Mechanisms of Lung Cancer Disparities in U.S.-Role of Risk & Protective Factors

Council Date: February 27, 2018

Objectives

This initiative will support research to understand the etiologic factors and the underlying mechanisms for lung cancer disparities among health disparity (HD) populations in the U.S.

Description of Initiative:

This joint initiative with NCI will support multidisciplinary research to understand the underlying causal factors and the mechanisms that result in lung cancer disparities in the U.S. health disparity populations. The NIH-designated health disparity populations include Blacks/African Americans (AA), Hispanics/Latinos, American Indians/Alaska Natives (AI/AN), Asians, Native Hawaiians and other Pacific Islanders, low socioeconomic status (SES) populations, sexual and gender minorities and underserved rural populations in the United States. Lung cancer has been shown to disproportionately affect various HD populations, with higher rates and worse survival. Although smoking is the known major cause of lung cancer, it does not explain all the disparities observed in HD populations. This initiative will support research to examine the interaction of underlying multiple factors, social, environmental, behavioral or molecular factors and the pathways through which they operate for lung cancer disparities.

Areas of interest include but are not limited to the following:

  • Influence of social and biological risk factors in HD populations that may cause worse outcomes with lower smoking rates. Genetic and gene-environment interactions that contribute to lung cancer in AA or AI/AN, or rural SES, or Sexual Gender Minority populations.
  • Differences in lung tumor biology and biological subtypes that may cause more aggressive lung cancers among high-risk HD populations.
  • Associations between Genetic Ancestries and Nicotine Metabolism Biomarkers among HD populations.
  • Protective factors that prevent Latino/Asian populations from poor health outcomes in lung cancer.
  • Causes and risk factors for lung cancer among never smokers in various HD-populations.
  • Interactions of contextual multiple factors (smoking, genes, built environment, social stressors such as discrimination, structural racism, health care system) among various racial and ethnic populations that contributes to lung cancer disparities.
  • Causes for screening and treatment disparities for lung cancer among low SES and other racial/ethnic populations, such as patient level, provider level and system level factors.
  • Role of healthcare access and quality in explaining disparities in lung cancer among HD populations.