Grant Number:	5U01CA290831-03 Interpret this number
Primary Investigator:	Gomez, Scarlett
Organization:	University Of California, San Francisco
Project Title:	A National Asian American Cohort for Assessing Multi-Level Determinants in Cancer Etiology: the Aspire Cohort
Fiscal Year:	2026

Abstract Large-scale prospective epidemiologic cohorts have been instrumental for discoveries of novel cancer risk factors. Moreover, traditional studies of populations with unique and dynamic exposure profiles have provided significant insights into cancer etiology. As we increasingly appreciate the multi-factorial contributions to cancer risk, we propose a paradigm shift in studies of cancer risk to include the examination of multilevel drivers of health, and the development of a methodologic approach to study the interactive effects of these drivers. Focusing on the Asian American population, a heterogeneous group with varying and rapidly changing exposure profiles, will provide invaluable insights on cancer risk factors and their pathways to cancer incidence. This will generate knowledge benefitting the health for all U.S. populations. We propose to establish the national ASPIRE– ASian American ProspectIve REsearch cohort, beginning with 20,000 adults ages 40-75 via focused community-engaged recruitment in six regions that comprise more than a third of the Asian American population (California (Bay Area, Los Angeles, Orange County, Sacramento), New York Metro/North Jersey, and Greater Philadelphia Metro/South Jersey), in addition to national outreach to other U.S. regions. This population-based cohort will include: 1) multiple Asian American communities; 2) collection of data on health behavior exposures across the life course; 3) detailed information on area-level factors; 4) a precision adaptive design to develop best practices for community-engaged research; and 5) methodologic research on analytic approaches to assess small populations and multilevel interactions. This cohort is supported by a national network of researchers and community partners with expertise in Asian American health and well-being. We will use transparent and bi-directional processes among scientific and community collaborators to inform research priorities, data collection and sharing, and dissemination of timely and actionable study results. The ASPIRE Cohort will thus be suitable to identify novel multilevel contributors to cancer risk. This first phase will address multilevel drivers of health and their impacts on multiple pathways to cancer initiation that considers: 1) healthcare access and cancer screening, 2) cancer-relevant health behaviors, and 3) stress exposures. The ultimate vision of ASPIRE is to serve as a rich, contemporary epidemiologic resource to advance our understanding of cancer etiology that will benefit all populations.