Publications from the current and previous year are listed below; articles are listed chronologically within each year from the most to the least recent.
Most research articles have a brief description below and a link to the published abstract (a detailed summary) through the U.S. National Library of Medicine.
For prior years, click on the following links:
(articles listed from most to least recent)
Last Updated: September 28, 2022
Harris H, Guertin K, Camacho F, Johnson C, Wu A, Moorman P, Myers E, Bethea TN, Bandera EV, Joslin C, Ochs-Balcom H, Peres L, Rosenow W, Setiawan V, Beeghly-Fadiel A, Dempsey L, Rosenberg L, Schildkraut J. Racial disparities in epithelial ovarian cancer survival: an examination of contributing factors in the Ovarian Cancer in Women of African Ancestry (OCWAA) consortium. Int J Cancer 2022;151(8):1228-39. doi: 10.1002/ijc.34141. PMCID: PMC9420829.
Black women have poorer survival from epithelial ovarian cancer than white women. In the Ovarian Cancer in Women of African Ancestry (OCWAA) consortium of seven U.S. studies, we found that college education, nulliparity, smoking status, body mass index, diabetes, postmenopausal female hormone use, histotype, and stage of ovarian cancer accounted for 48.8% of the disparity, with histotype/stage and postmenopausal female hormone use being most important. The findings suggest that several potentially modifiable factors play a role in the black/white survival disparity, though further research is needed to identify additional mediators and avenues of intervention. link to online article
Jordahl KM, …Palmer JR, et al. Beyond GWAS of colorectal cancer: evidence of interaction with alcohol consumption and putative causal variant for the 10q24.2 region. Cancer Epidemiol Biomarkers Prev 2022;31(5):1077-89. doi: 10.1158/1055-9965.EPI-21-1003.
Risk of colorectal cancer has known associations with common genetic variants, but these associations explain less than half of its heritability. Nondrinking and heavy consumption of alcohol are both associated with a higher risk of colorectal cancer. Using data from the Colon Cancer Family Registry, Colorectal Transdisciplinary Study, and Genetics and Epidemiology of Colorectal Cancer Consortium, we compared nondrinkers and heavy drinkers with light-to-moderate drinkers in Genotype by Environment (GxE) analyses to search for evidence of interaction between alcohol consumption and genetic variants. Our findings suggest that the previously observed association between colorectal cancer and one of the genetic variants is strongest in nondrinkers. Our study also identified a second variant as the putative causal regulatory variant for the region. link to online article
Zhou ES, Ritterband LM, Bethea TN, Robles YP, Heeren TC, Rosenberg L. Effect of culturally tailored, internet-delivered cognitive behavioral therapy for insomnia in Black women: a randomized clinical trial. JAMA Psychiatry 2022;79(6):538-49. doi: 10.1001/jamapsychiatry.2022.0653. PMCID: PMC9021979.
Black women are at high risk for insomnia disorder, but there has been limited research to investigate the efficacy of cognitive behavioral therapy for insomnia (CBT-I) in treating insomnia in this population. Participants in the BWHS who had been identified as experiencing elevated insomnia symptoms were recruited to participate in a randomized clinical trial to compare the efficacy of a standard version of an internet-delivered CBT-I program (SHUTi), a culturally tailored version (SHUTi-BWHS), and a patient education control program (PE) at improving insomnia symptoms. Findings show that both SHUTi and SHUTi-BWHS decreased insomnia severity and improved sleep outcomes more than PE, and that a higher proportion of SHUTi-BWHS than of SHUTi participants completed the full program, suggesting that the modified program was more effective at keeping participants engaged. Those who completed the program had the greatest improvements in their sleep. link to online article
Bigham Z, Robles Y, Freund KM, Palmer JR, Bertrand KA. Hypertensive diseases of pregnancy and risk of breast cancer in the Black Women’s Health Study. Breast Cancer Res Treat 2022;194(1):127-35. doi: 10.1007/s10549-022-06606-3. PMCID: PMC9190198.
Black women have a higher risk of developing hypertensive diseases of pregnancy (HDOP) such as preeclampsia and gestational hypertension, and a higher incidence of aggressive breast cancer subtypes. We followed 42,982 parous women in the Black Women’s Health Study to examine the relation of self-reported HDOP to breast cancer incidence overall and by estrogen receptor (ER) status. There was no association between a history of HDOP and breast cancer risk overall. A suggestive inverse association with ER- breast cancer may reflect an anti-tumorigenic hormone profile in HDOP, but this association requires confirmation in other studies. link to online article
Lowry KP, Geuzinge HA, Stout NK, Alagoz O, Hampton J, Kerlikowske K, de Koning HJ, Miglioretti DL, van Ravesteyn NT, Schechter C, Sprague BL, Tosteson ANA, Trentham-Dietz A, Weaver D, Yaffe MJ, Yeh JM, Couch FJ, Hu C, Kraft P, Polley EC, Mandelblatt JS, Kurian AW, Robson ME; Breast Working Group of the Cancer Intervention and Surveillance Modeling Network (CISNET), in collaboration with the Breast Cancer Surveillance Consortium (BCSC), and the Cancer Risk Estimates Related to Susceptibility (CARRIERS) Consortium. Breast cancer screening strategies for women with ATM, CHEK2, and PALB2 pathogenic variants: a comparative modeling analysis. JAMA Oncol 2022;8(4):587-96. doi: 10.1001/jamaoncol.2021.6204. PMCID: PMC8855312.
