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Advances in Research

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Explaining Disparities in Cancer Care

African American patients with cancer receive lower quality care and have higher mortality rates than Caucasians. According to Tracy Onega, PhD, "African Americans with cancer are less likely to receive the recommended therapy and are about 20% less likely to be alive at the end of three years." Yet studies have shown that when African Americans and Caucasians receive cancer care from the same facility, treatment and mortality rates are similar.

Onega, who has written about geographic differences in access to specialized cancer care, will examine where African Americans and Caucasians go for their cancer care and whether that setting is responsible for the disparity in care and mortality. She will utilize a large national database of breast, lung, colorectal, and prostate cancer data to determine if attributes such as patient volume and nurse per bed ratio might account for the differences. She is also evaluating how short-term complications and post-treatment screening affect long-term health.

Cigarette Smoke Causes Genetic Changes

It's not surprising to find cancer in places that come in direct contact with cigarette smoke: the lungs, head, and neck. However, exposure to cigarette smoke is also linked to higher cancer rates in organs that are not directly exposed to cigarette smoke, including the breast, bladder, colon, cervix, pancreas, kidney, and liver. Lung cancer studies have proven that exposure to cigarette smoke can turn on harmful genes and turn off genes that protect against cancer.

Margaret Crane-Godreau, PhD, a researcher in microbiology and immunology, is testing the hypothesis that similar damaging genetic changes also occur in the uterus and colon as a result of cigarette smoke. She will conduct an analysis of gene expression in the lungs, uterus, and colon to determine what genetic changes take place after cigarette smoke exposure. Her work could provide a greater understanding of how genetic changes caused by cigarette smoke set the stage for the development of cancer.

Predicting Bladder Cancer Risk Factors

Bladder cancer, which is respon-sible for 3% of all cancer deaths, is most likely caused not by a single risk factor but by the influence of thousands of genes on vital chemical processes in the body. Predicting an individual's vulnerability can require a powerful computer and lots of time crunching data. "When the number of variables is large, there are an effectively infinite number of combinations that could be evaluated," says Jiang Gui, PhD, a biostatistician and cancer researcher. Gui plans to simplify these complications by identifying only the most impor-tant gene interactions affecting a patient's survival. He is developing a modified version of a well-known data mining method that would include variables such as age, smoking status, and tumor grade in its calculations. His method will create a new process that links genetic variations with survival data, potentially identi-fying specific gene pairs that are risk factors for bladder cancer.

April 25, 2008