Citations

Background: While much of cancer research has historically centered on innovations within clinical or laboratory settings, most of the factors shaping equity in cancer outcomes reside outside hospital walls—in neighborhoods, workplaces, and community networks. This reality underscores the need for community-involved and community-living interventions: programs co-designed and delivered within communities to meet people where they live, work, and socialize . Such interventions hold the greatest promise for sustainability because they are embedded in the daily lives, cultures, and resources of the populations they serve. Methods: This special collection brings together research that illuminates the power of community-centered and community co-led strategies for prevention, early detection, treatment, and survivorship across diverse settings. Results: The articles in this series illustrate how innovation, cultural humility, and local engagement can bridge persistent gaps in cancer care. Conclusion: Together, they highlight how communities themselves are essential partners in dismantling disparities and achieving lasting cancer control.

Abstract Introduction. Understanding the unique social and environmental contexts of communities is essential for designing effective, locally tailored cancer intervention strategies. This study aimed to identify key findings from a comprehensive, multifaceted, cancer-focused needs assessment conducted across three U.S. regions, offering insights into the social, behavioral, and structural barriers that hinder cancer prevention and control, and informing regionally tailored interventions. Methods. This study focused on adult residents within the Mayo Clinic Comprehensive Cancer Center catchment areas, covering 75 counties across Arizona, Florida, and the Midwest (Minnesota, Wisconsin, and Iowa). Data was collected through collaborations with the University of Florida and Mayo Clinic Survey Research Centers, and the “Boots on the Ground" approach involving community health workers. Methods included phone calls, online submissions, and community outreach for an anonymous survey. Validated measures assessed healthcare access, lifestyle, social networks, neighborhood conditions, and discrimination. Descriptive analyses were conducted using valid responses. Non-responses and selections of “Prefer not to answer” were excluded from percentage calculations to ensure interpretive accuracy. Results. Involving 2,681 respondents, the data reveal consistent yet regionally nuanced barriers to cancer prevention. Health insurance coverage was relatively high across all regions—77.6% in Arizona, 85.5% in Florida, and 89.2% in the Midwest. Despite this, access to care remained limited. In Arizona, 22% of respondents could not afford to see a regular doctor, and 41.3% reported delays due to work or transportation. In Florida, 26.6% reported financial barriers to primary care, and nearly half (49.7%) experienced delays in receiving care. The Midwest showed fewer neighborhood safety concerns but still faced high rates of care delays (46.7%) and housing-related issues (42.6%). Neighborhood-level challenges were common. Housing-related problems were reported by 42.9% of respondents in Arizona, 54% in Florida, and 42.6% in the Midwest. Concerns about drug use were highest in Arizona (40%) but present across all regions. Health behavior risks were also widespread: 72–79% of respondents reported sleep difficulties, and many reported low physical activity, suboptimal sun protection, and routine alcohol use. Psychosocial stressors were prominent, with 51–65% of respondents reporting experiences of disrespect and 42–66% feeling unheard by healthcare providers. Conclusions. Despite relatively high rates of insurance coverage, communities across all regions face persistent challenges in accessing timely, affordable, and respectful healthcare. Coupled with neighborhood instability, adverse health behaviors, and psychosocial stressors, these barriers highlight the urgent need for regionally tailored strategies that strengthen both cancer prevention and care. Addressing these interconnected challenges at the community level is essential for promoting more equitable cancer outcomes. Citation Format: Tingyu Zou, Monica L. Albertie, Emelina Asto-Flores, Manisha Salinas, Farhia Omar, Adeline Abbenyi, Noreen Stephenson-Hubert, Nuwanthi Heendeniya, Kathleen Yost, Folakemi T. Odedina. Place, people, and prevention: Contextual drivers of cancer health equity in three US Regions [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr B031.