Screening mammography and magnetic resonance imaging (MRI) are recommended for women with ATM, CHEK2, and PALB2 pathogenic variants, but there is little data to guide screening regimens for these women. Using two established breast cancer microsimulation models from the Cancer Intervention and Surveillance Modeling Network (CISNET), benefits and harms of breast cancer screening strategies involving mammography and MRI at various start ages were compared. Results suggest that annual MRI screening starting at age 30 to 35 followed by annual MRI and mammography at age 40 may reduce breast cancer mortality by more than 50% for women with pathogenic variants. Results also suggest that if a patient is already receiving annual MRI screening, there may be little benefit to mammography prior to age 40. link to online article
Bethea TN, Cozier YC. The Black Women’s Health Study: working together to improve the health of Black women. In: Evans SY, Davis SK, Hinkson LR, and Wathington DJ, eds. Black Women and Public Health: Strategies to Name, Locate, and Change Systems of Power. 1st ed. Albany, NY: SUNY Press, 2022:101-24.
Black Women and Public Health discusses issues of race, gender, and health. Grounded in the lived experiences and expertise of Black women, this collection bridges gaps between researchers, practitioners, educators, and advocates. The three dozen authors offer analysis, critique, and recommendations for overcoming longstanding and contemporary challenges to equity in public health practices. link to book
Wu Y, Palmer JR, Rosenberg L, Ruiz-Narváez EA. Admixture mapping of anthropometric traits in the Black Women’s Health Study: evidence of a shared African ancestry component with birth weight and type 2 diabetes. J Hum Genet 2022;67(6):331-8. doi: 10.1038/s10038-022-01010-7.
In the U.S., obesity, type 2 diabetes, and low birth weight are all more prevalent among Black women than White women, and the reasons why are not well understood. Using data from the Black Women’s Health Study, we conducted admixture mapping of body mass index (BMI) at age 18, adult BMI, and adult waist circumference, and waist-to-hip ratio adjusted for BMI. We searched for evidence of shared African genetic ancestry components among the four anthropometric traits and among birth weight and type 2 diabetes. Findings show that global percent African ancestry was associated with higher adult BMI, and shared ancestry analysis identified local African ancestry regions associated with multiple traits. Findings for one genomic region are consistent with the fetal insulin hypothesis, which suggests that low birth weight and type 2 diabetes have a common genetic basis. Further research is needed to identify the actual genetic variants responsible for the clustering of these conditions in African Americans. link to online article
Yiannakou I, Barber LE, Adams-Campbell L, Li S, Palmer JR, Rosenberg L, Petrick JL. A prospective analysis of red and processed meat intake in relation to colorectal cancer in the Black Women’s Health Study. J Nutr 2022;152(5):1254-62. doi: 10.1093/jn/nxab419. PMCID: PMC9071344.
Black Americans are at higher risk from colorectal cancer (CRC) than any other racial/ethnic group in the United States. Consumption of red and processed meats is associated with an increased risk of CRC in White populations, but three prior studies in Black populations reported no association. Using data from the Black Women’s Health Study, we assessed intakes of processed and unprocessed red meat, saturated fatty acids (SFAs) and monounsaturated fatty acids (MUFAs) in relation to CRC risk. Results show that unprocessed red meat intake was associated with a 2-fold increase in CRC risk. These findings are the first positive evidence that red meat plays a role in the etiology of CRC in Black women, and they also suggest opportunities for prevention. link to online article
Townsend MK, ... Palmer JR, … Rosenberg L, et al. Cohort Profile: The Ovarian Cancer Cohort Consortium (OC3). Int J Epidemiol 2022;51(3):e73-86. doi: 10.1093/ije/dyab211.
The Ovarian Cancer Cohort Consortium (OC3), an international collaboration that includes deidentified data from 21 cohort studies, enables research on risk factors, biomarkers, outcomes and risk prediction of ovarian cancer and its subtypes. With data on a wide variety of exposure and outcomes from 1.3 million women, the consortium is a powerful tool for advancing knowledge. The BWHS is included in this Consortium. link to online article
Petrick JL, Wilkinson JE, Michaud DS, Cai Q, Gerlovin H, Signorello LB, Wolpin BM, Ruiz-Narvaez EA, Long J, Yang Y, Johnson WE, Shu X, Huttenhower C, Palmer JR. The oral microbiome in relation to pancreatic cancer risk in African Americans. Br J Cancer 2022;126(2):287-96. doi: 10.1038/s41416-021-01578-5.
