Hawaii Minority Health and Cancer Disparities SPORE

Project Summary/Abstract At the root of health disparities is the diversity that exists in the biological, behavioral, sociocultural, and environmental characteristics of individuals and populations. Hawai`i offers exceptional opportunities for minority health research due to its uniquely diverse population with varying cancer burdens and its high-quality health

care and cancer registration. The University of Hawai`i Cancer Center has a successful track record of leveraging Hawai`i's multiethnic population to study racial/ethnic differences in cancer risk and outcomes. It has built a community-facing infrastructure to translate these findings into major biological discoveries and clinical

innovations that would help to alleviate cancer disparities in the US. We propose in this P50 (PAR-20-305) to establish a SPORE program to conduct translational research focusing on Asians Americans, Native Hawaiians and Pacific Islanders (AANHPI), the fastest growing US minority, to initially address three cancers of particularly

high relevance. Project 1 will address the high rates of hepatocellular carcinoma (HCC) in this population by implementing a randomized lifestyle intervention among AANHPI patients with non-alcoholic fatty liver (NAFLD) and by investigating mechanistic biomarkers (cell-free and leukocyte DNA methylation) that may also provide

much needed clinical management tools. We will test the efficacy of intermittent vs. continuous energy restriction to reverse the progression of NAFLD in AANHPI, the most common etiology of chronic liver disease and liver cancer in this population. Project 2 will address the excess lung cancer burden experienced by Native Hawaiians

by developing a risk-based and culturally-informed lung cancer screening strategy, and investigate the mutation, methylation and transcriptomic profiles of lung squamous cell and small cell carcinomas and adenocarcinomas that contribute to the unexplained poor survival in this vulnerable population. Project 3 will address the very high

breast cancer burden of Native Hawaiians and the rising rates in Asian Americans by testing the adequacy of current radiomic risk prediction algorithms for predicting breast cancer in these populations and by investigating related molecular and histopathologic features of breast tumor environment which may be related to visceral

adiposity and have prognostic significance. We will also establish: 1) an Administrative Core with strategic planning, advisory and evaluation components; 2) an Outreach and Recruitment Core (ORC) facilitating studies among minorities; 3) a centralized biorepository of paired fresh-frozen tumor and blood samples, as well

as archival tumor blocks (Pathology & Biospecimen Core); 4) a Biostatistics & Bioinformatics Core; 5) a Developmental Research Program to fund innovative pilot studies and a Career Enhancement Program to support promising investigators new to translational research; and 6) new collaborations, with other institutions

for the further translation of our findings. The successful completion of this grant will significantly advance our ability to reduce the high burden of liver, lung and breast cancers in AANHPI and to conduct other innovative translational minority health research that will benefit Hawai`i, the Pacific region and the rest of the US.