Black women in the US have both a higher percentage of late-stage diagnoses as well as the highest rates of mortality from breast cancer when compared to women of other ethnic subgroups. Additionally, Black women have the second highest prevalence of cervical cancer. Many reports evaluating the cancer outcomes of Black women combine data on African born immigrants and US born Blacks. This categorization ignores subtle yet important cultural differences between the two groups, which may ultimately affect breast and cervical cancer screening practices. Therefore, this study investigated knowledge and awareness levels of breast and cervical cancer screening practices among female African born immigrants to the US residing in the Washington D.C. metropolitan area. Data were collected from 38 participants through key informant interviews, focus group sessions and a socio-demographic questionnaire over a three-month study period. Results suggest that fatalism, stigma and privacy are among the major factors that affect the decision to seek preventative screening measures for breast and cervical cancer among this population. Additionally, the study implies that cervical cancer awareness is significantly lower among this population when compared to breast cancer. This study highlights differences between women of African descent residing in the US and the need for continued research to increase understanding of the manner in which immigrant status affects health-seeking behavior. This information is critical for researchers, physicians and public health educators aiming to design culturally appropriate interventions to effectively reduce the prevalence of breast and cervical cancer among female African immigrants living in the US.

Background and objectives Autoantibodies to complement C1q (anti-C1q) are associated with the diagnosis of lupus nephritis. In this study, we compare anti-C1q IgG with another complement autoantibody, anti-C3b IgG, as a biomarker of lupus nephritis and lupus nephritis flare.Design, setting, participants, & measurements Our investigation involved the Ohio SLE Study, a prospective observational cohort of patients with recurrently active lupus who were followed bimonthly. Serum anti-C1q and anti-C3b IgG levels were assessed cross-sectionally by ELISA in 40 normal controls and 114 patients in the Ohio SLE Study (41 nonrenal and 73 lupus nephritis) at study entry, and longitudinally in a subset of patients in the Ohio SLE Study with anti-C1q-positive lupus nephritis in samples collected every 2 months for 8 months leading up to lupus nephritis flare (n=16 patients). ResultsIn the cross-sectional analysis, compared with anti-C1q IgG, anti-C3b IgG was less sensitive (36% versus 63%) but more specific (98% versus 71%) for lupus nephritis. Only anti-C3b IgG was associated with patients with lupus nephritis who experienced at least one lupus nephritis flare during the Ohio SLE Study period (P,0.01). In the longitudinal analysis, circulating levels of anti-C1q IgG increased at the time of lupus nephritis flare only in patients who were anti-C3b positive (P=0.02), with significant increases occurring from 6 (38% increase) and 4 months (41% increase) before flare. Anti-C3b IgG levels also trended up at lupus nephritis flare, although the change did not reach statistical significance (P=0.07). Neither autoantibody increased 2 months before flare.Conclusions Although not as prevalent as anti-C1q IgG, anti-C3b IgG showed nearly complete specificity for lupus nephritis. The presence of anti-C3b IgG identified patients with lupus nephritis who were prone to flare and in whom serial measurements of markers associated with complement, such as anti-C1q IgG, may be useful to monitor lupus nephritis activity.

Black women in the US have both a higher percentage of late-stage diagnoses as well as the highest rates of mortality from breast cancer when compared to White, Hispanic-Latino, American-Indian and Asian women in the US. Moreover, in comparison to these same ethnic subgroups, Black women also have the second highest prevalence of cervical cancer. Many reports evaluating the cancer outcomes of Black women combine African born immigrants and US born Blacks. Previous literature however, suggests that this categorization ignores subtle yet important cultural differences between the two groups, which in turn have widespread effects on breast and cervical cancer screening practices. Therefore, this study investigated knowledge and awareness levels of breast and cervical cancer screening practices, specifically among female African born immigrants to the US. Utilizing qualitative methods, this project was completed in conjunction with the African Women's Cancer Awareness Association (AWCAA), an established organization with strong ties to the substantial African immigrant population in the Washington, DC metropolitan area. Data were collected from 41 participants through key informant interviews, focus group sessions and a questionnaire, over a three-month study period. Key informant interviews and focus group sessions ranged in duration from 45-90 minutes and followed a semi-structured interview approach. AWCAA assisted in the recruitment of women for focus groups that were structured by age, with women 20-39 and 40-70 years old. Results suggest that fatalism, stigma and privacy, are among the major factors that affect the decision to seek preventative screening for breast and cervical cancer. Additionally, the study implies that cervical cancer awareness is significantly lower among this population when compared to breast cancer awareness. Participants also attributed their lack of screening to its low priority in comparison to other obligations such as job and family commitments. Furthermore, spirituality and the belief that cancer is not a part of God's plan for their life, was seen through repetition of the comment, “It is not my portion.” Although this is a small, focused study, it is adds to the minimal current literature regarding African immigrant women's perspectives of breast and cervical cancer screening. Additionally, this study demonstrates differences between women of African descent residing in the US and the need for continued research in this field. Information to this regard is critical for researchers, physicians and public health educators, aiming to design culturally appropriate interventions to reduce the prevalence of breast and cervical cancer among female African immigrants. Citation Format: Ezinne G. Ndukwe, Karen Patricia Williams, Vanessa Sheppard, Amr Soliman. Perspectives of breast and cervical cancer screening among female African immigrants to the U.S. [abstract]. In: Proceedings of the Fifth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2012 Oct 27-30; San Diego, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2012;21(10 Suppl):Abstract nr A79.

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