Black Americans have the highest incidence of pancreatic cancer of any racial/ethnic group in the US. The oral microbiome has been associated with increased risk of pancreatic cancer in a recent study. In a study that included BWHS participants in which we assessed the oral microbiome to risk of pancreatic cancer, there was no association between the microbiome and risk. link to online article
Gathirua-Mwangi WG, Palmer JR, Champion V, Castro-Webb N, Stokes AC, Adams-Campbell L, Marley AR, Forman MR, Rosenberg L, Bertrand KA. Maximum and time-dependent Body Mass Index and breast cancer incidence among postmenopausal women in the Black Women’s Health Study. Am J Epidemiol 2022;191(4):646-54. doi: 10.1093/aje/kwac004. PMCID: PMC9077111.
Excess weight is a known risk factor for postmenopausal breast cancer. We evaluated maximum body mass index (BMI, a weight-for-height measurement) and BMI at several timepoints prior to breast cancer diagnosis to evaluate whether the increased risk was related to excess weight (BMI ≥ 35) at a particular point in time. Maximum BMI and time-dependent BMI ≥ 35 were both strongly associated with postmenopausal ER+ breast cancer risk, suggesting that risk is increased regardless of timing. link to online article
Yusufov M, Recklitis C, Zhou E, Bethea TN, Rosenberg L. A population-based psychometric analysis of the Insomnia Severity Index in Black women with and without a history of cancer. J Sleep Res 2022;31(1):e13421. doi: 10.1111/jsr.13421.
The Insomnia Severity Index (ISI) is a commonly used tool to identify sleep disruption. However, its validity has not been tested in Black women and there has been little testing in cancer survivors. The ISI was included on the BWHS health questionnaire in 2015. Based on the data of 29,500 BWHS participants who completed the ISI, we found that internal consistency reliability was high in participants with and without a history of cancer. We found a one-factor model had the best fit to the data but the model was not robust. Assessment in other large studies is needed. link to online article
Potter AL, Yang CJ, Woolpert KM, Puttaraju T, Suzuki K, Palmer JR. Evaluating eligibility of US Black women under USPSTF lung cancer screening guidelines. JAMA Oncol 2021;8(1):163-4. doi: 10.1001/jamaoncol.2021.5790. PMCID: PMC8777560.
The 2021 US Preventive Services Task Force (USPSTF) lung cancer screening guidelines were changed to increase the number of smokers eligible for screening by lowering the age eligibility from 55 to 50 years and reducing the required pack-years of smoking from 30 to 20. While these changes should increase the proportion of Black individuals eligible for screening, many high-risk Black women may continue to be ineligible. Using data from the Black Women’s Health Study, we evaluated lung cancer screening eligibility among American Black women under the 2013 and 2021 USPSTF guidelines. Results show that the proportion of Black women diagnosed with lung cancer who would have been eligible for screening increased by 50% under 2021 USPSTF screening guidelines compared with 2013 guidelines, yet two-thirds of the patients with lung cancer still would have been ineligible for screening. Our findings suggest that removing the screening criteria that former smokers must have quit smoking within the past 15 years may benefit Black women. link to online article
Yadav S, …, Palmer JR, et al. Germline pathogenic variants in cancer predisposition genes among women with invasive lobular carcinoma of the breast. J Clin Oncol 2021;39(35):3918-26. doi: 10.1200/JCO.21.00640.
The contribution to invasive lobular carcinoma (ILC) of the breast of pathogenic variants (PVs) in the genes that are included in hereditary cancer testing panels were determined. PVs in some genes (ATM, BRCA2, CDH1, CHEK2, PALB2) were associated with increased risk of ILC; PVs in BRCA1 were not. It may be appropriate for those with ILC to have multigene panel testing, as it is for IDC (invasive ductal carcinoma). link to online article
Barber LE, Zirpoli GR, Cozier YC, Rosenberg L, Petrick JL, Bertrand KA, Palmer JR. Neighborhood disadvantage and individual-level life stressors in relation to breast cancer incidence in U.S. Black women. Breast Cancer Res 2021;23(1):108. doi: 10.1186/s13058-021-01483-y.
There has been little assessment of the relation of psychosocial stress to risk of breast cancer subtypes in Black women. In the BWHS, we derived scores for level of neighborhood disadvantage and of socioeconomic status, based on U.S. census data on education, employment, income, poverty, female-headed households, and race. We found that both neighborhood disadvantage and lower neighborhood socioeconomic status were associated with increased risk of estrogen receptor negative breast cancer. Future studies are needed to understand these associations, such as whether particular biologic responses to chronic stress are involved. link to online article
Barber LE, Bertrand KA, Petrick JL, Gerlovin H, White LF, Adams-Campbell LL, Rosenberg L, Roy HK, Palmer JR. Predicted vitamin D status and colorectal cancer incidence in the Black Women's Health Study. Cancer Epidemiol Biomarkers Prev 2021;30(12):2334-41. doi: 10.1158/1055-9965.EPI-21-0675.
