4 and TNBC stages (p=0.005657), indicating that environmental exposure to transportation infrastructure may increase the risk of advanced TNBC. A total of 196 miRNAs were identified as differentially expressed in relation to proximity to high-volume transportation infrastructure, and 69 miRNAs were associated with TNBC stage. Of these, 32 miRNAs were commonly differentially expressed across both RPL_EBM_DOM4 and TNBC stage. Conclusion: Our study identified miRNAs potentially mediating the influence of environmental exposures on TNBC progression. The discovery of shared DE miRNAs offers insights into the molecular mechanisms underlying TNBC and suggests potential targets for intervention and prevention strategies tailored to environmentally influenced cancer outcomes. Futher studies by incorporating additional TNBC-related outcomes (such as patient survival) and other environmental risk factors may gain more comprehensive understanding of TNBC and provide strategies for equitable healthcare. Citation Format: Nathan Xiang, Amjila Bam, Nubaira Rizvi, Micheal Celestin, Ty-Runet Bryant, Tung Sung Tseng, Bingbing Mao, Xiao-Cheng Wu, Qingzhao Yu. Impact of transportation infrastructure on differentially expressed miRNAs in triple negative breast cancer stages at diagnosis [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 2348.

Background: While colorectal cancer (CRC) incidence and mortality have declined among patients aged ≥50 years (late-onset), rates are increasing in those aged <50 years (early-onset). Historically, non-Hispanic Whites (NHW) have had better 5-year survival compared with non-Hispanic Blacks (NHB), and rectal cancer has had better outcomes than colon cancer. Whether these disparities by race and tumor location are evident for both early-onset (EOCRC) and late-onset (LOCRC) CRC remains unclear. Methods: CRC cases diagnosed from 2011 to 2022 were identified from the Louisiana Tumor Registry. EOCRC was defined as diagnoses at ages 20-49 years, and LOCRC was defined as diagnoses at ages ≥50 years. Racial groups included NHW and NHB; tumor location was categorized as proximal colon, distal colon, or rectum. Cox regression was used to assess unadjusted and adjusted overall and cancer-specific survival. Results: Of 23,738 CRC patients, 10.7% were diagnosed at age <50 years. Compared to LOCRC, EOCRC patients included a higher proportion of NHB (37.5% vs. 32.6%) and rectal tumors (44.4% vs. 29.9%). NHB had worse overall survival than NHW in early-onset distal colon cancer (adjusted HR [aHR] = 1.358; 95%CI: 1.024-1.801). Conversely, NHB had better overall (aHR = 0.899; 95%CI: 0.831-0.973) and cancer-specific survival (aHR = 0.873; 95%CI: 0.793-0.960) in late-onset rectal cancer. Among EOCRC NHW, proximal tumors were associated with worse overall (aHR = 1.407; 95%CI: 1.102-1.796) and cancer-specific survival (aHR = 1.379; 95%CI: 1.057-1.799) compared with distal tumors. Conclusions: Survival differences by race and tumor subsite are observed between EOCRC and LOCRC, with NHB showing a lower hazard of death in some LOCRC subgroups. These findings highlight the need to consider the age of onset and tumor location when addressing racial disparities in CRC outcomes.

OBJECTIVES:To report long-term oncological outcomes for men with clinically localised prostate cancer (PCa) treated with contemporary modalities in a population-based United States cohort. PATIENTS AND METHODS:The Comparative Effectiveness Analysis of Surgery and Radiation (CEASAR) study prospectively enrolled men with clinically localised PCa from 2011 to 2012. Patients were stratified into two groups: favourable prognosis (clinical T stage [cT]1-T2a/bN0M0, prostate-specific antigen [PSA] level ≤ 20 ng/mL, Grade Group 1-2) and unfavourable prognosis (cT2cN0M0, PSA level 20-50 ng/mL, or Grade Group 3-5). Main outcomes were PCa-specific mortality (PCSM), composite progression to advanced disease (metastasis, PCSM event, or systemic therapy), and overall survival (OS). Cox regression models adjusted for demographic and clinical covariates. RESULTS:Of the 2604 men included, 73% were White, 15% Black, and 7% Hispanic. All hazard ratios (HRs) were adjusted for demographic and clinical covariates using multivariable Cox and Fine-Gray models. In the favourable group, compared with surgery, external beam radiotherapy (EBRT; HR 1.5, 95% confidence interval [CI] 1.1-2.1, P < 0.01), brachytherapy (HR 2.1, 95% CI 1.3-3.3, P < 0.01), and active surveillance (HR 1.5, 95% CI 1.1-2.1, P = 0.02) were associated with higher all-cause mortality; the 10-year cumulative incidence of PCSM was ≤1.5% for all five strategies, and progression did not differ. In the unfavourable group, EBRT was associated with worse OS (HR 2.8, 95% CI 1.9-4.3, P < 0.01), with no adjusted differences in PCSM (10-year cumulative incidence 3.5% after surgery vs 8.8% after EBRT) or progression across treatments. CONCLUSION:In this population-based cohort treated with contemporary modalities, the 10-year risk of PCa death was low across all treatment strategies, including active surveillance. OS differences favouring surgery likely reflect residual confounding from baseline health and treatment selection. These findings underscore the importance of patient values and comorbidities in shared decision-making for localised PCa.

