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Principal Investigator: Christopher Alan Haiman
Organization: UNIVERSITY OF SOUTHERN CALIFORNIA
Fiscal Year: 2024
Award: $1,620,203
Funding agency: National Cancer Institute
African American (AA) men have a >80% higher incidence and are more than twice as likely to die from prostate
cancer (PCa) than white men. The reasons for the high burden relating to poor outcomes of PCa among AA men
are largely unknown. RESPOND is a nation-wide and comprehensive effort to understand PCa health disparities,
with research focused on the role of stress and the contextual environment, access to care and treatment,
inherited susceptibility, tumor somatic genetics, the inflammatory tumor microenvironment, as well as the
integration of these factors in the diagnosis of aggressive disease. AA men, diagnosed with PCa between 2015
and 2020, have been sampled and recruited from cancer registries in 7 states (California, Georgia, Louisiana,
Michigan (Detroit Metropolitan area), New Jersey, Texas, and New York). By December of 2023, the cohort will
include >12,700 AA men with PCa who completed a baseline survey, >7,600 who provided saliva/germline DNA
and tumor samples obtained for >3,400. Over the next 5 years, we will leverage the RESPOND recruitment
infrastructure and research expertise to update comorbidities, lifestyle behaviors, experience of stress, access
to care, and neighborhood environmental data, as well as to obtain information on PCa oncologic outcomes
including disease progression/recurrence (P/R) and mortality. Long-term follow-up of this cohort is essential
since the development of progressive disease may take several years after diagnosis. These data will be used
to address a number of scientific questions and hypotheses aimed at understanding key social and biological
factors and their inter-relationships that contribute to disease P/R and survival in this high-risk population. In Aim
1, we will examine multi-level provider, geospatial and personal factors that define access to care and their
relationship to PCa, P/R and survival as well as patient-reported outcomes. In Aim 2, we will investigate
residence in persistently disinvested neighborhoods and modification by chronic exposure to life-course
structural and social stressors on PCa aggressiveness, P/R and survival. In Aim 3, we will evaluate the impact
of lifestyle factors, comorbid conditions and genetic risk factors on PCa P/R and mortality. Lastly, in Aim 4, we
will leverage deep learning approaches applied to histopathologic images to improve prediction of PCa P/R and
survival in AA men. Each aim addresses a distinct research domain (access to care, social environment/stress,
lifestyle and genetic factors and tumor features), yet, when studied together in a single cohort, scientific synergy
is gained and a far more comprehensive picture of the major factors that contribute to PCa P/R and PCa survival
in AA men. We expect these findings to have broad reaching significance and address numerous challenges in
the clinical management and prevention of P/R in AA men, and ultimately improve health outcomes.
Furthermore, we expect RESPOND to become an invaluable resource for advancing our understanding of the
intersecting multilevel factors contributing to the longstanding high burden of PCa among AA men.
Terms: <Access to Care><Active Follow-up><Address><Adult-Onset Diabetes Mellitus><Affect><African American><African ancestry><African descent><Afro American><Afroamerican><Algorithms><Area><Attitude><BMI><BMI percentile><BMI z-score><Baseline Surveys><Behavior><Behavioral><Biologic Factor><Biological><Biological Factors><Body mass index><COVID-19 pandemic affected><COVID-19 pandemic consequence><COVID-19 pandemic effects><COVID-19 pandemic impact><COVID-19 pandemic impacted><California><Caring><Causality><Chronic><Clinical Management><Cognitive Discrimination><Cohort Studies><Communities><Complex><Concurrent Studies><DNA><DNA Alteration><DNA Sequence Alteration><DNA mutation><Data><Decrease health disparities><Deoxyribonucleic Acid><Development><Diagnosis><Discrimination><Disease><Disease Progression><Disorder><Environment><Environmental Hazards><Etiology><Exposure to><Face><Family Cancer History><Financial Hardship><Genetic><Genetic Predisposition><Genetic Predisposition to Disease><Genetic Susceptibility><Genetic mutation><Genetic predisposing factor><Genetic propensity><Genomics><Genotype><Germ Lines><Gleason Grade><Gleason Grade for Prostate Cancer><Gleason Score><Gleason Score for Prostate Cancer><Gleason Sum><Gleason-SC><Goals><Health><Health Facilities><Health Insurance for Aged and Disabled, Title 18><Health Insurance for Disabled Title 18><Health Services Accessibility><Health care facility><Health disparity mitigation><Health disparity reduction><Healthcare Facility><History><Hospitals><Hypertension><Image><Immunity><Impoverished><Incidence><Inflammatory><Infrastructure><Inherited Predisposition><Inherited Susceptibility><Insurance Coverage><Insurance Status><Ketosis-Resistant Diabetes Mellitus><Life Cycle><Life Cycle Stages><Life Style><Lifestyle><Link><Location><Long-term Follow-up><Longterm Follow-up><Louisiana><Lower health