Low vitamin D levels have been linked to increased risk of colorectal cancer in studies of White populations. Black Americans have lower levels of vitamin D and experience higher rates of colorectal cancer than other populations. Using a predicted vitamin D score developed and validated in the BWHS, we evaluated predicted vitamin D levels in relation to colorectal cancer risk among BWHS participants. Women with low predicted vitamin D scores had a higher risk of colorectal cancer than those with the higher scores, suggesting that low vitamin D levels may be a factor in the higher rates of colorectal cancer among Black Americans. link to online article
Palmer JR, Zirpoli G, Bertrand KA, Battaglia T, Bernstein L, Ambrosone CB, Bandera EV, Troester MA, Rosenberg L, Pfeiffer RM, Trinquart L. A validated risk prediction model for breast cancer in U.S. Black women. J Clin Oncol 2021;39(34):3866-77. doi: 10.1200/JCO.21.01236.
Identifying women at high risk for breast cancer enables appropriate screening for early detection, targeted intervention, and enrollment in preventive trials We developed a new breast cancer prediction tool for Black women, designed for use in primary care settings, that performs as well as breast cancer prediction tools developed for White women. The tool for Black women has better prediction among women under 40 years of age than among older Black women. Breast cancer prediction among young Black women is particularly useful because younger women with an increased risk of breast cancer are below the usual ages at which breast cancer screening typically begins. link to online article
Petrick JL, Barber LE, Warren Andersen S, Florio AA, Palmer JR, Rosenberg L. Racial disparities and sex differences in early- and late-onset colorectal cancer incidence, 2001-2018. Front Oncol 2021;11:734998. doi: 10.3389/fonc.2021.734998.
A worldwide increase in colorectal cancer (CRC) incidence at younger ages prompted a look at early and late onset disease in the US. There has been an increase in early-onset colorectal cancer in Whites, which has decreased the disparity in incidence of the disease between Blacks and Whites. There has also been an increase in colorectal neuroendocrine tumors in Blacks. The highest rates of CRC (early- and late- onset) are among Blacks and American Indians/Alaskan Natives. link to online article
Chen Z, Guo X, Long J, Ping J, Li B, Fadden MK, Ahearn TU, Stram DO, Shu XO, Jia G, Figueroa J, Ghana Breast Health Study Team, Palmer JR, Sanderson M, Haiman CA, Blot WJ, Garcia-Closas M, Cai Q, Zheng W. Discovery of structural deletions in breast cancer predisposition genes using whole genome sequencing data from > 2000 women of African-ancestry. Hum Genet 2021;140(10):1449-57. doi: 10.1007/s00439-021-02342-8.
This study identified structural deletions in several suspected breast cancer predisposition genes in samples from women of African ancestry. This is the first large-scale study to characterize the deletions, and if future studies confirm the findings it may inform future genetic testing for breast cancer. link to online article
Warner ET, Kent BV, Zhang Y, Argentieri MA, Rowatt WC, Pargament K, Koenig HG, Underwood L, Cole SA, Daviglus ML, Kanaya AM, Palmer JR, Huang T, Blais MA, Shields AE. The Study on Stress, Spirituality, and Health (SSSH): Psychometric Evaluation and Initial Validation of the SSSH Baseline Spirituality Survey. Religions (Basel) 2021;12(3):150. doi: 10.3390/rel12030150.
A baseline Spiritual Survey (SS-1) was developed and validated in a racially and ethnically diverse sample. The survey showed construct and predictive validity and was well correlated with other measures. The scales produced by the SS-1 were associated with attitudes about religion and spirituality and with some measures of mental health and physical health. link to online article
Bitsie KR, Cheng TD, McCann SE, Zirpoli G, Yao S, Bandera EV, Kolonel LN, Rosenberg L, Olshan AF, Palmer JR, Ambrosone CB. Dietary vitamin A and breast cancer risk in Black women: The African American Breast Cancer Epidemiology and Risk (AMBER) Consortium. J Nutr 2021;151(12):3725-37. doi: 10.1093/jn/nxab278.
Prior studies have shown an inverse association between dietary vitamin A intake and breast cancer risk among premenopausal women of European descent. In as study of Black women that included BWHS participants, we found similar results–higher dietary intake of vitamin A was associated with lower incidence of ER-positive breast cancer. link to online article
Bertrand KA, O'Brien KM, Wright LB, Palmer JR, Blot WJ, Eliassen AH, Rosenberg L, Sandin S, Tobias D, Weiderpass E, Zheng W, Swerdlow AJ, Schoemaker MJ, Nichols HB, Sandler DP. Gestational diabetes and risk of breast cancer before age 55. Int J Epidemiol 2021;50(6):1936-47. doi: 10.1093/ije/dyab165.
There are conflicting results about whether gestational diabetes mellitus (GDM, diabetes during pregnancy) is associated with the risk of breast cancer before age 55. In an assessment of GDM in relation to breast cancer risk in five studies, including the BWHS, we found that women with at least one birth who had a history of GDM had a risk of breast cancer similar to that of women with at least one birth who did not have a history of GDM. There is a well-established decrease in risk of ER-positive breast cancer among women with at least one birth, and in this study women with a history of GDM also showed a decreased risk of ER-positive breast cancer, suggesting that the protective effect of childbearing is not affected by GDM. link to online article
Cozier YC, Castro-Webb N, Hochberg NS, Rosenberg L, Albert MA, Palmer JR. Lower serum 25(OH)D levels associated with higher risk of COVID-19 infection in U.S. Black women. PLoS ONE 2021;16(7):e0255132. doi: 10.1371/journal.pone.0255132.
