R01CA249982

Socio-Environmental Context in Monoclonal Gammopathy of Undetermined Significance (MGUS) Disparities - Abstract

Compared to non-Hispanic whites, African Americans have a more than 2-fold higher incidence of multiple myeloma (MM) and its asymptomatic precursor condition, monoclonal gammopathy of undetermined significance (MGUS). However, the etiological factors underlying these racial disparities are not known, and few epidemiologic resources are currently available to support research in diverse populations.

Notably, there is little evidence that genetic factors explain these disparities; differences in the prevalence of MGUS and MM by race may thus reflect external lifestyle and social factors. We posit that racial disparities are reflected in socioeconomic status (SES) and geospatial factors such as the "health" of the environment in which one lives (termed "built environment"), both of which are known to be linked to race and a variety of health outcomes.

The Black Women's Health Study (BWHS) and the California Teachers Study (CTS), well-established complementary cohorts of women, provide a unique opportunity to study SES and built environment factors for MGUS in African American and non-Hispanic white women. These cohorts have up to 25 years of individual-level risk factor information, assessed through repeated health questionnaires, available as well as geocoded residential addresses.

We propose an epidemiologic study pooling data from these two cohorts to evaluate the role of individual and neighborhood SES and the built environment in racial disparities in MGUS. Prevalent cases of MGUS will be identified by screening 8,000 cohort participants (3,300 in BWHS and 4,700 in CTS) with archived blood specimens using gold-standard laboratory assays for the diagnosis of MGUS. We expect to identify 660 cases of MGUS (including 330 African American and 330 non-Hispanic white women).

We hypothesize that neighborhood disadvantage and attributes of the built environment that inhibit healthy behaviors increase risk and contribute to known racial disparities in MGUS. We will determine associations of neighborhood deprivation and markers of individual SES, such as educational achievement, parental education level, income, and early life financial instability, in relation to MGUS overall and by race.

We will also explore how characteristics of the built environment, such as urbanicity and neighborhood walkability, and the cross-classification of these variables with SES, are associated with MGUS and may explain observed differences in prevalence by race. Our proposed study is particularly innovative because it moves beyond the traditional, single-level predictor model to an approach that addresses the complexity of both individual- and contextual-level predictors for disease.

The wide geographic/rural-urban, racial, and socioeconomic diversity of our study population across cohorts makes it an ideal setting in which to interrogate the intersection between race, SES, and neighborhood attributes on MGUS and MM risk. This research therefore has great potential to advance current knowledge about MGUS etiology, to inform opportunities for risk reduction in high-risk understudied populations, and to close the gap in racial disparities in multiple myeloma and its precursor conditions.

Trustees Of Boston University

TO IDENTIFY CANCER RISKS AND RISK REDUCTION STRATEGIES, TO IDENTIFY FACTORS THAT CAUSE CANCER IN HUMANS, AND TO DISCOVER AND DEVELOP MECHANISMS FOR CANCER PREVENTION AND PREVENTIVE INTERVENTIONS IN HUMANS. RESEARCH PROGRAMS INCLUDE: (1) CHEMICAL, PHYSICAL AND MOLECULAR CARCINOGENESIS, (2) SCREENING, EARLY DETECTION AND RISK ASSESSMENT, INCLUDING BIOMARKER DISCOVERY, DEVELOPMENT AND VALIDATION, (3) EPIDEMIOLOGY, (4) NUTRITION AND BIOACTIVE FOOD COMPONENTS, (5) IMMUNOLOGY AND VACCINES, (6) FIELD STUDIES AND STATISTICS, (7) CANCER CHEMOPREVENTION AND INTERCEPTION, (8) PRE-CLINICAL AND CLINICAL AGENT DEVELOPMENT, (9) ORGAN SITE STUDIES AND CLINICAL TRIALS, (10) HEALTH-RELATED QUALITY OF LIFE AND PATIENT-CENTERED OUTCOMES, AND (11) SUPPORTIVE CARE AND MANAGEMENT OF SYMPTOMS AND TOXICITIES. SMALL BUSINESS INNOVATION RESEARCH (SBIR) PROGRAM: TO EXPAND AND IMPROVE THE SBIR PROGRAM, TO STIMULATE TECHNICAL INNOVATION, TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT FUNDING, TO INCREASE SMALL BUSINESS PARTICIPATION IN FEDERAL RESEARCH AND DEVELOPMENT, AND TO FOSTER AND ENCOURAGE PARTICIPATION IN INNOVATION AND ENTREPRENEURSHIP BY WOMEN AND SOCIALLY/ECONOMICALLY DISADVANTAGED PERSONS. SMALL BUSINESS TECHNOLOGY TRANSFER (STTR) PROGRAM: TO STIMULATE AND FOSTER SCIENTIFIC AND TECHNOLOGICAL INNOVATION THROUGH COOPERATIVE RESEARCH AND DEVELOPMENT CARRIED OUT BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO FOSTER TECHNOLOGY TRANSFER THROUGH COOPERATIVE RESEARCH AND DEVELOPMENT BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT FUNDING, AND FOSTER PARTICIPATION IN INNOVATION AND ENTREPRENEURSHIP BY WOMEN AND SOCIALLY/ECONOMICALLY DISADVANTAGED PERSONS.

93.393 - Cancer Cause and Prevention Research

National Cancer Institute (NCI) [HHS - NIH]

Boston, Massachusetts 021182640 United States

Single Zip Code

Provocative Questions (PQs) in Multiple Myeloma Disparities Research (R01 Clinical Trial Optional) (PAR-19-279)

Amendment Since initial award the total obligations have increased 322% from $760,146 to $3,206,176.