Tag: cancer

Largest, most diverse prostate cancer study shows genetic role in health disparities

86 new risk factors identified in research co-led by USC Norris Comprehensive Cancer Center.

By Wayne Lewis

Some racial and ethnic groups suffer relatively more often, and fare worse, from common ailments compared to others. Prostate cancer is one disease where such health disparities occur: Risk for the disease is about 75% higher, and prostate cancer is more than twice as deadly, in Blacks compared with whites. Yet whites are often overrepresented as research participants, making these differences difficult to understand and, ultimately, address.


With this problem in mind, scientists at the USC Center for Genetic Epidemiology and the Institute for Cancer Research in London led a study that brings together data from the majority of genomic prostate cancer studies globally. Including more than 200,000 men of European, African, Asian and Hispanic ancestry from around the world, the study is the largest, most diverse genetic analysis ever conducted for prostate cancer — and possibly for any other cancer.

The paper appears today in Nature Genetics.

The study’s authors identified 86 new genetic variations that increase risk for prostate cancer, not previously discovered, bringing the total number of risk loci for prostate cancer to 269. Applying a model for assessing prostate cancer risk based on the interplay of these genetic factors, the researchers showed that men of African ancestry inherit about twice the prostate cancer risk on average compared to men of European ancestry, while men of Asian ancestry inherit about three-quarter the risk of their white counterparts — evidence that genetics play some part in the differences in how often cancer occurs in different racial groups.

This research is also a step toward applying precision medicine to early detection.

Christopher Haiman. (USC Photo/Ricardo Carrasco III)

“Our long-term objective is to develop a genetic risk score that can be used to determine a man’s risk of developing prostate cancer,” said corresponding author Christopher Haiman, ScD, professor of preventive medicine at the Keck School of Medicine of USC  and director of the USC Center for Genetic Epidemiology. “Men at higher risk may benefit from earlier and more frequent screening, so the disease can be identified when it’s more treatable.”

Study tackles health disparities

Praise for the study’s potential in increasing health equity came from Jonathan W. Simons, MD, president and chief executive officer of the Prostate Cancer Foundation. The foundation funds Haiman’s other work leading the RESPOND initiative exploring the disease among African American men.

“PCF believes that Dr. Haiman’s research findings will lead to more effective prostate cancer precision screening strategies for men of West African ancestry,” Simons said. “PCF is certain that identification of these very high-risk individuals will make a positive impact on this significant health care disparity.”

Haiman and his colleagues used genomic datasets from countries including the U.S., the UK, Sweden, Japan, and Ghana to compare 107,247 men with prostate cancer to a control group comprising 127,006 men. By examining a spectrum of races and ethnicities, the study’s authors aim to make the genetic risk score more useful for more people.

“We not only found new markers of risk, but also demonstrated that, by combining genetic information across populations, we were able to identify a risk profile that can be applied across populations,” said Haiman. “This emphasizes the value of adding multiple racial and ethnic populations into genetic studies.”

Risk score could contribute to better screening

Today’s screening guidelines for prostate cancer suggest that those 55 and older with average risk can choose to take the prostate-specific antigen (PSA) test in consultation with their physicians. High PSA levels are associated with prostate cancer, but the PSA test tends to detect slow-growing tumors. With widespread use, it too often leads to unnecessary treatment.

The PSA test’s value as a screening tool would grow if it were deployed selectively to monitor people found to be at high risk for prostate cancer — which is where the genetic risk score could come into play. Those at particularly high risk might even begin screening before age 55.

In order to translate the current research findings into better early detection, a large-scale clinical trial would be needed.

“Most important, unlike previous screening trials, this one would need to be more representative of the diversity we see in the world,” Haiman said. “No population should get left behind.”

About this study

The paper has more than 230 co-authors, representing scores of organizations. Co-first authors of the study are David Conti, PhD, professor of preventive medicine, and Burcu Darst, PhD, a postdoctoral scholar and research associate, both of the Keck School of Medicine. Co-senior authors are Haiman, on behalf of the Elucidating Loci Involved in Prostate Cancer Susceptibility (ELLIPSE) consortium, and the ICR’s Rosalind Eeles, FMedSci, PhD, FRCP, FRCR, and Zsofia Kote-Jarai, PhD, on behalf of the Prostate Cancer Association Group to Investigate Cancer Associated Alterations in the Genome (PRACTICAL) consortium.

