Cancer Health Disparities

Substantial disparities exist in gynecologic cancer, and for a number of reasons. Using an epidemiologic approach, we have sought to understand the role of nativity (country of birth) and genomic ancestry as determinants of risk and outcome. Our work includes evaluations in endometrial, cervical, ovarian, and breast cancers. Ongoing investigations include the role of residential segregation and provider density in stage at diagnosis, and symptom interpretation across groups of diverse women. We continue to evaluate the role of quantitative genomic ancestry, instead of self-identified race, as a factor tied to cancer risk.

Vaginal microbiome

We have demonstrated that the vaginal microbiome is highly associated with histology and grade of endometrial cancers. We have an ongoing protocol seeking to collect biospecimens in women undergoing surgery for endometrial cancer to further characterize this. Such data will be used for prognostication, screening and early detection of disease, and to assess modifications to treatment outcomes with immunotherapy.

Global and Community Health

Recognizing that there is much to be learned by collaborations not just home, but abroad as well, we interface with colleagues in the Caribbean and West Africa. These relationships facilitate bidirectional clinical and research training opportunities. We will be launching a Phase II clinical trial in Nigeria, the Bahamas, and the US in 2024 to evaluate PARP inhibition in women of African ancestry and to evaluate safety/tolerability, efficacy, and quality of life. We also support our colleagues abroad in developing their own clinical trials, and at present serve as co-principal investigators on studies to evaluate the microbiome across the gynecologic cancer spectrum and understand the epidemiologic factors associated with gynecologic cancers in Sub-Saharan Africa.