Abstract Introduction: Advances in treatment have led to significant increases in survival rates, with over 90% of men diagnosed with prostate cancer (CaP) living at least five years. However, surviving cancer and its treatment often weigh a hefty survivorship burden. Men from the at-risk, vulnerable populations have the greatest burden. This study aims to understand distress among Black CaP survivors (CaPS) who bear the heaviest CaP burden. Method: We conducted key informant interviews with Motivational Interviewing techniques to collect CaPS demographic information, medical history, and multilevel distress evaluation. Descriptive analyses were conducted using SAS. Results: A total of 22 CaPS (aged from 48 to 72) were involved in the study. The majority of CaPS were African American (90.9%) and were diagnosed with stage 2 (31.8%) or stage 3 (36.4%). Over half of them (68.2%) were treated by surgery; most CaPS (90.9%) experienced side effects from prostate cancer treatments. CaPS reported distress in the following domains: Emotional well-being (e.g., Feeling sad, depressed or anxious, mental health) – 40.9%, Death of someone very close to you (e.g., family) – 36.4%, Alcohol use in close family – 36.4%, Experiences of discrimination or racism – 36.4%, Healthcare costs and coverage (e.g., medication, medical services, copay, insurance premium) – 31.8%, Loneliness and isolation – 27.3%, Serious injury/illness in close family (e.g., being a caregiver) – 27.3%, Money and finance – 22.7%, Using telehealth (e.g., using a smartphone or tablet for telephone or over the computer, clinic visit, patient portal, completing online forms, virtual classes) – 22.7%, Marriage, romantic relationships – 22.7%. Discussion: Black CaP survivors (CaPS) who bear the heaviest CaP burden are considered a priority population for research and care. These CaPS identified that their psychological distress was related to both familial and socioeconomic issues. The most endorsed life-stresses included emotional wellbeing, experiences of discrimination/racism, loneliness and isolation, healthcare cost/finance, family health, personal relationship, and telehealth use. The distress data as measured by the life-stress scale are invaluable in better documenting and addressing distress in interventions responsive to specific priority communities. Our novel findings suggest the relevance of grief and loss for these men. 36% reported death of someone close, and 27% indicated distress due to loneliness and isolation. Though the sample size was small, the distress data obtained may inform the science and practice of whole-person survivorship that consider distress emphasizing emotional wellbeing. The study is ongoing, and this abstract presents preliminary results; further muti-variate analyses will be conducted for the conference presentation. Citation Format: Kimlin Ashing, Floyd Willis, Chris Williams, John Mccall, Gaole Song, Fornati Bedell, Cassandra Moore, Ewan Cobran, Che Ngufor, Timethia Bonner, Getachew Dagne, Arnold Merriweather, Ernie Kaninjing, Rotimi Oladapo, Roxana Dronca, Fullwood Dottington, Folakemi Odedina. Whole person survivorship: Multilevel distress in prostate cancer survivors from priority communities [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr A024.

Abstract Introduction: Understanding how communities access and engage with health information is essential for effective health communication. Health literacy—the ability to read, understand, and use healthcare information—plays a crucial role in making informed health decisions. With the rise of digital technologies, internet access and online engagement have become key tools for obtaining health information. However, variations in health literacy and digital engagement can limit some populations' ability to fully access these resources. This study examined health literacy, cancer information-seeking behaviors, internet access, and digital engagement among adults in the Mayo Clinic Comprehensive Cancer Center catchment areas to inform more effective and region-specific health communication strategies. Methods: This study focused on adult residents within the Mayo Clinic Comprehensive Cancer Center catchment areas, covering 75 counties across Arizona, Florida, and the Midwest (Minnesota, Wisconsin, and Iowa). Data were collected through partnerships with the University of Florida and Mayo Clinic Survey Research Centers, and the "Boots on the Ground" approach involving community health workers. Methods included phone calls, online submissions, and community outreach for an anonymous survey. Validated measures assessed health literacy, information access, and digital engagement. Descriptive analyses were performed using valid responses, excluding non-responses and "Prefer not to answer" options to ensure interpretive accuracy. Results: Data from 2,681 respondents highlighted consistent barriers to cancer prevention with regional differences. In Arizona, 42.6% of respondents need help reading medical materials, but only 3.1% reported lacking confidence in obtaining cancer-related information. In contrast, 63.1% felt very or completely confident in accessing cancer advice. The primary sources of health information were doctors (17.6%), internet searches (11.4%), and family (9.8%). In Florida, 38.4% need assistance, but only 2.7% lack confidence, and 68.2% feel very or completely confident. Doctors (18%) and internet searches (13.1%) were top sources. In the Midwest, 38.5% struggle with medical documents, and 3.1% reported lacking confidence, while 66.4% felt very or completely confident. Internet access is widespread across all regions, with smartphones being the dominant device. Daily internet use for communication, browsing, and engagement with health apps and social networks remains high. Conclusion: Although many respondents face challenges with reading health-related materials, most report high confidence in obtaining cancer information, suggesting a gap between functional health literacy and perceived ability to access information. The widespread use of mobile devices and near-universal internet access offers a valuable opportunity to enhance health communication through digital tools. These findings emphasize the importance of tailored digital outreach to bridge literacy gaps and ensure underserved populations can access reliable health information. Citation Format: Tingyu Zou, Monica L. Albertie, Emelina Asto-Flores, Manisha Salinas, Farhia Omar, Adeline Abbenyi, Noreen Stephenson-Hubert, Nuwanthi Heendeniya, Kathleen Yost, Folakemi T. Odedina. Health literacy and digital engagement across US Regions: Insights from the mayo clinic catchment areas [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr B030.