This study was supported by National Institutes of Health (U19CA148537, R01CA194393, K99CA246063),  with further support from Cancer Research UK, Prostate Cancer UK, and the Movember Foundation.

Lourdes Baezconde-Garbanati earns AACR Distinguished Lectureship

Lourdes Baezconde-Garbanati. (USC Photo/Chris Shinn)

Lourdes Baezconde-Garbanati, PhD, MPH, Associate Dean for Community Initiatives, was the recipient of the 2020 American Association for Cancer Research Distinguished Lectureship on the Science of Cancer Health Disparities.

Báezconde-Garbanati presented her award lecture during the opening session of the virtual AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved on Oct. 2. Her lecture was titled “Optimizing engagement to reduce disparities among Hispanic/Latinos/Latinx and other underserved communities.”

This AACR lectureship recognizes an investigator whose novel and significant work has had or may have a far-reaching impact on the etiology, detection, diagnosis, treatment, or prevention of cancer health disparities.

Read the AACR release for more information.

To prevent cancer, USC researchers look beyond traditional risk factors

Big data studies in diverse populations will offer new insights into cancer risk and help USC investigators target outreach, screening and prevention efforts.

Researchers at USC Norris Comprehensive Cancer Center are integrating “big data“ related to multiple cancer risk factors to predict cancer occurrence and to help reduce risk in susceptible populations. (Illustration/iStock)

Why me? It’s a question doctors hear all the time when they diagnose people with cancer. If only the answer were simple.

Caryn Lerman is director of the Norris Comprehensive Cancer Center.
(USC Photo/Ricardo Carrasco III)

“Cancer — which is the uncontrolled growth of abnormal cells in the body — is a set of different diseases that arise from a complex interplay among environmental, genomic, lifestyle and sociodemographic factors,” said Caryn Lerman, the H. Leslie and Elaine S. Hoffman Cancer Research Chair and associate dean for cancer programs at the Keck School of Medicine of USC. Lerman joined USC in March 2019 as the director of the USC Norris Comprehensive Cancer Center.

“While medical research has considerably advanced our understanding of cancer etiology, there is now a tremendous opportunity to translate this knowledge into precision cancer prevention in different ethnic and racial populations,” she added.

Among the first eight cancer centers to be designated by the National Cancer Institute in 1973, the nationally recognized USC Norris cancer center has been a leader in advancing what we know about cancer — a diagnosis received by 1.7 million Americans each year. USC Norris cancer center researchers have led and contributed to studies demonstrating the role of tobacco, physical activity and diet and obesity, among many other cancer risk factors. USC Norris investigators have also advanced our understanding of the genomic factors contributing to cancer risk.

Big data fuels USC Norris cancer center research

Under Lerman’s leadership, the USC Norris cancer center is embarking on an ambitious plan to harness data science to integrate “big data” related to multiple risk factors. Their goal is to develop better models to predict cancer occurrence and intervene to reduce risk in susceptible populations.

“We have a tremendous opportunity to extend beyond traditional risk factors and genomic testing in a diverse population that differs widely in terms of socioeconomic status, diet and environmental exposures,” Lerman said.

There are many nontraditional risk factors, she explained, including where a person lives and their exposure to environmental carcinogens, whether they experience poverty and the role of the microbiome — a profile of microbes that live in different parts of our bodies and is influenced by diet and other environmental exposures.

To increase knowledge of the roles of these understudied risk factors, and more importantly to integrate this knowledge for more precise risk predictions, USC Norris cancer center researchers will use the latest surveillance technologies — including wireless monitoring devices — to record health-related and environmental exposure data from participants across Los Angeles County. Data scientists will leverage artificial intelligence and machine learning to analyze these data, draw insights, pinpoint trends and make predictions about how, where and when different people are impacted.

Translational genomics expert Troy McEachron, left, talks with director John Carpten. (Photo/Chris Shinn)

A central priority for the USC Norris cancer center is reducing disparities between people of different racial and ethnic groups in Los Angeles County.

“Understanding and addressing the cancer needs of our diverse populations is one of the things that makes our research at USC Norris so unique,” said Mariana Stern, associate director of population science at the cancer center and a professor of preventive medicine and urology at the Keck School of Medicine.

