Researchers recently launched a global genomics study of two cancers that carry a disproportionately high risk for poor outcomes in men and women of African ancestry. The observational study, which began enrollment late last year, will include 1,500-2,000 Black men and women diagnosed with prostate or breast cancers, respectively, from the U.S., the nine-nation African Caribbean Cancer Consortium, and a broad swath of the African subcontinent.
The goal is to build a specific cancer registry for these two prevalent cancers in populations of African descent. The study will attempt to identify not only novel genetic and molecular drivers of these cancers, but also their social determinants, such as health care access and lifestyle factors that influence the mutational landscape, to build a comprehensive database.
"This is the first study of its kind that includes such a diverse group of Black cancer patients from the U.S., the Caribbean, and Africa," said Camille Ragin, PhD, MPH, Associate Director of Diversity, Equity, and Inclusion at Fox Chase Cancer Center in Philadelphia and the study's co-principal investigator. "Our registry will add to the limited available data that now exists and help fill specific knowledge gaps in the literature addressing aggressive disease in this population."
Investigators from Fox Chase and the Sylvester Comprehensive Cancer Center at the University of Miami School of Medicine are leading the study in collaboration with Pfizer's Institute of Translational Equitable Medicine.
Black women are 40 percent more likely to die of breast cancer than White women, despite a lower incidence of the disease, according to the American Cancer Society. Since 2019, breast cancer has emerged as the leading cause of cancer death in this population, outpacing lung cancer, and often occurring in Black women at younger ages, when 5-year relative survival is low.
Data show that prostate cancers also carry a higher death rate in Black men than in White men-roughly 2-4 times higher-and these cancers, too, are frequently diagnosed late, proving more difficult to treat. Prostate cancer is currently the second leading cause of cancer death in Black men in the U.S., behind lung cancer.
Meanwhile, in the Caribbean and African nations under study, death rates from either prostate or breast cancers reflect similar lethal trends, with prostate cancer deaths in these countries considered among the highest in the world.
Study participants, prior to entry, agree to provide saliva DNA or blood samples for genetic testing; provide tissue samples from surgery or other procedures for receptor-status analysis of well-known cancer genes, such as HER2/neu; and complete questionnaires about family cancer history, dietary preferences, and quality-of-life factors, among other information. Researchers also plan to review patients' medical records to cull data pertaining to tumor stage and treatment.
Researchers' ability to conduct such a large-scale study stems from longstanding working relationships with site leaders from the African-Caribbean consortium, Ragin noted, which she founded and co-leads with Sophia George, PhD, Associate Director of Diversity, Equity, and Inclusion at Sylvester Comprehensive Cancer Center and the study's other principal investigator.
"The only way we could pull off this kind of coordinated effort is because everyone in the network is playing and leading their part of it," Ragin said. Because of the way in which the collaboration has been designed, George agreed, "there is equity in who is participating, who is leading, and who is at the center of the project."
As the study proceeds, test samples will be housed at multiple participating research sites, although most prostate cancer samples will be stored at Fox Chase, the coordinating center for these cancers. Breast cancer samples, on the other hand, will go mostly to the Miami Cancer Center, which is coordinating research in these malignancies.
However, for breast cancer survivor Charinus Johnson-Davis, the study's structural details had less to do with her decision to volunteer than a sense of personal urgency to help others. She made the decision after seeing a flyer during one of her follow-up visits to her Sylvester oncologist.
"Please, please do it-if not for yourself, then for the next generation," she said. "We need to see the day when we can end cancer."
Susan Jenks is a contributing writer.