Introduction Appendiceal adenocarcinoma is a rare and heterogeneous malignancy with management strategies historically mirroring those of colorectal cancer. The role of adjuvant chemotherapy (AC) in stage II disease remains poorly studied, particularly in stage IIB/IIC. We evaluated the impact of AC on overall survival (OS) in stage IIB/IIC appendiceal adenocarcinoma using the National Cancer Database (NCDB). Methods The NCDB was queried to identify adults diagnosed with stage IIB/IIC appendiceal adenocarcinoma from 2010 to 2021. Patients with carcinoid, goblet cell, or neuroendocrine histologies were excluded. Patients were stratified into surgery alone (S) or surgery plus adjuvant chemotherapy (S+). Kaplan-Meier and log-rank tests estimated survival distributions, and multivariable Cox proportional hazards regression with Firth’s correction assessed independent predictors of OS. Results 2082 patients met inclusion criteria. Adequate lymph node evaluation (≥12 nodes) was independently associated with improved survival (aHR: 0.62, P < .0001). Adjuvant chemotherapy conferred a significant survival benefit, with a 26% reduction in risk of death (aHR: 0.74, 95% CI: 0.62-0.89, P = .0016). Five-year OS was 78.9% for S+ vs 68.7% for S ( P < .001). Patients receiving both AC and adequate nodal harvest demonstrated the greatest survival benefit. Non-mucinous histology was associated with superior outcomes compared to mucinous disease (aHR: 0.62, P < .0001). Conclusion Adjuvant chemotherapy is independently associated with improved survival in patients with stage IIB/IIC appendiceal adenocarcinoma, particularly when combined with adequate lymph node evaluation. These findings challenge current treatment paradigms that extrapolate from colorectal cancer and support consideration of AC as standard therapy in this high-risk patient subset.

Outlier detection is a fundamental component of data preprocessing and quality monitoring across diverse scientific domains, including engineering, biomedical sciences, and finance. While many variables in controlled environments approximate a normal distribution, real-world data, particularly biological, environmental, and epidemiological measures, are frequently characterized by pronounced right-skewness. To address the shortcomings of conventional methods, this study introduces the Dynamic Threshold for Outlier Detection (DTOD), which reframes outlier detection as a concrete operational workflow. The DTOD framework dynamically adjusts detection thresholds based on a functional relationship between skewness and tail morphology. Validation through large-scale simulation experiments across light-, middle-, and high-skewness levels confirms the method’s versatility. The DTOD proves particularly effective at two ends of the spectrum: enhancing sensitivity for detecting subtle anomalies in light-skewed data while serving as a conservative, high-confidence screening tool that controls false positives in high-skewness environments. In real-world application to North American Association of Central Cancer Registries (NAACCR) data, the method successfully identified outliers with abnormally high unknown tumor size rates in colorectal cancer and maintained a low misclassification rate in highly skewed lung cancer data. Ultimately, the DTOD provides a promising, interpretable solution for improving data quality in skewed scenarios.