“Importantly, our efforts are not only geared towards understanding why some minority populations have higher cancer incidence and mortality rates than other groups but also on training the next generation of underrepresented minority scientists and dedicating significant efforts to engage our minority communities in cancer education and research.”

Cancer center researchers explore prevention, risk factors

Some of the initiatives led by USC Norris cancer center researchers:

  • Christopher Haiman, professor of preventive medicine at the Keck School of Medicine and co-leader of the USC Norris Cancer Epidemiology Research Program, is collaborating with multiple centers across the country in a large-scale study focused on understanding genomic, tumor and social determinants of cancer risk and outcomes among Black men with prostate cancer.
  • Lourdes Baezconde-Garbanati, professor of preventive medicine and associate director of community outreach and engagement at the USC Norris cancer center, and collaborators are leading efforts to increase screening for cervical cancer among Latina women.
  • Eunjung Lee, an associate professor of preventive medicine, is addressing the higher risk of stomach cancer among Koreans.
  • Myles Cockburn, professor of preventive medicine and co-leader of the USC Norris Cancer Control Research Program, is leading efforts focused on melanoma among Latinos, with focus on cancer prevention among kids and early detection among adults.
  • Adam Leventhal and Maryann Pentz, both professors of preventive medicine, as well as Jessica Barrington-Trimis, an assistant professor of preventive medicine, are studying how vaping progresses to tobacco use in young people.
  • Heinz-Josef Lenz and Amir Goldkorn of the USC Norris cancer center, along with their collaborators, are leading national studies testing a noninvasive procedure called a liquid biopsy that could help identify certain cancers early when they are most curable and also how tumors respond to different treatments to improve survival.

“These efforts, and many more underway at USC Norris, will help guide policy and help us better manage the health of the different populations we serve,” Lerman said. “If we can identify populations at risk for certain cancers, we can target prevention efforts where they are needed the most.”

— Sarah Nightingale

Cancer Surveillance Program welcomes new director, Lihua Liu

Lihua Liu, an associate professor of clinical preventive medicine, has been named the director and principal investigator of USC’s Cancer Surveillance Program (CSP).

Established by faculty members in USC’s Department of Preventive Medicine in 1972, the CSP is responsible for recording all cancer diagnoses in Los Angeles County. It is part of the California Cancer Registry (CCR) and a member of the National Cancer Institute (NCI)’s Surveillance, Epidemiology, and End Results (SEER) Program. By collecting information on cancer diagnoses across the state and nation, these organizations provide data that can be used to identify trends, inform prevention and treatment strategies, and improve public health.

Liu brings to the role a unique set of qualifications and a long history with CSP. As a PhD student in USC’s Department of Sociology, she combined socioeconomic data from the U.S. Census and cancer incidence data from the CSP to examine the relationship between socioeconomic status and cancer risk among L.A. County’s racially and ethnically diverse population.

After earning her PhD, Liu stayed at the CSP, completing postdoctoral training and then accepting a position as a staff research scientist. She joined the faculty as an assistant professor of clinical preventive medicine in 2008. Over the years and in various roles, Liu has accumulated extensive knowledge of registry operations and developed a wide professional network with local, state, national, and international counterparts and collaborators. With a PhD in demography—the study of human populations—Liu has enriched CSP’s data by paving the way for researchers to study cancer risk in different segments of the population.

As an immigrant herself, Liu became fascinated by cancer risk in the approximately 13 percent of U.S. residents who were born in another country.

“I have become an advocate for better cancer surveillance and more research among this growing but often overlooked segment of the U.S. population,” Liu said. “Studying immigrants may prove vital in understanding the non-genetic factors in cancer development to advance cancer control strategies.”

Liu succeeds Dennis Deapen, professor of clinical preventive medicine, who led the CSP from 1988 to 2020.

“With a background in demography, Lihua has provided multiple population-wide innovations to the CSP and the researchers who use the data. She has led local and national work on the classification and analysis of cancer by racial ethnic group and has provided multiple mechanisms to share population-based cancer research opportunities with faculty and students,” Deapen said. “I’ve enjoyed sharing her research interests in the fascinating findings that can be extracted from analyzing cancer data among immigrants to Los Angeles and California, and how our CSP data can improve their experience.”

As CSP director, Liu will oversee registry operations and research development. Her priorities include building CSP’s analytical support capability, developing data mining tools to better support innovation and collaboration for cancer research, and boosting the accessibility and usability of data for cancer control activities.