disparities><Malignant Tumor of the Prostate><Malignant neoplasm of prostate><Malignant prostatic tumor><Maps><Maturity-Onset Diabetes Mellitus><Measurement><Measures><Medicaid><Medical><Medicare><Michigan><Mitigate health disparities><Modification><Molecular><NIDDM><Neighborhoods><New Jersey><New York><Non-Insulin Dependent Diabetes><Non-Insulin-Dependent Diabetes Mellitus><Noninsulin Dependent Diabetes><Noninsulin Dependent Diabetes Mellitus><Out-of-Pocket Expense><Outcome><PSA screening><PSA test><Pathogenicity><Pathologic><Pathologist><Patient Outcomes Assessments><Patient Reported Measures><Patient Reported Outcomes><Patient risk><Patients><Persons><Physical activity><Physicians><Population><Poverty><Predicting Risk><Prevention><Progressive Disease><Prostate CA><Prostate CA therapy><Prostate Cancer><Prostate Cancer therapy><Prostate malignancy><Prostatic Cancer><Provider><QOL><Quality of life><Quetelet index><Race><Races><Recording of previous events><Recurrence><Recurrent><Reduce health disparities><Research><Research Resources><Research Specimen><Resources><Risk Factors><Role><Saliva><Sampling><Sequence Alteration><Services><Slow-Onset Diabetes Mellitus><Smoking><Social Environment><Sociology><Specialty><Specimen><Stable Diabetes Mellitus><Stress><Structural Racism><Survey Instrument><Surveys><System><T2 DM><T2D><T2DM><Testing><Texas><Time><Title 18><Training><Translational Research><Translational Science><Transportation><Trust><Type 2 Diabetes Mellitus><Type 2 diabetes><Type II Diabetes Mellitus><Type II diabetes><Uncovered Medical Expenses><Uncovered Uninsured Medical Expense><Uninsured Medical Expense><Update><Variant><Variation><Vascular Hypertensive Disease><Vascular Hypertensive Disorder><Visualization><Wait Time><Work><access to health care><access to health services><access to healthcare><access to services><access to treatment><accessibility of health care><accessibility to health care><accessibility to health services><accessibility to healthcare><active followup><adult onset diabetes><availability of services><biologic><cancer disparity><cancer health disparity><cancer imaging><cancer microenvironment><cancer registry><cancer survival><cancer-related health disparity><care access><care facilities><care services><care systems><causation><co-morbid><co-morbidity><cohort><comorbidity><coronavirus disease 2019 pandemic consequence><coronavirus disease 2019 pandemic impact><data analytics dashboard><data dashboard><data dissemination><deep learning><deep learning algorithm><deep learning method><deep learning strategy><developmental><digital><disease causation><disparity in cancer><effective intervention><effects following the COVID-19 pandemic><environmental stresses><environmental stressor><experience><faces><facial><financial adversity><financial burden><financial distress><financial insecurity><financial strain><financial stress><follow up><follow-up><followed up><followup><forecasting risk><genetic etiology><genetic mechanism of disease><genetic risk factor><genetic vulnerability><genetically predisposed><genome scale><genome-wide><genomewide><genomic alteration><health care access><health care availability><health care service><health care service access><health care service availability><health insurance for disabled><health service access><health services availability><healthcare access><healthcare accessibility><healthcare availability><healthcare service><healthcare service access><healthcare service availability><high blood pressure><high risk><high risk group><high risk individual><high risk people><high risk population><histories><hyperpiesia><hyperpiesis><hypertensive disease><hypertensive disorder><imaging><impact of the SARS-CoV-2 pandemic><improved><inherited factor><ketosis resistant diabetes><life course><life-style factor><lifestyle factors><long-term followup><longterm followup><maturity onset diabetes><medical expenses not covered by insurance><medical specialties><men><metropolitan><modifiable lifestyle factors><molecular phenotype><mortality><multiple data sources><neoplasm registry><oncologic imaging><oncology imaging><out-of-pocket costs><out-of-pocket health care costs><polygenic risk score><population based><predict risk><predict risks><predicted risk><predicted risks><predicting risks><predictive risk><predicts risk><prognostic indicator><prognostication><progression risk><prospective><prostate cancer progression><prostate cancer treatment><prostate specific antigen screening><prostate specific antigen test><public health priorities><racial><racial background><racial origin><recruit><residence><residential building><residential site><resilience><resilient><risk prediction><risk predictions><satisfaction><segregation><service availability><social><social climate><social context><social factors><social role><social stress><social stresses><social stressor><socially stressed><socioenvironment><socioenvironmental><stressor><synergism><tool><total medical expenditure><translation research><translational investigation><treatment access><tumor><tumor imaging><tumor microenvironment><type 2 DM><type II DM><type two diabetes><visual dashboard><visualization dashboard><web based dashboard><web dashboard><whole slide imaging>