Limited evidence suggests that higher blood levels of vitamin D may be protective against COVID-19 infection. Black women often have insufficient vitamin D levels, and they are more likely to become infected with COVID-19 than white women. In a study conducted within the BWHS, lower blood vitamin D levels were associated with a higher risk of COVID-19 infection. Studies are needed to confirm this association in other populations and to determine the optimum level of vitamin D needed to prevent infection. link to online article
Sribenja S, Maguire O, Attwood K, Buas MF, Palmer JR, Ambrosone CB, Higgins MJ. Deletion of Foxa1 in the mouse mammary gland results in abnormal accumulation of luminal progenitor cells: a link between reproductive factors and ER-/TNBC breast cancer? Am J Cancer Res 2021;11(6):3263-70.
It has been shown that the risk of estrogen receptor-negative (ER-) breast cancer is higher among those who have given birth; breastfeeding mitigates the increased risk. Exploring the hypothesis that normal suppression of the FOXA1 gene during pregnancy results in cellular changes in the breast that increase risk of ER- tumors, deletion of the FOXA1 gene in mouse mammary glands resulted in cellular changes consistent with this hypothesis. These observations provide a possible mechanism for the observed association of pregnancy and ER- tumors. link to online article
Boddicker NJ, …, Palmer JR, …, Bertrand KA, et al. Risk of late-onset breast cancer in genetically predisposed women. J Clin Oncol 2021;39(31):3430-40. doi: 10.1200/JCO.21.00531.
In a study that included women with and without breast cancer from the BWHS and multiple other studies, the goal was to establish the frequency of pathogenic variants (PVs) and remaining risk of breast cancer for each gene linked to breast cancer risk in women 65 and over. Results suggested that all women who are diagnosed with triple-negative breast cancer or with ER-negative breast cancer should receive genetic testing. Those women who test positive for certain breast cancer genes and PVs who are also over age 65 should be considered for magnetic resonance image screening. link to online article
Lo CH, …, Cozier YC, Rosenberg L, … Palmer JR et al. Race, ethnicity, community-level socioeconomic factors, and risk of COVID-19 in the United States and the United Kingdom. EClinicalMedicine 2021;38:101029. doi: 10.1016/j.eclinm.2021.101029.
A study of over two million individuals in the U.S. and the United Kingdom has been in progress since March of 2020 to assess factors related to COVID-19 infection. Participants from many studies, including the BWHS, were invited to join the study and to provide information on factors that might be related to COVID-19 infection and on whether they had become infected. There was an increased risk of COVID-19 infection associated with living in communities identified as more deprived (according to the Neighborhood Deprivation Index and the Index of Multiple Deprivation). The higher risk of COVID-19 infection among racial and ethnic minorities demonstrates the critical role of social determinants of health, such as the circumstances in which people live. link to online article
Gao C, …, Palmer JR, et al. Risk of breast cancer among carriers of pathogenic variants in breast cancer predisposition genes varies by polygenic risk score. J Clin Oncol 2021;39(23):2564-73. doi: 10.1200/JCO.20.01992.
This study examined the association of pathogenic variants (PVs) in genes that are associated with an increased risk of breast cancer and polygenic risk scores (PRS) with breast cancer in the general population. Among those who carry PVs in breast cancer predisposition genes, PRS improved personalization of breast cancer risk. Adding PRS may help to prevent over-screening and may enable a breast cancer risk management plan that is more personalized. link to online article
Castro-Webb N, Cozier YC, Barbhaiya M, Ruiz-Narváez EA, Li S, Costenbader KH, Rossenberg L. Association of macronutrients and dietary patterns with risk of systemic lupus erythematosus in the Black Women’s Health Study. Am J Clin Nutr 2021;114(4):1486-94. doi: 10.1093/ajcn/nqab224.
We assessed dietary intake in relation to risk of systemic lupus erythematosus (SLE), a condition that disproportionately affects Black women. Most prior studies examining dietary intake in relation to SLE risk have been in White populations and have been null. Using self-reported diet information, this analysis suggests an increased risk of SLE among Black women whose diet is high in carbohydrates and low in fats. link to online article
Graff M, …, Palmer J, …et al. Discovery and fine-mapping of height loci via high-density imputation of GWASs in individuals of African ancestry. Am J Hum Genet 2021;108(4):564-82. doi: 10.1016/j.ajhg.2021.02.011.
Genetic loci (specific locations on genes) that are associated with height have been identified in populations of European ancestry, but few studies have been conducted among individuals of African ancestry. The present study examined populations with African ancestry based on data from over 50,000 African ancestry individuals as well as published data on European ancestry populations. Many new genetic loci linked to height were found in both the African ancestry and the European ancestry data. link to online article
Coogan PF, Rosenberg L, Palmer JR, Cozier YC, Lenzy YM, Bertrand KA. Hair product use and breast cancer incidence in the Black Women’s Health Study. Carcinogenesis 2021;42(7):924-30. doi: 10.1093/carcin/bgab041.
