Role of Epigenetics in Cancer Health Disparities

Mohammed, Sulma I.; Springfield, Sanya A.; Das, Rina

doi:10.1007/978-1-61779-612-8_25

Cited by 33 publications

(25 citation statements)

References 76 publications

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“…In addition, epigenetic processes, in particular DNA methylation, may play a role in the induction of phenotypes in cancer. More importantly, significant epigenetic differences in between racial groups may account for the differences seen in tumor initiation, progression, aggressiveness, and outcome of these cancers [21]. …”

Section: Discussionmentioning

confidence: 99%

Racial Disparities in Gastrointestinal Cancers-Related Mortality in the US Population

Jinjuvadia

Liangpunsakul

2012

Dig Dis Sci

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Background Racial difference in cancer-related mortality has been described in epidemiological studies and evidence points towards higher mortalities in the minorities. To determine the magnitude of racial disparities and sex differences in GI cancer-related mortalities in the US population, we analyzed the data using the third National Health and Nutrition Examination Survey (NHANES III) and related mortality data files. Methods NHANES III and its related public linked mortality files were used for this study. Our study cohort included subjects who were ≥18 years and were part of the longitudinal mortality follow-up database. The overall GI cancers related mortality was calculated using combined mortality from malignant neoplasm of esophagus, stomach, colon, liver and pancreas. The evaluation of independent predictors of overall GI cancer-related mortality and of each individual GI cancer was carried out using the Cox proportional hazards model. Results A total of 13,221 individuals were included in the analyses with the average person year follow-up of 13.9 years. During the follow-up period, 4,146 subjects died. Of these, 199 were from GI-related cancers. Non-Hispanic black (NHB) had significantly higher overall GI-cancer related mortality compared to non-Hispanic white (NHW, adjusted hazard ratio, aHR: 2.31, 95 % CI 1.57–3.38, p < 0.001). Subgroup analyses by sex demonstrated higher mortality from gastric, colorectal and primary liver cancer related mortality in NHB men compared to NHW men. Esophageal and pancreatic cancer mortalities were higher in NHB women compared to NHW women. Conclusion Overall GI cancer-related mortality is significantly higher among NHB compared to NHW in the US population.

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Section: Discussionmentioning

confidence: 99%

Racial Disparities in Gastrointestinal Cancers-Related Mortality in the US Population

Jinjuvadia

Liangpunsakul

2012

Dig Dis Sci

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“…Differential methylation has been repeatedly established between cancerous and benign tissue. 53,54 In a study of 65 breast tumor samples from the University of Maryland Medical Center and the Baltimore Veterans Administration, Wang et al demonstrated that women with early-onset disease had significant hypermethylation of the tumor suppressor gene, CDH13 . 53 CDH13 when inactivated, is associated with early onset breast cancer.…”

Section: Health Outcomes and Dna Methylationmentioning

confidence: 99%

Epigenetics and Health Disparities

Vick

Burris

2017

Curr Epidemiol Rep

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Purpose of review African Americans disproportionately suffer from leading causes of morbidity and mortality including cardiovascular disease (CVD), cancer, and preterm birth. Disparities can arise from multiple social and environmental exposures, but how the human body responds to these exposures to result in pathophysiologic states is incompletely understood. Recent findings Epigenetic mechanisms, particularly DNA methylation, can be altered in response to exposures such as air pollution, psychosocial stress, and smoking. Each of these exposures has been linked to the above health states (CVD, cancer, and preterm birth) with striking racial disparities in exposure levels. DNA methylation patterns have also been shown to be associated with each of these health outcomes. Summary Whether DNA methylation mediates exposure-disease relationships and can help explain racial disparities in health is not known. However, because many environmental and adverse social exposures disproportionately affect minorities, understanding the role that epigenetics plays in the human response to these exposures that often result in disease, is critical to reducing disparities in morbidity and mortality.

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“…Breast cancer incidence is lower among AA women relative to Caucasians, but the mortality rate is significantly higher in the AA community (1). Additionally, AA women are more likely to be diagnosed with the disease at an early age and express more aggressive phenotypes that are higher-grade and are linked to worse outcomes (84)(85)(86)(87). Associations between ancestry and epigenetics have been found within breast cancer.…”

Section: Insights From Other Cancersmentioning

confidence: 99%

Lung cancer early detection and health disparities: the intersection of epigenetics and ethnicity

Lerner¹,

Winn²,

Hulbert³

2018

J. Thorac. Dis.

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Lung cancer is the most prominent cause of cancer-related mortality. Significant disparities in incidence and outcome characterize the disease's manifestations among ethnically and racially diverse populations. Complete surgical resection is the most effective curative treatment. However, success relies on early tumor detection. The National Lung Cancer Screening trial showed that lung cancer related mortality can be reduced by the use of low-dose CT (LDCT) screening. However, this test is plagued by a high false positive rate of 97% and the device itself is limited to designated cancer centers due to its expense and size. This restriction makes it difficult for underserved groups to access LDCT screening, the current standard of care. Highly sensitive and specific epigenetic DNA methylation-based biomarkers have the potential to work independently or in conjunction with LDCT screening to identify early-stage tumors. These tests could reduce unnecessary invasive confirmatory diagnostic tests and their associated morbidity and mortality.These tests also have the opportunity to bring lung cancer screening to the community thereby reducing unequal accessibility. However, epigenetic alterations are closely linked to the interplay between hereditary and environmental factors such as diet, lifestyle, ethnic ancestry, toxin exposure, residential segregation, and disparate community support structures. Despite this, the overwhelming number of early detection DNA methylation biomarker studies to date have either failed to control for ethnicity or have employed heavily Caucasian-biased patient cohorts. This review seeks to summarize the literature related to the early detection of lung cancer through molecular biomarkers among different ethnicities. Ethnical specific epigenetic biomarkers have the potential to be the first step towards an accessible, available personalized medicine approach to cancer through liquid biopsy.

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Role of Epigenetics in Cancer Health Disparities

Cited by 33 publications

References 76 publications

Racial Disparities in Gastrointestinal Cancers-Related Mortality in the US Population

Racial Disparities in Gastrointestinal Cancers-Related Mortality in the US Population

Epigenetics and Health Disparities

Lung cancer early detection and health disparities: the intersection of epigenetics and ethnicity

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