Background: Triple-negative breast cancer (TNBC) is an aggressive subtype with persistent disparities in stage at diagnosis. While transportation-related exposures are increasingly recognized as environmental health risks, the biological mechanisms linking these exposures to cancer progression remain unclear. This study evaluated whether tumor microRNAs (miRNAs), which regulate gene expression and tumor behavior, mediate the association between transportation burden and TNBC stage at diagnosis. Methods: We analyzed 434 TNBC cases from the Louisiana Tumor Registry (2009-2019). The transportation burden from the 2022 Environmental Justice Index reflects the residential proximity to high-volume roads, railways, and airports. miRNA expression was measured via high-throughput sequencing and normalized using the trimmed mean of M-values method. Three-phase analysis (screening, individual, and multiple mediation) was performed. KEGG pathway enrichment analysis assessed downstream biological pathways. Results: After adjusting for age, race, body mass index, marital status, primary payer, and concentrated disadvantage index (CDI), every 0.10 (10-percentile) increase in transportation burden rank was significantly associated with a 9% increase in the odds of late-stage TNBC diagnosis (Adjusted OR = 1.09, 95% CI: 1.01-1.17, p = 0.021). Five miRNAs significantly mediated this relationship: downregulated hsa-let-7c-5p, hsa-let-7b-5p, hsa-miR-30a-3p, and hsa-miR-92a-3p, and upregulated hsa-miR-151a-3p. Joint mediation analysis demonstrated complete mediation (indirect effect = 0.324; p = 0.027). hsa-let-7c-5p was the primary independent mediator. The enriched pathways included MAPK, PI3K-Akt, Wnt, and p53 signaling. Conclusions: These findings identified molecular pathways linking transportation-related environmental exposures to TNBC progression through dysregulation of miRNAs. By integrating environmental exposure assessment with tumor biology, this study advances our understanding of how the built environment contributes to cancer disparities.

We present a global explainability method to characterize sources of errors in a real-world multitask deep abstaining classifier (DAC), in the context of cancer histology prediction. Our multitask classifier, currently deployed for automated annotation of cancer pathology reports from NCI-SEER registries, was trained and evaluated on 1.04 million hand-annotated samples and makes simultaneous predictions of cancer site, subsite, histology, laterality, and behavior for each report. The DAC framework enables the model to abstain on ambiguous reports and confusing classes to achieve the target accuracy on the retained (non-abstained) samples, but at the cost of decreased coverage. Requiring 97% accuracy on the histology task caused our model to retain only 22% of all samples, mostly the less ambiguous and common classes. Local explainability with the GradInp technique provided a computationally efficient way of obtaining contextual reasoning for hundreds of thousands of individual predictions. Our method, involving dimensionality reduction of approximately 13000 aggregated local explanations (ALE), offers a tractable path to true global explainability. It enabled identification of sources of errors in histology classification, globally, as hierarchical complexity among classes, label noise, insufficient information, and conflicting evidence. This suggests several strategies for iterative improvement of our DAC, including well-designed exclusion criteria, focused annotation, and reduced penalties for errors involving hierarchically related classes.

BACKGROUND:Women diagnosed with triple-negative (ER-, PR-, HER2-) breast cancer (TNBC) have poor survival outcomes compared with other breast cancer subtypes. Yet there is little nonexperimental data on whether guideline-concordant therapy translates to better outcomes over time, or about factors associated with receipt of such guideline care. This study addresses these issues. METHODS:Using data from the Centers for Disease Control and Prevention National Program of Cancer Registries (NPCR) augmented via medical records abstraction, the authors constructed a cohort of women diagnosed with invasive, nonmetastatic (stage I-III) TNBC in 2004 (N = 747) and followed through 2015. The date and primary cause of death were derived from the NPCR and the National Death Index. Standard-of-care treatment (as aligned with the study's timeframe) was defined as being guideline concordant (GC) for surgery, radiation therapy, and chemotherapy based on appropriate initiation, regimen, and completion. Through regression modeling, the authors examined predictors of being GC and the association of GC with 10-year survival outcomes. RESULTS:Controlling for patient, tumor, and sociodemographic factors, patients whose management was GC had significantly better all-cause survival (hazard ratio [HR], 0.59; 95% confidence interval [CI], 0.45-0.77), breast cancer-specific survival (HR, 0.60; 95% CI, 0.42-0.86), and also better non-breast cancer survival (HR, 0.63; 95% CI, 0.40-1.00), compared with those whose management was Not GC. Treatment at a Commission on Cancer-accredited facility was a significant predictor of receiving GC care (odds ratio, 1.87; 95% CI, 1.34-2.59). CONCLUSION:Building on this study's methodology and its findings about the effectiveness of long-standing approaches to TNBC management, additional population-based studies are urgently needed as new therapeutic approaches are being integrated into guidelines and clinical practice.

