Adana A.M. Llanos, PhD, MPH, cancer and molecular epidemiologist, associate professor of epidemiology, Mailman School of Public Health, Columbia University, member, Cancer Population Science (CPS) Program, Herbert Irving Comprehensive Cancer Center, member, NIEHS Center for Environmental Health, adjunct associate professor, Rutgers School of Public Health, discusses the relationship between prediagnostic allostatic load and breast cancer clinicopathology in Black women.

Providing background for the study Llanos presented at the 2023 AACR Annual Meeting, she discussed research from a 2020 study led by the Women’s Circle of Health, evaluating the connection between prediagnositic allostatic load and poorly differentiated outcomes in Black women. Research showed that higher allostatic load scores were cross-sectionally associated with breast cancers in Black woman, whereas there was no relationship between allostatic load scores and pooroutcomes in White women, Llanos begins.

Moreover, given that this was a cross-sectional association, investigators were curious to further understand whether it is possible to utilize the use allostatic load as a biomarker of risk and poor prognosis, Llanos emphasizes. It is known that allostatic load is strongly related to social determinants of health, such as socioeconomic status, race, ethnicity, and structural determinants of health, such as racism, Llanos expands. Given these relations to allostatic load, understanding the contribution of the stressors from a person’s daily life and further understanding social determinants of health and social interactions could be beneficial, Llanos adds. Moreover, it could be beneficial to examine how the accumulation of these stressors may affect the overall risk of breast cancer, which will ultimately influence disease outcomes, this would be of benefit to patients, Llanos notes.

Overall, this research shows evidence that elevated allostatic load before diagnosis can be used as an indicator of unfavorable breast cancer clinicopathology and may be beneficial to use as a n important prognostic marker, Llanos concludes.

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Adana A.M. Llanos, PhD, MPH, discusses the relationship between prediagnostic allostatic load and breast cancer clinicopathology in Black women.


Dr Llanos on Prediagnositic Allostatic Load and Breast Cancer Clinicopathology in Black Women

Adana A.M. Llanos, PhD, MPH, cancer and molecular epidemiologist, Mailman School of Public Health, Columbia University, adjunct associate professor, Rutgers School of Public Health, discusses the role of social and biological determinants on cancer risk.

An individual’s lived experiences should be one of the factors considered when determining who may be at an elevated risk for a cancer diagnosis, Llanos says. Combining an individual’s social determinants of health with biological and molecular factors can create a clearer picture when assessing cancer risk, Llanos explains.

Utilizing all available information to understand which individuals may be at a greater risk for cancer can allow clinicians to better address the needs of those individuals, Llanos continues. Better understanding the role of social mechanisms in cancer risk can also help address disparities on a larger scale, Llanos concludes.

Adana A.M. Llanos, PhD, MPH, discusses the role of social and biological determinants on cancer risk.


Dr. Llanos on the Role of Social and Biological Determinants on Cancer Risk

Adana A.M. Llanos, PhD, MPH, cancer and molecular epidemiologist, Mailman School of Public Health, Columbia University, adjunct associate professor, Rutgers School of Public Health, discusses disparities in genetic research in cancer care.

When considering emerging data and ongoing studies evaluating the genetics of patients with cancer, such as triple-negative breast cancer (TNBC), limitations still exist regarding this research, Llanos says. Racial and ethnic minority groups, specifically those of African ancestry, have been underrepresented in prior research into the genetics of cancer, Llanos explains.

Broad representation in new and future studies will be critical, Llanos adds. Expanding research to provide a more inclusive look at genetic and etiological differences in patients will provide a clearer picture as to how they can affect treatment, Llanos concludes.

Adana A.M. Llanos, PhD, MPH, discusses disparities in genetic research in cancer care.


Dr. Llanos on Genetic Disparities in Cancer Care

Adana A.M. Llanos, PhD, MPH, cancer and molecular epidemiologist, Mailman School of Public Health, Columbia University, adjunct associate professor, Rutgers School of Public Health member, American Association for Cancer Research, member, American Public Health Association, member, American Society of Preventive Oncology, member, American Society of Clinical Oncology, member, African-Caribbean Cancer Consortium, discusses how to recognize social determinants of disparities in cancer care.

Although the biology and genetics do play a role with disparities in cancer care, it is important to recognize that social and structural determinants also factor into cancer screening, detections, treatment, and outcomes across different types of cancer, Llanos explains.

Focusing on the various time points throughout this continuum will help achieve more health equity and more equitable outcomes for a greater proportion of patients, Llanos adds. Addressing these disparities needs to be a major goal of long-term research in cancer, Llanos concludes.

Adana A.M. Llanos, PhD, MPH, discusses how to recognize social determinants of disparities in cancer care.


Adana A.M. Llanos, PhD, MPH

Articles

Dr Llanos on Prediagnositic Allostatic Load and Breast Cancer Clinicopathology in Black Women

Dr. Llanos on the Role of Social and Biological Determinants on Cancer Risk

Dr. Llanos on Genetic Disparities in Cancer Care

Dr. Llanos on Recognizing Social Determinants of Disparities in Cancer Care