Jacqueline B Vo

Associations of self-identified race and ethnicity and genetic ancestry with mortality among cancer survivors

Abstract Self-identified race and ethnicity (SIRE) and genetic ancestry are potentially associated with disparities in health outcomes; however, independent effects of SIRE and genetic ancestry on mortality in cancer survivors including when adjusting for multiple risk factors are understudied. Among 23 445 cancer survivors in the Prostate, Lung, Colorectal, and Ovarian Screening Trial, SIRE was associated with mortality among prostate, colorectal, lung, ovarian, and breast cancer survivors; genetic ancestry was associated with mortality among prostate, colorectal, and breast cancer survivors. Associations were strong when adjusting for age at cancer diagnosis, sex, and tumor characteristics but attenuated when adjusting for individual-level factors and population-level socioeconomic status. For example, mortality risk was higher among Black vs White prostate cancer survivors and African genetic ancestry vs European genetic ancestry, but associations were attenuated after multilevel adjustment. Results suggest that SIRE and genetic ancestry do not solely reflect biologic variation; rather, social factors may drive mortality differences by SIRE and genetic ancestry.

Racial and ethnic differences in HPV-related cancer incidence in the United States, 2001-2020

Abstract Background Human papillomavirus (HPV) causes cervical cancer and a proportion of oropharyngeal, vulvar, vaginal, penile, and anal cancers. Evaluating racial and ethnic heterogeneity by anatomic site will identify populations with the highest cancer incidence rates (IRs) and help to optimize available prevention strategies. Methods Using the 2001-2020 US Cancer Statistics database, we estimated age-standardized IRs of cervical carcinoma, oropharyngeal, anal, vaginal, vulvar, and penile squamous cell carcinomas (SCCs) by race and ethnicity. We examined changes over time by comparing IRs in 2016-2020 with 2001-2005. Results Between 2001 and 2020, 750 897 HPV-related cancers occurred among 6.17 billion total person-years, with 61% (n = 455 475) in females. Among females, the highest IRs of oropharyngeal (1.6/100 000 person-years), vulvar (2.3/100 000 person-years), and anal (2.1/100 000 person-years) SCC were among White females. The highest IR for vaginal SCC (0.6/100 000 person-years) was among Black females and for cervical carcinoma (10.0/100 000 person-years) among Hispanic females. Among males, the highest IR for oropharyngeal SCC (8.0/100 000 person-years) was among White males, penile SCC (1.3/100 000 person-years) among Hispanic males, and anal SCC (1.5/100 000 person-years) among Black males. From 2001-2005 to 2016-2020, for most racial and ethnic groups, both in terms of absolute incidence, and proportion of the total HPV-related cancer burden, cervical carcinoma and vaginal SCC rates decreased, vulvar and anal SCC increased, and there was no clear pattern in oropharyngeal and penile SCC rates. Conclusion For all cancer types, there were disparate racial and ethnic patterns by anatomic site likely caused by a constellation of factors, including access to preventive care and site-specific HPV prevalence.