Introduction: Medicaid expansion (ME) has positively impacted colon cancer screening. ME’s effect on colon cancer treatment is less clear. This study analyses the effect of ME on patterns of colon cancer treatment. Methods: Patients with primary invasive colon cancer were identified using the Louisiana Tumor Registry. Patients diagnosed with colon cancer prior to ME (2014–2015) were compared to those diagnosed after (2017–2018). Coordinate variables were analyzed using Fisher’s exact test. Treatment status was modeled with multivariable logistic regression and the results are reported as adjusted odds ratios. Results: The proportion of uninsured patients decreased following ME (5.5 versus 1.9, p < 0.001), with the greatest reductions among patients between 45 and 54 years old (13.5% to 3.5%, p < 0.0001), African Americans (8.9 to 2.1%, p < 0.0001), and those in high-poverty neighborhoods (7.1 to 2.1%, p < 0.0001). Following ME, all patients with Stage I-III disease were more likely to receive surgery (OR = 1.95; 95%: CI 1.21–3.14)—especially the extremely impoverished (OR = 2.39; 95% CI 1.41–4.02). Young patients with Stage IV colon cancer were more likely to receive chemotherapy (OR-1.6; 95% CI 1.03–2.4). Patients with Stage IV colon cancer were less likely to receive treatment within 30 days of diagnosis (OR = 0.7; 95% CI 0.5–0.9), but, on subset analysis, this was only observed in non-Medicaid patients. Conclusion: ME is associated with increased treatment for patients with colon cancer, and it did not appear to affect time to treatment. However, it seems to affect different subsets of the population differently.

Background:Triple-negative breast cancer (TNBC) is a highly aggressive subtype that disproportionately affects African American (AA) women, leading to worse survival rates and higher metastasis risks compared to Caucasian American (CA) women. MicroRNAs (miRNAs) are crucial in cancer development and hold promise as biomarkers, but their role in racial disparities in TNBC outcomes is unclear. Methods:This study used Louisiana Tumor Registry data and collected tumor tissues for miRNA sequencing to examine significant miRNAs differentially expressed by race and TNBC stages at diagnosis among 3,298 TNBC cases diagnosed from 2011 to 2017. Results:Of the TNBC cases, 49.7% were AA. AA patients were more often diagnosed at advanced stages (69.6% vs. 60.2%, p < 0.001). miRNA sequencing of 384 samples identified 88 miRNAs differentially expressed by cancer stage and 78 by race. Notably, 36 miRNAs were associated with both stage and race, with distinct expression patterns linked to breast cancer subtypes and pathways related to cellular stress and motility. Conclusions:These findings highlight distinct miRNA expression patterns between AA and CA women, offering insights for targeted interventions to reduce racial disparities in TNBC outcomes. The comprehensive dataset holds broad interest for scientists aiming to screen and validate biomarkers that explain racial differences in TNBC outcomes. It is publicly available through the Louisiana Tumor Registry and can be accessed upon request.

This work evaluated algorithmic bias in biomarkers classification using electronic pathology reports from female breast cancer cases. Bias was assessed across 5 subgroups: cancer registry, race, Hispanic ethnicity, age at diagnosis, and socioeconomic status. We utilized 594 875 electronic pathology reports from 178 121 tumors diagnosed in Kentucky, Louisiana, New Jersey, New Mexico, Seattle, and Utah to train 2 deep-learning algorithms to classify breast cancer patients using their biomarkers test results. We used balanced error rate (BER), demographic parity (DP), equalized odds (EOD), and equal opportunity (EOP) to assess bias. We found differences in predictive accuracy between registries, with the highest accuracy in the registry that contributed the most data (Seattle Registry, BER ratios for all registries >1.25). BER showed no significant algorithmic bias in extracting biomarkers (estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2) for race, Hispanic ethnicity, age at diagnosis, or socioeconomic subgroups (BER ratio <1.25). DP, EOD, and EOP all showed insignificant results. We observed significant differences in BER by registry, but no significant bias using the DP, EOD, and EOP metrics for socio-demographic or racial categories. This highlights the importance of employing a diverse set of metrics for a comprehensive evaluation of model fairness. A thorough evaluation of algorithmic biases that may affect equality in clinical care is a critical step before deploying algorithms in the real world. We found little evidence of algorithmic bias in our biomarker classification tool. Artificial intelligence tools to expedite information extraction from clinical records could accelerate clinical trial matching and improve care.

