Delineating the underlying reasons for the racial disparity in gastric cancer incidence in the united states

Active Project Grant Awarded Last action

Award ID
R01CA267842
Recipient
Awarding agency
Obligated
$3,327,791

Award facts

Assistance listing
93.393 Cancer Cause and Prevention Research
Completion date 83% complete
Place of performance
Durham, NC 27705, USA

Award details come from USAspending.gov.

Description

Abstract
The burden of gastric cancer falls disproportionately on racial/ethnic minorities in the US, with incidence rates among blacks, asians, and hispanics two- to three-fold higher than that among non-hispanic whites. Further, individuals who self- identify as belonging to any of these three groups are also more likely to DIE from gastric cancer, and comparing black men to white men, specifically, this mortality disparity is greater than that for all other cancers. In the US, gastric cancer has a particularly low survival rate (32% at 5-years) as IT is generally asymptomatic until late-stage, when treatment is no longer effective. Each year in the US, 26,000 people are diagnosed with gastric cancer, and over 10,000 people DIE of the disease. Moreover, the racial disparity in gastric cancer continues to grow over time. And yet, the underlying reasons for this racial disparity in gastric cancer incidence in the US are substantially understudied. The predominant cause of gastric cancer is infection with the common bacterium, helicobacter pylori (h. Pylori). H. Pylori is more prevalent among people of color than non-hispanic whites, and, in fact, h. Pylori is the world's single leading carcinogenic infectious agent, responsible for an estimated 36.9% of the over 2.2 million infection-associated cancers diagnosed in 2018, more even than those attributed to human papillomavirus (31.5%), or the hepatitis b and c viruses combined (23.5%). Currently, however, little is known about whether the disparity in gastric cancer is a result of differences in h. Pylori prevalence, host response to h. Pylori, or differences in other risk factors that might affect the development of gastric cancer. These potential other risk factors include key individual and neighborhood characteristics that differ greatly by race, such as household crowding and residential segregation, which could increase the risk of h. Pylori infection, contribute to chronic stress, and induce a more severe immune response. Our goal is to fill the GAP in knowledge of risk factors for h. Pylori- associated gastric cancer to provide the understanding of the underlying factors that indicate who is at high risk of gastric cancer in the US. To do this, we will build a nested case-control study of approximately 800 non-cardia gastric cancer cases and 2:1 matched controls, utilizing prospective cohort data from a diverse population in the US (67% non-white) from 4 NCI-funded cohorts with pre-diagnostic specimens available: multiethnic cohort study (MEC); prostate, lung, colorectal, and ovarian cancer screening trial (plco); southern community cohort study (sccs); and women's health initiative (WHI). We will assay these biospecimens for antibody levels to h. Pylori-specific proteins and for pepsinogen (a validated marker of gastric atrophy), thoroughly assess individual and neighborhood factors that are associated with gastric cancer risk, and determine what drives the differences in race by h. Pylori antibody levels and atrophy and resulting gastric cancer risk. Finally, we will develop an integrated "cells to society" modeling framework to assess the impact of social determinants of health on the patterns of h. Pylori antibody levels, gastric atrophy and resulting disparities in gastric cancer. Ultimately, these findings will provide the information needed to allow for targeting of high-risk patients for the clinical trials necessary to create screening guidelines for the prevention and early detection of gastric cancer in the US, and will help clinicians with precision prevention by laying the groundwork for the building of a risk prediction tool.

Transactions

Action Obligated Date
Amendment $12,604
Amendment $639,776
Amendment $597,836
Amendment $627,947
Amendment $724,814
Original award $724,814

Subawards

Subrecipient Amount Awarded
Vanderbilt University Medical Center Vanderbilt University Medical Center (VUMC) will collaborate with Duke University in the development and support of an investigation of racial disparities in… $159,144
University Of Hawaii Delineating the Underlying Reasons for the Racial Disparity in Gastric Cancer Incidence in the United States. Prepare a data file containing study-specific… $202,621
Fred Hutchinson Cancer Center Co-Investigator and Sponsoring PI responsibilities: Maintain communications between ancillary study (AS) investigators and the WHI Clinical Coordinating… $147,131
Thomas Jefferson University Dr. Hyslop and the staff biostatistician will be responsible for integrating the data from multiple cohorts into one case-control cohort, including… $462,253
Rutgers The State University Of New Jersey 1. Meet with Dr. Epplein and other members of the study team to discuss plans for sample collection, biomarker testing, and quality control.2. Be representative… $90,115
Deutsches Krebsforschungszentrum Dres. Waterboer and Butt will analyze serum/plasma samples from the participating cohorts for antibodies against Helicobacter pylori. This analysis will be… $148,616

Quick answers

Who received award R01CA267842?

R01CA267842 was awarded to Duke University by National Cancer Institute (National Institutes of Health) on September 1, 2022.

How much is award R01CA267842 worth?

$3,327,791 has been obligated on R01CA267842.

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