Grant Details
Grant Number: |
5U01CA164974-14 Interpret this number |
Primary Investigator: |
Palmer, Julie |
Organization: |
Boston University Medical Campus |
Project Title: |
A Follow-Up Study for Causes of Cancer in Black Women |
Fiscal Year: |
2024 |
Abstract
Pervasive health disparities affecting U.S. Black women are now widely recognized, but large gaps in
knowledge remain. We began the Black Women’s Health Study (BWHS) in 1995 to identify reasons for
disparities, including cancer health disparities; at that time Black women represented a very small proportion of
participants in observational cohort studies. We enrolled 59,000 participants over an 8-month period in 1995
via a lengthy mail questionnaire. Subsequently, participants were asked to complete follow-up questionnaires,
usually four pages in length, every two years, either on paper or online. In the most recent questionnaire cycle,
responses were split equally between the two methods. Over 51,000 participants are still alive and response
rates continue to be good. Among approximately 48,000 who were sent a 2019/20 questionnaire, 71%
completed it and 79% responded to either that questionnaire or the prior one. Saliva samples as a source of
germline and microbial DNA have been obtained and stored for 27,800 participants and blood samples for
13,030 participants. Breast tumor samples have been obtained for over 1,000 breast cancer cases; tumor
tissue collection was begun in the most recent funding period for four other cancers. BWHS research covers
the spectrum from individual behaviors, medication use, and other characteristics, to psychosocial factors,
genetic factors, and neighborhood-level factors. Peer-reviewed publications have addressed a range of health
conditions: cancers that include breast, lung, ovarian, colorectal, endometrial, pancreatic, liver, and multiple
myeloma; type 2 diabetes; obesity; lupus; sarcoidosis; preterm birth; infertility; uterine leiomyoma; cognitive
decline; sleep disorders; hypertension; COVID-19 infection; and mortality. More than half of current participants
are under age 64, affording the potential for additional research on cancer etiology, including with collection of
new or repeated exposures and covariates. During the next funding period, we expect to produce impactful
findings with regard to risk of multiple myeloma and colorectal, lung, and pancreatic cancer; breast and
colorectal cancer survivorship; cognitive decline and Alzheimer’s disease; end-stage renal disease; and other
conditions, such as COVID-19, that disproportionately affect Black women. (According to the National Death
Index (NDI), over 100 BWHS participants died from COVID-19 infection in 2020.) To reduce costs, we will
reduce the frequency of questionnaires while still linking to NDI, Medicare, and cancer registries to identify and
confirm new cancers, other illnesses, and deaths. We will continue to share BWHS data and samples with
outside investigators, and underrepresented minority investigators in particular, and will modernize our website
and data sharing systems to increase accessibility. Continued follow-up of this landmark study is critical to
inform opportunities for risk reduction in a vulnerable population and to close the gap in racial disparities in
cancer and other illnesses.
Publications