Black women commonly use hair relaxers and leave-in conditioners and oils. Some of these products contain estrogens or estrogen-disrupting compounds, which might contribute to breast cancer risk. We assessed the use of these products in relation to breast cancer in the BWHS. There was no association between conditioner use and breast cancer. For hair relaxers, there was a possible increased risk of breast cancer associated with frequent use of products containing lye, but there was no association of increased risk with non-lye products More research is needed to firmly establish the relationship between hair relaxers and breast cancer. link to online article
Davis CP, Bandera EV, Bethea TN, Camacho TF, Joslin CE, Wu AH, Beeghly-Fadiel A, Moorman PG, Myers E, Ochs-Balcom HM, Peres LC, Rosenow WT, Setiawan VW, Rosenberg L, Schildkraut JM, Harris HR. Genital powder use and risk of epithelial ovarian cancer in the Ovarian Cancer in Women of African Ancestry Consortium. Cancer Epidemiol Biomarkers Prev 2021;30(9):1660-8. doi: 10.1158/1055-9965.EPI-21-0162.
Studies of genital powder use and ovarian cancer risk have been conducted in predominantly White populations, although genital powder use has been more common among Black women. Using data from the Ovarian Cancer in Women of African Ancestry consortium, which includes the BWHS, we found genital powder use to be associated with increased risk of ovarian cancer among both Black and White women. link to online article
Wesselink AK, Rosenberg L, Wise LA, Jerrett M, Coogan PF. A prospective cohort study of ambient air pollution exposure and risk of uterine leiomyomata. Hum Reprod 2021;36(8):2321-30. doi: 10.1093/humrep/deab095.
Two epidemiologic studies have found positive associations between air pollution exposure and uterine leiomyomata (UL) risk, but neither included large numbers of Black women. UL, also known as uterine fibroids, are a type of benign uterine tumor that occurs more commonly among Black women. Using data from the BWHS, we assessed whether three types of air pollution– particulate matter <2.5 microns (PM2.5), nitrogen dioxide (NO2) and ozone (O3) — are associated with risk of UL. PM2.5 and NO2 were not appreciably associated with UL.O3 concentrations were associated with increased UL risk, with a stronger association among women <35 years and parous women. These findings require confirmation. link to online article
Domchek SM, Yao S, Chen F, Hu C, Hart SN, Goldgar D, Nathanson KL, Ambrosone C, Haiman C, Couch FJ, Polley EC, Palmer JR, and the CARRIERS Consortium. Comparison of the prevalence of pathogenic variants in cancer susceptibility genes in Black women and non-Hispanic White women with breast cancer in the United States. JAMA Oncol 2021;7(7):1045-50. doi: 10.1001/jamaoncol.2021.1492 PMCID: PMC8160931.
Germline pathogenic variants (PV) are inherited genetic mutations. This large study examined the differences in prevalence of 12 breast cancer susceptibility genes in Black women with breast cancer and non-Hispanic White women with breast cancer in the US. There were no differences between the two populations, suggesting that policy regarding genetic testing recommendations does not need to be changed at this time. Efforts should be made to promote equal access to and uptake of genetic testing. link to online article
Du Z, Gao G, …, Zirpoli G, …, Palmer JR, et al. Evaluating polygenic risk scores for breast cancer in women of African ancestry. J Natl Cancer Inst 2021;113(9):1168-76. doi: 10.1093/jnci/djab050.
Polygenic risk scores (PRS) summarize the estimated effect of many genetic variants on an individual’s predisposition for a given trait or medical condition. PRSs have been demonstrated to identify women of European, Asian, and Latino ancestry at elevated risk of developing breast cancer. In a multi-study analysis, the performance of existing PRSs predicted breasted cancer risk among women of African ancestry less well than among other racial/ethnic groups. More work is needed to improve breast cancer risk prediction among Black women. link to online article
Sarnowski C, Cousminer DL, Franceschini N, Raffield LM, Jia G, Demerath EW, Fernández-Rhodes L, Grant SFA, Hakonarson H, Lange LA, Long J, Sofer T, Tao R, Wallace RB, Wong Q, Zirpoli G, Boerwinkle E, Bradfield JP, Correa A, Kooperberg CL, North KE, Palmer JR, Zemel BS, Zheng W, Murabito JM, Lunetta KL. Large trans-ethnic meta-analysis identifies AKR1C4 as a novel gene associated with age at menarche. Hum Reprod 2021;36(7):1999-2010. doi: 10.1093/humrep/deab086. PMCID: PMC8213450.
Age at menarche (AAM, or age at first period) is associated with health outcomes over the lifetime and varies by race and ethnicity. Most genome-wide association studies (GWAS) that identify loci (locations on genes) linked to AAM have been conducted in European ancestry populations. By conducting a GWAS study on a large population of women with predominantly non-European ancestry, we were able to identify a new AMM locus that is more frequent in African-ancestry participants. These results support the need to study a wide range of ancestries and ethnicities to better identify genetic variants associated with diseases or traits. link to online article
Wu Y, … Palmer JR, et al. Dairy foods, calcium, and risk of breast cancer overall and for subtypes defined by estrogen receptor status: a pooled analysis of 21 cohort studies. Am J Clin Nutr 2021;114(2):450-61. doi: 10.1093/ajcn/nqab097.
