||5R01CA261752-02 Interpret this number
||University Of Michigan At Ann Arbor
||Social Genomic Mechanisms of Health Disparities Among Adolescent and Young Adult (AYA) Cancer Survivors
Social genomic mechanisms of health disparities among Adolescent and Young Adult (AYA) cancer
Survivors of cancer diagnosed in adolescence or young adulthood have an elevated risk of multiple health
problems. They also experience specific and unique psychosocial stressors and life disruptions having
ramifications for their health, mental health, and quality of life (QOL). These outcomes, and disparities in these
outcomes (by race/ethnicity, sex and gender, geographic location), may be partially a function of social
determinants of health, including socioeconomic gradients, exposures to early childhood traumas or adversity,
and accumulated experiences of discrimination. Yet, little is known about these effects including the biological
pathways through which the known effects of social-environmental risk factors on population health and well-
being influence outcomes in post-treatment AYA cancer survivors, particularly with regard to morbidity, mortality,
and QOL. Therefore, the research proposed here is intended to identify and define functional genomic pathways
through which current and past psychosocial and social environmental risk and resilience factors influence gene
regulation in AYAs, and thus contribute to a greater understanding of health disparities in post-treatment
survivorship. We propose a 5-year longitudinal prospective cohort study of 2000 AYA cancer survivors recruited
within one year following completion of treatment for Hodgkin or non-Hodgkin lymphomas. Using repeated
measures of risk and resilience factors and blood assays, we will evaluate the extent to which biological,
psychological and social indicators are associated with, and potentially predict, mortality and morbidity in AYA
cancer survivors within two years following completion of therapy. In collaboration with the Eastern Cooperative
Oncology Group-American College of Radiology Imaging Network (ECOG-ACRIN) research infrastructure and
the National Cancer Institute Community Oncology Research Program (NCORP), this study will 1) identify the
genome-wide transcriptional impact of social-environmental RISK factors (i.e., adverse living conditions/poverty,
childhood trauma exposure, social isolation, and discrimination) and define the relationships of those genomic
profiles to AYA survivor mortality, morbidity, and QOL; 2) identify the genome-wide transcriptional impact of
individual RESILIENCE factors (i.e., social support, sense of purpose/meaning-making, self-efficacy) and define
the relationships of those genomic profiles to AYA mortality, morbidity, and QOL; and, 3) identify the genome-
wide molecular correlates of vulnerable populations, as structured by race/ethnicity, sexual/gender identity, and
geography (e.g., rural vs. urban), and define the relationships of those genomic profiles to AYA survivor mortality,
morbidity, and QOL. The study results may inform the conceptualization and development of new biological /
molecular targets for future interventions to reduce risks for long-term and late effects of treatment and maximize
likelihood of long-term health and QOL for AYA cancer survivors.
A Developmental Science Approach to Informing Age Subgroups in Adolescent and Young Adult Cancer Research.
, Fladeboe K.M.
, Ip E.
, Zebrack B.
, Snyder M.A.
, Salsman J.M.
The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 2023 Sep; 73(3), p. 543-552.
Social Genomics as a Framework for Understanding Health Disparities Among Adolescent and Young Adult Cancer Survivors: A Commentary.
, Cole S.
, Salsman J.M.
, Wagner L.
, Duan F.
, Gareen I.
, Lux L.
, Parsons S.K.
, Cheung C.
, Loeb D.M.
, et al.
JCO precision oncology, 2022 Jun; 6, p. e2100462.