Skip to main content
An official website of the United States government
Grant Details

Grant Number: 4UH3CA260317-03 Interpret this number
Primary Investigator: Penedo, Frank
Organization: University Of Miami Coral Gables
Project Title: Avanzando Caminos (Leading Pathways): the Hispanic/Latino Cancer Survivorship Cohort Study.”
Fiscal Year: 2024


Abstract

Project Summary Cancer is the leading cause of death among Hispanics/Latinos (H/Ls) in the US. H/Ls account for 57.5 million Americans (18%), now the largest minority expected to double over the next four decades. H/Ls have variable SES, nativity, geographic distribution, genetic admixture, and social, psychosocial and behavioral determinants of health. Significant disparities exist in prevalence, invasiveness and mortality in specific cancers (e.g., cervix, liver, stomach) and across multiple patient reported outcomes (PROs) regardless of disease site. H/Ls are more likely to present with advanced disease, greater comorbidities and report greater symptom burden and poorer health-related quality of life (HRQoL). Survivorship in H/Ls is further compromised by low SES, education and insurance coverage, language barriers and limited access to care. Survivorship studies in H/Ls have been limited due to: (a) small samples with short follow-ups; (b) focus on common cancer (e.g., breast or prostate), limiting attention to high-prevalence/mortality sites; restricted H/L origin and SES representation; and (d) lack of guiding models considering multiple determinants (e.g., sociocultural, medical, stress, psychosocial, lifestyle, biological) of survivors’ outcomes. Avanzando Caminos (Leading Pathways): the Hispanic/Latino Cancer Survivorship Cohort Study will involve recruitment, assessment and follow-up of ~3,000 H/Ls who completed primary cancer treatment within the past 2 years and are diverse in H/L background, urban vs. rural residence and cancer site across two major US metropolitan areas—Miami and San Antonio. Both areas have majority H/L populations (~65% of Miami; ~64% of San Antonio), are diverse regarding H/L origin and SES and are served by NCI-designated cancer centers. We will recruit a sample that approximates the diversity of the H/L population in the US (~ 50% Mexican & ~50% other H/L origin). The Florida Cancer Data System and the Texas Cancer Registry will supplement recruitment (~30% of cohort) and serve to establish representativeness. Our primary outcomes are symptom burden (e.g., pain, fatigue, depression, cognition), HRQoL and disease activity (e.g., progression, recurrence, cancer & all-cause mortality). Our transdisciplinary team has a strong and successful record of academic productivity and collaboration across the five targeted domains that will be evaluated as determinants of our outcomes: (1) sociocultural (e.g., SES, acculturation, cultural values); (2) stress and adversity (e.g., chronic and traumatic stress, ethnic-stress); (3) psychosocial (e.g., social support, coping, family cohesion/conflict); (4) lifestyle and behavioral (e.g., physical activity, nutrition, health information seeking); and (5) biological (e.g., inflammatory/pro-metastatic gene expression signaling, cardiometabolic markers, genetic admixture). Participants will be assessed at baseline, 6-months, 12-months and annually thereafter. Methods in multilevel latent longitudinal modeling, cancer genomics and computational biology will be used to test our hypotheses. During the UG3 phase, we will hire and train staff, establish and finalize study protocols, recruit ~18% of the sample and conduct preliminary analyses. During the UH3 phase we will complete recruitment, conduct all remaining assessments, analyze data and disseminate findings to guide and implement secondary and tertiary prevention in H/L survivors.



Publications

Expanded Indications for Neoadjuvant Endocrine Therapy in Early-Stage Breast Cancer During the COVID-19 Pandemic.
Authors: Khorfan R. , Vora H.P. , Namm J.P. , Solomon N.L. , Lum S.S. .
Source: Annals Of Surgical Oncology, 2024-08-12 00:00:00.0; , .
EPub date: 2024-08-12 00:00:00.0.
PMID: 39133445
Related Citations

Associations Between Perceived Discrimination, Screening Mammography, and Breast Cancer Stage at Diagnosis: A Prospective Cohort Analysis.
Authors: Hernandez A.E. , Borowsky P.A. , Lubarsky M. , Caroll C. , Choi S. , Kesmodel S. , Antoni M. , Goel N. .
Source: Annals Of Surgical Oncology, 2024-07-26 00:00:00.0; , .
EPub date: 2024-07-26 00:00:00.0.
PMID: 39060693
Related Citations

Avanzando Caminos (Leading Pathways): design and procedures of the Hispanic/Latino Cancer Survivorship Study.
Authors: Penedo F.J. , Moreno P.I. , Pons M. , Pinheiro P.S. , Antoni M.H. , Lopes G. , Calfa C. , Chalela P. , Garcini L. , Wang C.P. , et al. .
Source: American Journal Of Epidemiology, 2024-07-08 00:00:00.0; 193(7), p. 940-950.
PMID: 38576195
Related Citations

Effects of neighborhood disadvantage on cortisol and interviewer-rated anxiety symptoms in breast cancer patients initiating treatment.
Authors: Goel N. , Hernandez A.E. , Ream M. , Clarke E.S. , Blomberg B.B. , Cole S. , Antoni M.H. .
Source: Breast Cancer Research And Treatment, 2023-08-10 00:00:00.0; , .
EPub date: 2023-08-10 00:00:00.0.
PMID: 37561280
Related Citations

Stress Management Interventions to Facilitate Psychological and Physiological Adaptation and Optimal Health Outcomes in Cancer Patients and Survivors.
Authors: Antoni M.H. , Moreno P.I. , Penedo F.J. .
Source: Annual Review Of Psychology, 2023-01-18 00:00:00.0; 74, p. 423-455.
EPub date: 2022-08-12 00:00:00.0.
PMID: 35961041
Related Citations

Spiritual well-being, distress and quality of life in Hispanic women diagnosed with cancer undergoing treatment with chemotherapy.
Authors: Barata A. , Hoogland A.I. , Small B.J. , Acevedo K.I. , Antoni M.H. , Gonzalez B.D. , Jacobsen P.B. , Lechner S.C. , Tyson D.M. , Meade C.D. , et al. .
Source: Psycho-oncology, 2022-09-19 00:00:00.0; , .
EPub date: 2022-09-19 00:00:00.0.
PMID: 36121699
Related Citations

Cancer Epidemiology in Hispanic Populations: What Have We Learned and Where Do We Need to Make Progress?
Authors: Fejerman L. , Ramirez A.G. , Nápoles A.M. , Gomez S.L. , Stern M.C. .
Source: Cancer Epidemiology, Biomarkers & Prevention : A Publication Of The American Association For Cancer Research, Cosponsored By The American Society Of Preventive Oncology, 2022-05-04 00:00:00.0; 31(5), p. 932-941.
PMID: 35247883
Related Citations

Biobehavioral Pathways and Cancer Progression: Insights for Improving Well-Being and Cancer Outcomes.
Authors: Chang A. , Sloan E.K. , Antoni M.H. , Knight J.M. , Telles R. , Lutgendorf S.K. .
Source: Integrative Cancer Therapies, 2022 Jan-Dec; 21, p. 15347354221096081.
PMID: 35579197
Related Citations




Back to Top