She also plans to make CSP data, which has resulted in more than 10,000 peer-reviewed articles to date, more integrated into USC’s teaching and research objectives.

“The CSP is a goldmine of data that is waiting to be analyzed,” Liu said. “But knowing how to make use of such a rich and complex data source can be daunting. I want to create collaborative opportunities that enable junior researchers to get a start in cancer surveillance research, and at the same time advance our knowledge to better control and prevent cancer.”

More about the L.A. Cancer Surveillance Program:

  • Population-based cancer registry for Los Angeles County
  • Established by USC Department of Preventive Medicine faculty members in 1972
  • Became part of the new California Cancer registry in 1988
  • Joined the National Cancer Institute (NCI)’s Surveillance, Epidemiology, and End Results (SEER) Program in 1992
  • A member in the North American Association of Central Cancer Registries (NAACCR)
  • Long-time contributor to International Association of Cancer Registries (IACR) and International Agency for Research on Cancer (IARC)
  • Contains more than 1.7 million cancer records diagnosed among residents of Los Angeles County since 1972
  • Annual case count over 45,000
  • Employs 28 full-time staff members plus affiliated faculty researchers
  • Data used in more than 10,000 peer-reviewed publications

A new test may better predict ovarian cancer survival

The tool, developed by USC researchers, could help identify patients with the most to gain from a clinical trial as well as guide therapeutic targets.

Tumor gene test predicts ovarian cancer survival (Photo/iStock)

Scientists may have found a better way to estimate survival for women with aggressive ovarian cancer, according to a new study by USC researchers and international colleagues.

The findings, which appear Monday in the print edition of the journal Annals of Oncology, could focus the development of targeted therapeutic approaches and identify women who might benefit from clinical trials.

An estimated 21,750 American women will be diagnosed with ovarian cancer this year. Average survival for women with the most common and aggressive form is around four years. But survival varies widely between patients, underscoring the need to estimate who is facing a fast-moving or slower disease.

In this study, researchers discovered that a tumor gene test, which is based on tissue removed during cancer surgery, is better at predicting survival among women with ovarian cancer than making estimates the usual way, which is based on a patient’s age and cancer stage.

“We envisioned a test to use at the time of diagnosis — to identify patients unlikely to benefit from current treatments and potentially offer them alternatives,” said Joshua Millstein, an associate professor of research in preventive medicine at the Keck School of Medicine of USC and the study’s first author. “For example, those patients might be good candidates for clinical trials or for different treatments that might improve their survival.”

Tumor gene test can predict ovarian cancer survival rate

To start, researchers gathered preserved tumor samples and data about duration of survival after diagnosis from nearly 4,000 women worldwide whose information had been collected for previous studies.

They custom-designed a test to measure each sample for the expression of 500 genes linked to the ovarian cancer disease process. Genes “express” proteins and other molecules, based on the gene’s particular DNA, to perform particular functions. They then “trained” the test with a portion of the tumor samples, inputting gene expression data from each tumor as well as the number of years the patient survived after their diagnosis.

Soon, the tumor gene test could accurately predict a patient’s five-year survival rate based on their tumor’s gene expression profile alone. This important information could help newly diagnosed women and their doctors make treatment decisions as well as set targets for developing new therapies.

“Some of the genes we identified as being predictors for good or poor survival may be potential targets for new treatments,” said senior author Susan Ramus, an ovarian cancer researcher previously at the USC Norris Comprehensive Cancer Center and now a professor at the University of New South Wales in Sydney.

“At the moment, the majority of ovarian cancer patients get the same treatment. It’s not like breast cancer or other cancers where they look at your tumor and select from a range of treatments,” she added. “So this is a way to stratify patients and potentially give more personalized treatment down the track.”

– By Leigh Hopper

The research paper involved 125 authors across 86 organizations, including USC. In addition to Millstein, a member of the USC Norris cancer center, the other USC author on the study was Anna Wu, a professor of preventive medicine at the Keck School of Medicine.

The study was funded, in part, with grants from the National Institutes of Health (R01CA172404, R01CA168758), the United States Department of Defense Ovarian Cancer Research Program (OC110433), the National Cancer Institute (P30CA014089, P30CA034196, K22 CA193860).