Results on the relationship between consumption of specific dairy products and calcium and risk of breast cancer have been inconclusive. Combining the data of over 1 million women, including 37,861 with breast cancer, associations were evaluated for dairy product and calcium intake with risk of breast cancer overall and estrogen receptor (ER) status subtypes. Adult dairy and calcium consumption was weakly if at all associated with risk of breast cancer overall or breast cancer subtypes. However, higher intake of yogurt and cottage/ricotta cheese was inversely associated with the risk of ER-negative breast cancer. link to online article
Shafrir AL, Wise LA, Palmer JR, Shuaib ZO, Katuska LM, Vinayak P, Kvaskoff M, Terry KL, Missmer SA. Validity of self-reported endometriosis: a comparison across four cohorts. Hum Reprod 2021;36(5):1268-78. doi: 10.1093/humrep/deab012.
Because medical records for endometriosis are both difficult to obtain and not standardized, epidemiologic studies have relied on self-report. Using data from four different cohort studies including the BWHS, we compared questionnaire-reported endometriosis with medical records. For women’s self-report of endometriosis, the overall confirmation rate was > 70%, while the confirmation rate was >94% for self-report of laparoscopic confirmation. Relying on self-report appears to be valid; however, standardization in clinical and surgical data documentation would be needed to obtain the details for subgrouping patients. link to online article
Boynton-Jarrett R, Sponholtz TR, Rosenberg L, Palmer JR, Bethea TN, Wise LA. Abuse in childhood and risk for sleep disruption in adulthood in the Black Women’s Health Study. Sleep Med 2021;83:260-70. doi: 10.1016/j.sleep.2021.02.053.
We assessed the relation of early life physical and sexual abuse to several measures of disrupted sleep, including sleep quality and low sleep duration, in the BWHS. Abuse in childhood or teenage years was associated with sleep disruption in adulthood. link to online article
Bethea TN, Ochs-Balcom HM, Bandera EV, Beeghly-Fadiel A, Camancho F, Chyn D, Cloyd EK, Harris HR, Joslin CE, Myers E, Moorman PG, Peres LC, Rosenow W, Setiawan VW, Wu AH, Rosenberg L, Schildkraut JM. First- and second-degree family history of ovarian and breast cancer in relation to risk of invasive ovarian cancer in African American and White women. Int J Cancer 2021;148(12):2964-73. doi: 10.1002/ijc.33493.
Family history of ovarian cancer and breast cancer are well-established risk factors for ovarian cancer. Based on data from the Ovarian Cancer in Women of African Ancestry Consortium which includes the BWHS, first-degree family history of ovarian cancer was more strongly associated with high-grade serous carcinoma than with other histotypes in Black and White women. The association of second-degree family history of cancer with risk of ovarian cancer may differ by race. link to online article
Adedokun B, …, Palmer JR, et al. Cross-ancestry GWAS meta-analysis identifies six new loci for breast cancer in women of African and European ancestry. Nat Commun 2021;12(1):4198. doi: 10.1038/s41467-021-24327-x. PMCID: PMC8263739.
Using a cross-ancestry genome-wide association study (GWAS) approach, we identified six new gene loci [locations on genes] that are associated with risk of breast cancer overall or of estrogen receptor-negative breast cancer in populations with African or European ancestry. The methods used and the loci identified may contribute to better understanding of the genetics of breast cancer. link to online article
Hu C, Hart SN, Gnanaolivu R, ..., Palmer JR, ..., Rosenberg L, et al. A population-based study of genes previously implicated in breast cancer. N Engl J Med 2021;384(5):440-51. doi: 10.1056/NEJMoa2005936.
Using data from the Cancer Risk Estimates Related to Susceptibility (CARRIERS) consortium of many breast cancer studies, risks associated with pathogenic variants in known breast cancer-predisposition genes were estimated. Testing for these variants can inform cancer screening and improve clinical strategies. link to online article
White AJ, Gregoire AM, Niehoff NM, Bertrand KA, Palmer JR, Coogan PF, Bethea TN. Air pollution and breast cancer risk in the Black Women's Health Study. Environ Res 2021;194:110651. doi: 10.1016/j.envres.2020.110651.
Previous research of the relationship between air pollution and breast cancer risk has been predominantly focused on White women. Black women may have higher air pollution exposure due to geographic and residential factors. Using data from the BWHS, we assessed the association between air pollution and breast cancer risk. Overall, there was no association of PM2.5, NO2, or O3 with breast cancer risk. However, there were some associations in specific areas of the U.S. that require confirmation. link to online article
Isehunwa OO, Warner ET, Spiegelman D, Zhang Y, Palmer JR, Kanaya AM, Cole SA, Tworoger SS, Shields LO, Gu Y, Kent BV, De Vivo I, Shields AE, and the National Consortium on Psychosocial Stress, Spirituality, and Health. Depression, religiosity, and telomere length in the Study on Stress, Spirituality, and Health (SSSH). Int J Ment Health Addict 2021;20(3):1465-84. doi: 10.1007/s11469-020-00455-1. PMCID: PMC9211376.