Prostate cancer represents a significant health disparity among Black men, who experience higher rates of both incidence and mortality compared to other racial groups. Understanding the complex interplay of cultural, familial, and socioeconomic factors that shape health behaviors is essential for the development of effective interventions. This study sought to explore the lived experiences of ethnically diverse Black men with prostate cancer, focusing on how cultural context, family history, and spirituality influence health decisions and engagement with care. Through a secondary analysis of existing data, personal narratives from 32 Black prostate cancer survivors, primarily U.S.-born Black men, were examined to identify recurring themes that revealed the multifaceted challenges and motivations these men face. The analysis uncovered eight key themes that reflect a complex landscape, including medical distrust fueled by cultural perceptions and past negative experiences, the dual influence of family history on seeking early care versus hesitation, and the role of spirituality as a guiding force in health decisions. Additionally, financial constraints and limited access to comprehensive health information emerged as critical factors affecting engagement with preventive care. The findings underscore the need for culturally sensitive approaches that acknowledge the diverse experiences of Black men in their prostate cancer journey. By understanding the influence of family dynamics, spirituality, and socioeconomic challenges, future research can create targeted interventions that promote informed decision-making and help reduce disparities in prostate cancer outcomes.

PURPOSE Oncology pharmacists (OPs) play a crucial role in cancer care, treatment, survivorship, and multidisciplinary teams (MDTs). OPs have specialized training in designing, administering, monitoring, and modifying oncology chemotherapy; managing adverse events; and evaluating clinical trials and investigational drugs. Yet, the state of OP has remained largely unknown in the clinical oncology workforce of the West African region. Therefore, this study aimed to understand who reconstitutes chemotherapy and to explain the OP educational and practice needs, challenges, and solutions in Nigeria. MATERIALS AND METHODS Using a concurrent embedded mixed method design, 35 OPs completed a questionnaire, and 12 others responded to a semistructured interview. The data were then subjected to inductive thematic and descriptive analyses. RESULTS The findings showed that 54% of the OPs were responsible for chemotherapy reconstitution, and only 60% of the oncology centers had a biosafety cabinet. 91% of OPs were practicing; however, only 54% were trained in OP, and none of the OPs were board-certified. Most of the OPs spent time weekly on reconstitution, administrative duties, teaching, and training; only 3% spent on oncology clinical trials and conferences and 8% on noninterventional research. We identified four themes: (1) Some OPs are not reconstituting chemotherapy: A Call for MDT, (2) For OP, No Training is Enough, (3) Board Certification will give OPs Recognition, and (4) Introduction of OP Course in Universities. CONCLUSION To improve patient treatment outcomes, training on chemotherapy reconstitution should be prioritized, integration of OPs into MDTs, and the safe handling of chemotherapy in centers should be mandated in the region. The West African Postgraduate College of Pharmacists should be supported in expanding its curriculum and introducing OP fellowships.

