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The Eighth Annual Frontiers in Cancer Prevention Research meeting was held in Houston, Texas, in November 2009. This report highlights significant presentations that advance the fields of chemoprevention, clinical trial recruitment and retention, cancer screening including optical imaging, energy balance, and nutritional epidemiology, and health communications and decision making. In findings from the randomized Reduction by Dutasteride of Prostate Cancer Events trial, dutasteride reduced the risk of biopsy-detectable prostate cancer in high-risk men by 23% compared with placebo. Important clues about the dosing and window of susceptibility for supplementation with choline, vitamin D, and folate were revealed from epigenetic research that has implications for future nutritional epidemiology research. Noninvasive optical imaging techniques using endoscopic ultrasound and autofluorescence for the early detection of cancers in the lung, pancreas, and oral cavity are being studied. The report also addresses the challenges of promoting cancer prevention. Understanding how individuals process risk information and make sustained behavior changes and the effect of socioeconomic status on health disparities were identified as critical areas of research. This multidisciplinary research meeting of basic, clinical, and behavioral scientists and epidemiologists continues to play a major role in identifying the research priority areas of cancer prevention, elucidating new mechanisms of carcinogenesis for targeted chemoprevention therapies and delivering a comprehensive strategy for engaging individuals in the unifying goal to reduce cancer incidence. Cancer Prev Res; 3(8); 1044–8. ©2010 AACR.

CN11-02 Increasingly, cultural beliefs and values are being recognized as important to outcomes following cancer diagnosis. Although the way in which cultural beliefs and values are evaluated has implications for support programs that are developed to enhance survivorship, it is not known if cultural factors are best conceptualized as moderators or mediators of racial differences in psychological behaviors following prostate cancer diagnosis. Therefore, the purpose of this study was to determine if religiosity acted as a moderator or mediator of racial differences in coping efforts following prostate cancer diagnosis. Subjects were 224 African American and white men who were newly diagnosed with prostate cancer. Coping efforts and cultural factors were evaluated during a structured telephone interview. Overall, there were racial differences in religiosity (p=0.0001) and utilization of religious and spiritual coping (p=0.0001). African American men reported significantly greater levels of religiosity compared to white men and were most likely to use religion and spirituality to cope with their diagnosis. In the moderator analysis, the interaction between race and religiosity was not significant (p=0.22). However, in the mediation analysis, the effect for race became non-significant (p=0.36) when religiosity was entered into the model. Religiosity had a significant effect on religious and coping efforts (p=0.0001) in the final model; men with greater religiosity were most likely to use these strategies to cope with their diagnosis. These findings suggest that religiosity is not likely to be important to coping efforts only among African American men; rather, these beliefs and values are likely to influence how both African American and white men cope with their prostate cancer diagnosis. Citation Information: Cancer Prev Res 2008;1(7 Suppl):CN11-02.

Introduction: Obesity, which has important implications for cancer risk and outcomes, is the cumulative effect of diet and physical activity behaviors. Many adults, especially those from racial and ethnic minority groups, do not meet the recommended guidelines for these behaviors. Previous research has shown that cancer risk information is effective at motivating early detection, but empirical data are not available on the effects of risk factor information on prevention behaviors. Purpose: We conducted a randomized trial to evaluate the effects of alternate forms of risk factor education on prevention behaviors in a community-based sample of African American adults (n=212). Methods: This study was conducted as part of an academic-community partnership; the intervention protocols were developed collaboratively by a multi-disciplinary investigative team consisting of academic and community investigators. The integrated risk counseling (IRC) protocol provided education about the overlap in behavioral risk factors for cancer and cardiovascular disease and the disease-specific (DSC) protocol only provided education about behavioral risk factors for cardiovascular disease. Elements from motivational interviewing were incorporated into IRC and DSC; interactive activities were included in both protocols to develop and enhance skills for increasing fruit and vegetable intake and physical activity. Adherence to recommendations for fruit and vegetable intake and physical activity were evaluated by self-report by telephone at baseline and at 1-month following intervention. We predicted that IRC would lead to greater adherence rates compared to DSC. Regression analyses, using an intent-to-treat approach were conducted to evaluate adherence rates for behavioral outcomes while controlling for baseline levels. Results: Compared to DSC, IRC was associated with increased adherence rates for fruit intake only (OR=1.85, 95% CI=0.99, 3.44, p=0.05). At baseline, 37.4% of participants who were randomized to IRC met the recommended guidelines for fruit intake, but at follow-up 57.4% were adherent. There were no significant changes in adherence rates for fruit intake among those who were randomized to DSC (31.1% versus 41.5%). Conclusions: Our findings suggest that integrated risk factor education leads to improved behavioral prevention for some outcomes. Making multiple behavioral changes simultaneously may be particularly difficult. Citation Format: Melanie S. Jefferson, Benita Weathers, Scarlett Bellamy, Ernestine Delmoor, Vanessa Briggs, Jerry Johnson, Rodney Rogers, Joseph Purnell, Chanita Hughes-Halbert. Effects of integrated risk counseling on cancer prevention behaviors. [abstract]. In: Proceedings of the Eleventh Annual AACR International Conference on Frontiers in Cancer Prevention Research; 2012 Oct 16-19; Anaheim, CA. Philadelphia (PA): AACR; Cancer Prev Res 2012;5(11 Suppl):Abstract nr A06.