Telomeres are nucleotide strands at the ends of chromosomes. Telomere length gets shorter with age. Prospective studies of the association between depression and telomere length, conducted in primarily European ancestry populations, have had mixed results. We examined telomere length in relation to depression in four race/ethnic population cohorts. We found no statistically significant association in the overall cohort or the specific race/ethnic populations, but did see some evidence of a modifying effect of religiosity or spirituality, religious congregation membership, and group prayer. Further research is needed to explore the potential modifying impact of religion and spirituality in diverse populations. link to online article
Cozier YC, Barbhaiya M, Castro-Webb N, Costenbader KH, Rosenberg L. A prospective study of reproductive factors in relation to risk of systemic lupus erythematosus among black women. Lupus 2021;30(2):204-10. doi: 10.1177/0961203320973074. PMCID: PMC7854483.
Systemic lupus erythematosus (SLE) is an autoimmune disease in which the immune system attacks its own tissues, causing inflammation and tissue damage. It occurs most commonly among women of reproductive age. Using data from the BWHS, we assessed the relationships of reproductive factors to SLE risk. Later age at menarche and longer duration of breastfeeding were both associated with increased risk of SLE. These findings require confirmation in other studies of Black women. link to online article
Peres LC, Bethea TN, Camacho TF, Bandera EV, Beeghly-Fadiel A, Harris HR, Joslin CE, Moorman PG, Myers E, MD, Ochs-Balcom HM, Setiawan VW, Wu AH, Rosenberg L, Schildkraut JM. Racial differences in population attributable risk for epithelial ovarian cancer in the OCWAA Consortium. J Natl Cancer Inst 2021;113(6):710-8. doi: 10.1093/jnci/djaa188.
Causes of racial disparities in the incidence of epithelial ovarian cancer (EOC) are not well-understood, but the prevalence of certain risk factors may explain these disparities. With data from four case-control studies and three case-control studies, including the BWHS, in the Ovarian Cancer in Women of African Ancestry Consortium, we estimated race-specific associations of ten known or suspected EOC risk factors. The selected risk factors accounted for slightly more of the risk among Black women than White women, and interventions focused on modifiable risk factors may be slightly more beneficial to Black women than White women at risk for EOC. link to online article
Benefield HC, Zirpoli GR, Allott EH, Shan Y, Hurson AN, Omilian AR, Khoury T, Hong CC, Olshan AF, Bethea TN, Bandera EV, Palmer JR, Ambrosone CB, Troester MA. Epidemiology of basal-like breast cancer among black women in the AMBER consortium. Cancer Epidemiol Biomarkers Prev 2021;30(1):71-9. doi: 10.1158/1055-9965.EPI-20-0556.
There are different ways of classifying breast cancers, one of which is the so-called six-marker IHC (ImmunoHistoChemistry) classification. One reason to classify breast cancers is that different types may have different causes, and analyzing risk factors for the different classifications can reveal this. In data from the AMBER consortium, a group of studies that includes the BWHS, breast cancer subtypes had distinct etiologic profiles; that is, different risk factors were associated with different types. In case-control analyses, increased body mass index and waist-to-hip ratio were associated with increased risk of luminal A subtype, while older age at menarche and parity (childbirth) were associated with a reduced risk. For basal-like cancers, parity without breastfeeding and increased waist-to-hip ratio were associated with increased risk, while breastfeeding was associated with reduced risk. link to online article
Jordan SJ, …, Palmer JR, et al. Pregnancy outcomes and risk of endometrial cancer: a pooled analysis of individual participant data in the Epidemiology of Endometrial Cancer Consortium. Int J Cancer 2021;148(9):2068-78. doi: 10.1002/ijc.33360.
Full-term pregnancy is associated with reduced risk of endometrial cancer, but it has been unclear whether the effect of additional pregnancies is independent of age at last pregnancy. In data from the Epidemiology of Endometrial Cancer Consortium (E2C2), which includes BWHS data, a full-term pregnancy was associated with greater reduction in risk than an incomplete pregnancy, and each additional pregnancy was associated with further reduction in endometrial cancer risk independent of age at last full-term pregnancy. This suggests the very high progesterone level of the last trimester of pregnancy is not the only explanation for the protective effect. link to online article
Zavala VA, Bracci PM, Carethers JM, Carvajal-Carmona L, ..., Palmer JR, et al. Cancer health disparities in racial/ethnic minorities in the USA. Br J Cancer 2021;124(2):315-32. doi: 10.1038/s41416-020-01038-6.
Several well-established disparities in cancer incidence and outcomes according to race and ethnicity are reviewed. Although substantial progress has been made in understanding underlying factors, inequities persist. More effort needs to be made to increase diversity in cancer research. Structural racism and barriers to healthcare access need to be eliminated in order to eliminate disparities. link to online article