Search

Significance A key link to understand human history in Island Southeast Asia is the Philippine archipelago and its poorly investigated genetic diversity. We analyzed the most comprehensive set of population-genomic data for the Philippines: 1,028 individuals covering 115 indigenous communities. We demonstrate that the Philippines were populated by at least five waves of human migration. The Cordillerans migrated into the Philippines prior to the arrival of rice agriculture, where some remain as the least admixed East Asians carrying an ancestry shared by all Austronesian-speaking populations, thereby challenging an exclusive out-of-Taiwan model of joint farming–language–people dispersal. Altogether, our findings portray the Philippines as a crucial gateway, with a multilayered history, that ultimately changed the genetic landscape of the Asia-Pacific region., Island Southeast Asia has recently produced several surprises regarding human history, but the region’s complex demography remains poorly understood. Here, we report ∼2.3 million genotypes from 1,028 individuals representing 115 indigenous Philippine populations and genome-sequence data from two ∼8,000-y-old individuals from Liangdao in the Taiwan Strait. We show that the Philippine islands were populated by at least five waves of human migration: initially by Northern and Southern Negritos (distantly related to Australian and Papuan groups), followed by Manobo, Sama, Papuan, and Cordilleran-related populations. The ancestors of Cordillerans diverged from indigenous peoples of Taiwan at least ∼8,000 y ago, prior to the arrival of paddy field rice agriculture in the Philippines ∼2,500 y ago, where some of their descendants remain to be the least admixed East Asian groups carrying an ancestry shared by all Austronesian-speaking populations. These observations contradict an exclusive “out-of-Taiwan” model of farming–language–people dispersal within the last four millennia for the Philippines and Island Southeast Asia. Sama-related ethnic groups of southwestern Philippines additionally experienced some minimal South Asian gene flow starting ∼1,000 y ago. Lastly, only a few lowlanders, accounting for

Background: Nationally, cancer disparities negatively impact minority communities at alarming rates. Minorities have low rates of cancer screenings compared to white counterparts, resulting in Latinos having poor cancer outcomes in lung, colon, breast, and prostate cancers. Previous studies have examined race/ethnic cancer disparities, yet improved health outcomes are lagging in the Latino community. We assessed perceptions and recommendations to improving cancer screenings, treatment, research participation, and survivorship within the Latino community as part of the codevelopment of a health-equity agenda around cancer services and research at the Duke Cancer Institute. Methods: We conducted five 90-minute focus groups reaching a total of 51 members of the Latino community, including clergy, community members, survivors, caregivers, and local leaders, to identify the barriers and facilitators to engaging the Latino community in cancer services and research. Data were recorded and analyzed using Atlas Ti Software. Results: Barriers to cancer screenings and treatment included affordability of care, lack of health insurance or other financial resources, lack of knowing when to seek screenings, poor patient provider communication, treatment and options seem to be different based on insurance and/or immigration status, language barriers, machismo, stigma and fear of a cancer diagnosis, long wait times, and excessive and unclear paperwork when seeking cancer screening and treatment services. Participation in clinical trials and research was considered limited due to lack of outreach, education, and full engagement with the Latino community around research. Key strategies include engaging families and communities to increase community's knowledge and access to prevention, screenings, and available treatment options, including clinical trials. Develop partnerships with Latino faith-based and serving organizations to extend services and education about cancer screenings and research. Have services more accessible and culturally responsive to promote screening and timely follow-up, and incorporate staff and lay community leaders to promote awareness and participation in research. Conclusion: Developing sustainable and equitable collaborations and partnerships between the cancer center and the Latino community to increase access to education, screening, treatment, and research is critical to addressing longstanding cancer disparities. There are key community-derived opportunities to incorporate culturally tailored community programs designed to ensure the Latino community and patients gain access to quality, culturally responsive health care and research. Ongoing outreach and education across the cancer continuum needs to reflect and respond to the values and perspectives of the Latino community. Leveraging the family and the community strengths to address the need and build capacity to fully engage in clinical services and research has the potential to yield better cancer outcomes. Likewise, heightened education and training opportunities are needed to engage the Latino community in oncology research and clinical trials from idea generation to full participation to effectively improve community and population health and decrease cancer disparities. Citation Format: Nadine J. Barrett, Kearston L. Ingraham, Xiomara Boyce, Rebecca Reyes. Attitudes, perceptions, and strategies toward increasing cancer screening, treatment, and participation in research among Latinos [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr B18.

Across the nation academic health centers, including cancer centers are establishing offices or departments focused specifically on health disparities and health equity. This movement is critical to ensure health disparities research and its dissemination, becomes an ongoing theme in the fabric of an institution. Offices or departments of this nature can often be shaped and defined based on initial funder priorities and may miss the opportunity to engage authentically with the community in the initial stages of its development. Limited practical research is available to describe the development, implementation, and initial outcomes of a new Office of Health Equity built within a NCI designated cancer institute. Using CBPR methodology, this project conducted assessments reaching over 121 diverse community members, faith leaders, cancer survivors, and caregivers from Latino, Asian, African American and medically underserved communities. Community partnerships were developed to conduct group sessions designed to describe community attitudes on cancer, clinical trials and research participation. Participants provided recommendations to collaboratively overcome barriers to accessing cancer information and care, clinical trials education and participation, and reduce cancer health disparities. Findings are reported back to the community and a full research platform and strategic plan has been developed and currently implemented with the community, survivors and practitioners. Practical methods of authentic community engagement are utilized to improve outreach and access to cancer services, clinical trials education and minority participation, ensure cancer survivors have a seamless journey throughout the cancer continuum, and to enhance cancer disparities research. Citation Format: Nadine Josann Barrett, Valarie Worthy, Xiomara Boyce-Manon, Rebecca Reyes, Lamisha Banks, Steve Patierno, Claire Chu. Using the principles of community-based participatory research to build an office of health equity within a nationally designated cancer institute. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr A30. doi:10.1158/1538-7755.DISP13-A30