Prostate Cancer (PCa) is the most commonly diagnosed cancer and the second leading cause of cancer death among men. In Louisiana (LA), Black men are disproportionately diagnosed at later stages compared to White men. This study explores environmental risk factors as potential intermediate variables linking race to cancer diagnosis stage. The Louisiana Tumor Registry data included 24,647 male patients diagnosed with PCa in LA between 2010 and 2018. Among them, 15,875 (64.40%) were Caucasian American (CA) and 8772 (35.59%) African American (AA). Mediation analysis using multiple additive regression trees (MART) identified possible intermediate variables that potentially explain the observed disparity. The study found that individual characteristics and environmental factors jointly explained 84% (95% CI: 44.1%, 94.6%) and 18.6% (95% CI: 7.3%, 53.7%) of the observed racial disparity in PCa stage at diagnosis, respectively. Individual factors included BMI (35.9%), marital status (28.5%), CDI (8.2%), female-headed households (2.3%), comorbidity (3.9%), and insurance status (6.3%). Environmental contributors included cancer risk due to air toxicity exposure (7.2%), asthma prevalence (6.6%), acetaldehyde levels (2.1%), railroad proximity (2.1%), walkability (0.3%), and ozone level (−0.1%). Environmental factors jointly played a significant role in the observed racial disparity. The factors such as air toxicity, acetaldehyde levels, and asthma prevalence highlight the need to address industrial pollutants to reduce the differences.

The mediation analysis method is used to investigate effects of mediators that intervene in the pathways between an exposure variable and an outcome variable. Bayesian methods are naturally used in mediation analysis due to the hierarchical structure of Bayesian models. This paper introduces an innovative adaptive Bayesian mediation analysis method that incorporates adaptive Laplace priors into the predictive model to account for high-dimensional mediators. This approach introduces a penalization function on the estimated direct and indirect effects rather than solely on the coefficients of predictive models. Consequently, estimated effects that lack statistical significance may shrink to zero, facilitating a more robust analysis. We demonstrate the efficacy of our adaptive mediation analysis method on simulations and on a Louisiana triple negative breast cancer (TNBC) dataset to examine racial disparity in diagnosed stage among TNBC patients diagnosed between 2010 and 2017. The dataset is linked to the 2017 hazardous air pollutant emissions burden estimation database using patients' residential address. We effectively explain a portion of the disparity using currently collected variables. The analysis identifies crucial mediators and confounders, highlighting the significance of variables such as age of diagnosis, insurance status, tumor grades, and the concentration of Naphtha in the air.

Background/Objectives: Triple negative breast cancer (TNBC) is an aggressive, molecularly heterogeneous subtype of breast cancer, accounting for approximately 10-15% of all cases. While reproductive and metabolic factors contribute to breast cancer development, growing concerns about environmental exposures, alongside biological and socio-cultural influences, underscore the need for targeted prevention strategies across diverse populations. Despite increasing evidence linking biological, socioeconomic, and environmental factors to TNBC outcomes, the molecular mechanisms underlying these relationships remain poorly understood. Micro-RNAs (miRNAs), which regulate gene expression and play critical roles in cancer development, have emerged as potential mediators between environmental exposures and TNBC progression. The goal of this research is to identify environmental risk factors that directly relate to TNBC stages and enhance understanding of the mechanisms underlying how miRNAs link environmental exposures to TNBC stages. Methods: In this study, we analyzed 434 Formalin-Fixed, Paraffin-Embedded (FFPE) tumor samples from 434 women diagnosed with TNBC between 2009 and 2019, encompassing diverse cancer stages (184 cases from early stage and 250 cases from advanced stage), racial backgrounds, and socioeconomic statuses. The sequencing data were linked with the Louisiana Tumor Registry data and the Environmental Justice index. Results: A total of 348 unique miRNAs were identified as differentially expressed across environmental risk factors statistically associated with TNBC stage, adjusting for plate effects. An UpSet plot revealed 44 miRNAs commonly differentially expressed across TNBC stages and multiple environmental exposures. At least one differentially expressed (DE) miRNA was shared between the TNBC stage and each environmental factor, with many associated with receptor-negative and aggressive breast cancer subtypes. Conclusions: These findings highlight potential biological pathways through which exposures may drive the TNBC progression and contribute to disparities in outcomes.

