Special Studies
Cancer Survivorship
A diagnosis of cancer and cancer treatment can affect women for many years afterward, but little is known about how Black women’s lives may change after cancer. This project collects data from Black Women’s Health Study participants who have been diagnosed with cancer to learn about their cancer treatments and how their lives have been affected. The mortality rate from breast cancer, the most commonly occurring cancer among women in the U.S., is 39% higher in Black women than White women. The reasons for this difference are largely unknown, so the research will also study factors that affect death due to breast cancer and other cancer outcomes.
Cancer Tumor Tissue Collection
It has become increasingly clear that breast cancer is not a single disease but rather consists of two or more subtypes that may have different causes and require different treatments. A particularly aggressive form of breast cancer (the triple-negative subtype) occurs more often among African American women than U.S. women of other racial/ethnic groups, although it is still relatively uncommon (about 20% of all breast cancers in African American women). We can lessen our risk of developing the more common type of breast cancer – tumors responsive to estrogens – by avoiding use of menopausal hormones, reducing alcohol intake, and avoiding excess weight gain, but little is known about what factors play a role in triple negative breast cancer. Therefore, much of the current breast cancer research in the BWHS is focused on triple negative breast cancer.
In addition to breast cancer, we are now collecting tumor tissue for colorectal, kidney, lung, ovarian and uterine cancers. It is very helpful to be able to include information from the tumor itself in our analyses. To do so, we need to obtain the tumor tissue samples that have been stored in laboratories at the hospitals in which women were originally treated for their cancers. We remove a very small section of the tumor tissue and then return the sample to the hospital. Part of the section is used for tests that identify specific subtypes and the rest will be used to look at the biology of the tumor itself. Before requesting samples from the hospitals, we obtain written informed consent from each participant.
We hope and expect that our current and future research using tumor tissue will help to identify ways to identify and treat these diseases.
Cognitive Health and Aging Study
The BWHS has received funding from the National Institute on Aging to study factors that may impact cognitive aging (changes in thinking and memory) in BWHS participants. For reasons that are not well understood, it appears that Black women are more likely to experience declines in cognition and receive diagnoses of dementia at younger ages than other American women. The BWHS will conduct a five-year study to understand factors associated with cognitive aging among its participants. Beginning in late summer of 2024, the BWHS will invite participants who are age 55 and older and who have previously provided a blood sample to participate in the cognition study. The goal is to enroll 2,500 BWHS participants. Once a year during the 5-year study period, each participant will take part in a cognitive interview lasting about 20 minutes. The cognitive interviews will be conducted over the telephone. The annual cognitive interview data together with information from the blood samples and from BWHS questionnaires sent every two years since 1995 will be used to identify factors that influence cognitive aging.
Crohn’s Disease and Ulcerative Colitis
Crohn’s disease (CD) and ulcerative colitis (UC) are chronic progressive inflammatory bowel diseases (IBD) of the gastrointestinal tract with rapidly rising incidence, enormous social and economic impact, and increased mortality. In the US, IBD affects nearly 1.5% of the population and account for significant health care expenditures and decrease quality of life. There are significant racial differences in IBD presentation and natural history in the US. Two of the aims of this study are to identify modifiable lifestyle risk factors for IBD among US Black women and to examine the relationship between individual and environmental stressors on risk of IBD among Black women.
Lung Cancer Screening Study
In the United States, Black women are more likely to be diagnosed with later stages of lung cancer and are less likely to be eligible for lung cancer screening compared to White women. Early detection of lung cancer and heart disease is the most promising strategy to reduce the number of lung cancer and heart disease-related deaths. Lung cancer screening has been shown to reduce lung cancer mortality in high-risk populations and it is currently recommended by the United States Preventative Services Task Force (USPSTF) for individuals who meet the criteria.
The goal of this study is to investigate the use of Low-Dose CT scan (LDCT) screening to identify lung and heart diseases in Black women. These screening exams are used to check for diseases in people who do not feel any symptoms. Screening exams can find diseases early, before they cause symptoms which is when they are easier to treat.
Mammogram Collection: examining breast density and other factors related to breast cancer risk
High breast density, which can be seen on a mammogram, is considered a well-established risk factor for breast cancer, but most previous studies have been based on women of European ancestry. Prior studies have suggested that the distribution of breast density could be very different among Black vs. White women. In addition, emerging evidence suggests that other breast tissue features identifiable on mammograms might also predict breast cancer risk.
The goal of this study is to collect copies of mammograms from 6,700 BWHS participants, including 700 who have reported being diagnosed with breast cancer. A random sample of BWHS participants will be contacted to request permission for BWHS investigators to contact their mammography clinics to obtain their records. This effort began in September 2017 and will continue until the full sample size is reached. Mammogram images will be analyzed using computer-assisted techniques that determine breast density and identify other features. Because these techniques were developed for research purposes, results of the mammogram assessment will not be returned to participants. The information obtained from the mammograms will be used, in conjunction with BWHS questionnaire data, to study predictors of high mammographic density and to assess associations of mammographic density and other breast features with breast cancer risk. Ultimately, findings from this study could be useful for improving risk prediction models for breast cancer in Black women.
Parkinson's Disease
Even though Parkinson’s Disease (PD) is considered a “well-studied” disorder, African Americans (AA) have been historically underrepresented in PD studies. The goal of this project is to evaluate whether established and suspected risk factors for PD are associated with PD risk in Black women.