Despite the development and implementation of health promotion and prevention programs, African Americans continue to experience high rates of morbidity and mortality from cancer. Active community engagement in research is being recognized as a critical component of accurate and credible science that is essential for ensuring that research addresses the needs of communities and populations at risk for poorer outcomes. However, active community involvement in the development, implementation, and evaluation of health promotion and preventive strategies has been limited. To address this issue, we developed an academic-community partnership called the West Philadelphia Consortium to Address Disparities. This partnership consists of four community-based organizations in Philadelphia and academic researchers and staff at the University of Pennsylvania. Consistent with the principles of community-based participatory research (CBPR), the partnership focuses on facilitating active collaboration between community and academic members in three key areas: (1) identification of the health priorities and concerns of African American residents in the West and Southwest Philadelphia community, (2) development and evaluation of interventions to address community concerns related to health promotion and disease prevention, and (3) communication of results and cancer information to community residents. Through a combination of qualitative and quantitative methods, our research has demonstrated that cancer, cardiovascular disease, and risk factors (e.g., diet, physical activity, obesity) for these conditions are among the health concerns identified by African American residents. Through a collaborative approach grounded in CBPR, we developed an integrated risk education program to address these concerns. In a preliminary evaluation of the program, we determined if participants were representative of community residents in terms of sociodemographic factors and evaluated rates of program participation. We found that of 156 eligible individuals, 137 (88%) enrolled in the study. The rate for participating in risk counseling (74%) equaled the number of program acceptors (n=101) divided by the total number of individuals who enrolled in the study (n=137). Consistent with the characteristics of community residents, our sample included more females than males and the proportion of men and women who participated in risk counseling was consistent with the percentage of male and female residents. In addition, a comparable proportion of risk counseling participants were not married relative to community residents. However, our sample included a greater proportion of individuals who only had a high school education relative to community residents. In terms of health-related outcomes, integrated risk education did not increase motivations to change preventive behaviors, but improved self-efficacy for diet and physical activity behaviors. Our findings underscore the importance of actively involving community stakeholders in the development, implementation, and evaluation of health promotion and prevention efforts. Citation Information: Cancer Prev Res 2010;3(1 Suppl):CN08-04.

B5 Obesity is an important risk factor for breast cancer, which disproportionately affects African American women. For women who have a personal or family history of disease that is suggestive of hereditary cancer, obesity may be particularly problematic. However, empirical data are not available on rates and correlates of obesity in this population. Therefore, the purpose of this study was to identify factors having significant independent associations with obesity in African American women at increased risk for hereditary breast cancer. Subjects were 126 African American women who had a personal and/or family history of breast cancer that was suggestive of BRCA1/2 mutations. Obesity was determined by self-report during a structured telephone interview. Reproductive factors (e.g., age at menarche), cultural beliefs (e.g., temporal orientation), and cancer-specific distress were also evaluated during the telephone interview. Overall, 43% of women were obese. Women who had a younger age at menarche were about four times more likely to be obese compared to women who had their first menstrual period at an older age (OR=3.88, 95% CI=1.65, 9.15, p=0.002). Obesity was also associated with greater levels of present temporal orientation (OR=0.67, 95% CI=0.46, 0.99, p=0.05). Intrusive thoughts about cancer was marginally related to obesity (OR=1.46, 95% CI=0.99, 2.15, p=0.06). The results of this study suggest that attention to cultural factors should be given in programs designed to address obesity among African American women at increased risk for hereditary breast cancer. Citation Information: Cancer Prev Res 2008;1(7 Suppl):B5.