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Breast, colorectal and lung cancers are significant public health burdens in the U.S., accounting for more than 688,000 newly-diagnosed cancers in 2023, with significant racial and ethnic disparities in disease incidence and mortality, according to the American Cancer Society.

While previous research has identified some links between the incidence of these cancers and certain immediate patient exposures around the time of diagnosis, long-term cancer risk in different populations has yet to be investigated through a cumulative assessment of multiple exposures over time.

David Wheeler, Ph.D.

David Wheeler, Ph.D., member of the Cancer Prevention and Control research program at VCU Massey Cancer Center, was recently awarded a five-year, $1.7 million R01 grant from the National Cancer Institute to address this gap in scientific understanding through the use of innovative statistical models and analysis.

“This is a first-of-its-kind comprehensive study investigating the variable patterns of geographic and neighborhood exposures that breast, colorectal and lung cancer patients experience as they change residences over the course of their lives, many years prior to a diagnosis,” said Wheeler, who is also a professor in the Department of Biostatistics at the VCU School of Population Health.

Many tumors develop slowly over the course of multiple decades, and most risk factors for disease vary for individuals over time and location. Therefore, it is becoming increasingly necessary to better understand a variety of factors over long periods of time to effectively identify causal associations between lifetime exposures and cancer development. These include factors such as access to societal and economic resources, racial segregation, environmental pollution, residential location and built-in geographic barriers, among others.

Using comprehensive data from state cancer registries in Virginia and Pennsylvania and advanced population-based statistical models, Wheeler and his team will conduct a thorough assessment of neighborhood exposures over decades that could better explain the factors leading to cancer incidence and disparities in regard to breast, colorectal and lung cancers.

“Our holistic approach could shed light on the most influential cancer risk factors,” Wheeler said. “Understanding the role of neighborhood histories in cancer risk can transform cancer prevention research by identifying societal factors driving health inequity, inform evidence-based policies to reshape structural neighborhood characteristics and advance our potential to reduce disparities in incidence and outcomes for some of the most common cancers.”

Black patients are diagnosed with cancer at later stages and die from the disease at higher rates than other patients. Additionally, census data indicate that Black cancer patients live in more disadvantaged neighborhoods than white cancer patients. Wheeler’s grant-funded research will specifically examine the effects of historic racial segregation and neighborhood deprivation on breast, colorectal and lung cancers.

Wheeler was previously awarded more than $1.3 million to better understand environmental, geographic and socioeconomic risk factors that lead to bladder cancer and non-Hodgkin’s lymphoma.

Written by: Blake Belden