Supplementary Table 1. The average of the sum of pathology reports during March to May of 2018 and 2019 (pre-pandemic period) compared to the sum of pathology reports during March to May 2020 (pandemic period) by cancer site.

Previous research demonstrated Non-Hispanic Black populations experience higher COVID-19 mortality rates than Non-Hispanic White individuals. Additionally, cancer status is a known risk factor for COVID-19 death. While prior studies investigated comorbidities as exploratory variables in differences in COVID-19 hospitalization, none have explored their role in COVID-19-related deaths. This study aimed to evaluate whether Charlson Comorbidity Index (CCI) and subsequently, individual diseases are potential explanatory variables for this relationship. The analysis focused on Non-Hispanic Black and Non-Hispanic White cancer patients aged 20 or older, diagnosed between 2011 and 2019, who tested positive for COVID-19 from the start of pandemic through June 30, 2021 from Louisiana Tumor Registry. Two separate mediation analyses were conducted. First checked whether overall comorbidity, measured by CCI, could explain the difference in COVID-19 mortality. If so, further checked which individual comorbidities contributed to this difference. The hazard rate for Non-Hispanic Black cancer patients dying from COVID-19 was 6.46 times than that of Non-Hispanic White patients. The CCI accounted for 12.7% of the differences observed in COVID-19 mortality, with renal disease as the top contributor, explaining 4.9%. These findings could help develop interventions to reduce COVID-19 mortality and address the disproportionate impact, especially by managing chronic conditions like renal disease.

Triple-negative breast cancer (TNBC) is a prevalent breast cancer subtype with the lowest 5-year survival. Several factors influence outcomes, but their inherent molecular and cellular heterogeneity are increasingly acknowledged as crucial determinants. Here, we report on the spatio-molecular heterogeneity underlying TNBC tumors in a retrospective, treatment-naive cohort with differential prognoses (17 good prognoses [GPx] >15-year survival and 15 poor prognoses [PPx] <3-year survival]) profiled using GeoMx Digital Spatial Profiler. Analyses reveal that epithelial and microenvironment (TME) states are transcriptionally distinct between groups. Invasive GPx epithelia show an increase in immune transcripts, with a more immune-rich TME (via IF). PPx epithelia, in contrast, are more metabolically and translationally active, with a mesenchymal/fibrotic TME. Pre-cancerous epithelia in PPx exhibit a presence of aggressiveness, marked by increased EMT signaling and complement activity. We identify distinct epithelial gene signatures for PPx and GPx that can accurately classify diagnostic samples and likely inform therapy.

Supplementary Table from Association of Abdominal Visceral Adiposity and Total Fat Mass with Cancer Incidence and Mortality in White and Black Adults

Objectives: Compare functional outcomes and treatment-related regret over 10 years in Spanish- and English-speaking Hispanic men compared to non-Hispanic men following treatment of localized prostate cancer. Methods and Materials: Data from a prospective cohort study of men with localized prostate cancer treated with active surveillance, radical prostatectomy or radiotherapy were used to examine the effect of survey language (Spanish speaking vs. English speaking) and ethnicity (Hispanic vs. non-Hispanic) on functional outcomes and treatment-related regret over 10 years. Outcomes were measured using validated questionaries adjusting for baseline patient and disease characteristics. Results: A total of 770 men were included, 12% were Spanish-speaking and 12% were English-speaking Hispanic men. Compared to non-Hispanic men, Spanish-speaking Hispanic men had clinically meaningfully better urinary incontinence scores at years 3, 5 and 10 (adjusted mean difference [aMD], 12.4, 95% CI, 4.8 to 20.0; at year 10), as well as better bowel function scores at 10 years (aMD, 5.1, 95% CI 2.3 to 8.0). Englishspeaking Hispanic men had clinically worse urinary incontinence at 3 and 5 years (aMD,-10.7 [95% CI,-17.6 to-3.9]; at year 5) and bowel function at 10 years (aMD,-4.3 [95% CI,-8.2 to-0.4]) compared to Spanish-speaking Hispanic men. English-speaking Hispanic men were more likely to report regret than Spanish-speaking Hispanic men at 10 years (adjusted odds ratio, 7.9, 95% CI, 1.3-46.2). Conclusions: These findings underscore the importance of considering language and ethnicity when providing counseling and support for prostate cancer survivors, emphasizing the need for personalized patient-centered care. (c) 2024 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)