Abstract In the US and globally, Black men experience the highest prostate cancer burden among all racial and ethnic groups, underscoring the urgent need for research to guide the development and implementation of culturally tailored strategies aimed at reducing disparities and improving outcomes. In response, the Inclusive Cancer Care Research Equity (iCCaRE) Consortium was created to advance health equity and reduce disparities in prostate cancer. Importantly, a Survivorship Care Plan (SCP) is recommended to educate and empower patients, enabling them to be better informed about their cancer diagnosis, treatment, and survivorship care recommendations. To date, there is no SCP targeted to Black prostate cancer survivors (CaPS) who have the greatest disparities with the poorest survivorship outcomes (ACS F&F; AACR HD Report; Fullwood, 2024). Therefore, we aimed to develop a SCP tailored for Black men. Addressing the unique needs of Black men require a genuine bidirectional relationship between scientist and the community rooted in community engaged research (CER). The SCP was first informed by the literature (Bonner, 2024) and the ASCO template (canceradvocacy.org). With input from the iCCaRE leadership and the Partnership Engagement Services (PES) Core, the Whole Person SCP better responds to the informational, clinical and quality of life needs of Black Prostate Cancer survivors. Based on CER, we included 22 diverse, Black CaPs to further guide and tailor the iCCaRE. Our findings indicate that the iCCaRE Survivorship Care Plan (SCP) enhanced the ASCO template by incorporating and expanding several unique domains, including family history, care team contacts, follow-up and surveillance, symptoms, quality of life, survivor concerns, major comorbidities, health advisories, and culturally relevant resources, creating a comprehensive, whole-person SCP tailored specifically for Black men. It is crucial to continue to improve support for clinical research and advocate for Black men and their communities to reduce prostate cancer burden. Prostate cancer also needs to include incidence, mortality, and disparities for Black men to raise awareness of scarcely studied field of Black men and prostate cancer survivorship. Citation Format: Kimlin Tam Ashing, Timethia Bonner, Ewan K. Cobran, Folakemi Odedina, Aj Merriweather, Ernie Kaninjing, Floyd Willis, Cassandra Moore, Joanne Oliver, Fornati Bedell, John McCall. Advancing health equity and reducing disparities in prostate cancer in Black men: iCCaRE [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 994.

Abstract Background: Epidemiology studies have linked frequent consumption of well-done cooked red meat with aggressive prostate cancer (CaP) risk, whereas rare intake or consuming medium-cooked meat is not. Providing public information about the impact of well-done cooking and its potential role in CaP risk may foster the adoption of evidence-based lifestyle modification of meat consumption to lower CaP risk. This pilot study aimed to provide preliminary data on the occurrence of CaP and the pattern of consumption of cooked red beef among ethnically diverse males in the US. Methods: The proposed project is an exploratory study focused on the assessment of the consumption of various beef dishes among ethnically diverse males in the United States. The study included 408 ethnically diverse males from Florida, Georgia, and Texas. Participants were recruited primarily from partnering restaurants, pharmacies, barbershops and collaborating community businesses using QR codes on the study flyer. Participants completed the self-administered survey that captured demographics, as well as information on beef consumption patterns, including cooking methods, frequency and degree of cooking, and the occurrence of CaP. The data were analyzed using descriptive statistics (frequency and percentages) to summarize demographics and variables on beef dishes. Chi-square was employed to determine the relationship between beef consumption patterns, demographic variables, and CaP occurrence. Results: The study showed that about half (49.8%) of the participants were between ages 44-63 years and 34.2% were 30-43 years old. The participants were quite diverse, as 51.7%, 16.3%, 13.1%, 11.%, and 2.7% were African American, African immigrants, White, Caribbean immigrants, and Hispanics, respectively. Rural dwellers comprised 34.2%, 26.8% were suburban, and 35.7% lived in urban areas. Educational status showed that 22.7%, 27.8%, and 22.7% were completed high school, college graduates, and associate degrees. The beef consumption pattern shows that 23.6%, 33.3%, 40.1%, and 30.3% regularly had boiled, fried, grilled, and barbequed beef, respectively, but 63, 2% reported never eating boiled beef. Doneness preferences differed among participants; 26%, 43.9%, 49.3, and 45.1% preferred well-done, while 1.7%, 1.5%, 2..9%, and 2.7% preferred rare, and 9%, 14.5%, 17.4%, and 15.7% preferred medium boiled, fried, grilled, and barbeques beef, respectively. Only 4.4% of the participants reported being diagnosed with CaP in the past. The pattern of beef consumption, such as the degree of doneness, was found for boiled (p=0.045), fried (p<0.001), grilled (p<0.001), and barbequed (p<0.001) beef, as well as frequency of consumption of (p<0.001), fried (p<0.001), grilled (p=0.001), and barbequed (p<0.001) to be associated with CaP. Conclusion: Beef consumption pattern was found to be associated with the risk of CaP among participants. Citation Format: Opeyemi Oreoluwa Bolajoko, Daniel W. Lee, Catherine Adebukola Oladoyinbo, Ernie Kaninjing, Samuel O. Antwi, Dee M. Glaser-Boivin, Robert J. Turesky, Folakemi T. Odedina. Pattern of beef consumption and prostate cancer risk among males in the United States [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 7112.

The rise in prevalence of cardiometabolic multimorbidity indicates the need for more research examining associated risk factors. Identifying multilevel risk factors is especially critical for U.S. health disparity populations who have been shown to experience a disproportionate burden of chronic disease-related morbidity and mortality. This study examines differences in the prevalence of and risk factors associated with cardiometabolic multimorbidity status among health disparity populations in a representative sample of U.S. adults. Additionally, we investigate the role of perceived discrimination as a mediator of the relationship between rural identity and cardiometabolic multimorbidity status. We report the overall and stratified prevalence of cardiometabolic multimorbidity. Findings from multivariate logistic regression indicated that age, rural identity, healthcare access, and perceived discrimination were associated with higher odds of cardiometabolic multimorbidity. Perceived discrimination was found to be a significant mediator for the relationship between rural identity and cardiometabolic multimorbidity status. These findings have implications for the design and implementation of effective multilevel interventions to reduce the impact of perceived discrimination on cardiometabolic multimorbidity among rural adults.

ABSTRACTObjectiveThis scoping review explores the multifaceted experience of cancer survivorship in Sub‐Saharan Africa (SSA), with a focus on the post‐treatment phase. The primary objective is to examine the psychosocial, cultural, and economic factors that influence post‐treatment survivorship care and outcomes.MethodsA comprehensive literature review was conducted using databases such as Web of Science Core Collection to identify studies published between 2000 and 2023. Eligible studies focused on post‐treatment cancer survivorship in SSA. Data were extracted, analyzed, and synthesized to identify key themes and research gaps.ResultsThe review identified substantial psychological distress among survivors, including depression, anxiety, and insomnia, often exacerbated by financial toxicity and limited access to psychosocial support services. Cultural factors, such as spiritual beliefs, reliance on traditional healers, and cancer‐related stigma, influenced healthcare‐seeking behaviors and overall well‐being. Despite these challenges, social support networks, religiosity, and targeted psychosocial interventions improved emotional resilience and quality of life. However, major gaps remain, including insufficient integration of cultural beliefs into survivorship care, inadequate long‐term follow‐up (LTFU) programs, limited oncofertility support, and a lack of regionally diverse and longitudinal data.ConclusionsCancer survivorship in SSA is shaped by intricate psychosocial, cultural, and economic dynamics that extend beyond clinical care. Addressing these challenges requires culturally sensitive, evidence‐based interventions, including financial counseling, spiritual care integration, and the establishment of structured LTFU programs. Additionally, expanding access to oncofertility support and integrating culturally relevant psychosocial services can further enhance survivorship outcomes. Strengthening collaboration between policymakers, healthcare providers, and researchers—through interdisciplinary task forces, psycho‐oncology workforce development, and community‐driven initiatives—is essential for improving post‐treatment outcomes and advancing cancer survivorship care in SSA.