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Background: Neighborhood deprivation is associated with both race and cancer incidence, but there is a need to better understand the effect of structural inequities on racial cancer disparities. The goal of this analysis was to evaluate the relationship between a comprehensive measure of neighborhood‐level social disadvantage and cancer incidence within the racially diverse population of metropolitan Detroit. Methods: We estimated breast, colorectal, lung, and prostate cancer incidence rates using Metropolitan Detroit Cancer Surveillance System and US decennial census data. Neighborhood socioeconomic disadvantage was measured by the Area Deprivation Index (ADI) using Census Bureau's American Community Survey data at the Public Use Microdata Areas (PUMA) level. Associations between ADI at time of diagnosis and cancer incidence were estimated using Poisson mixed‐effects models adjusting for age and sex. Attenuation of race‐incidence associations by ADI was quantified using the "mediation" package in R. Results: ADI was inversely associated with incidence of breast cancer for both non‐Hispanic White (NHW) and non‐Hispanic Black (NHB) women (NHW: per‐quartile RR = 0.92, 95% CI 0.88–0.96; NHB: per‐quartile RR = 0.94, 95% CI 0.91–0.98) and with prostate cancer incidence only for NHW men (per‐quartile RR = 0.94, 95% CI 0.90–0.97). ADI was positively associated with incidence of lung cancer for NHWs and NHBs (NHW: per‐quartile RR = 1.12, 95% CI 1.04–1.21; NHB: per‐quartile RR = 1.37, 95% CI 1.25–1.51) and incidence of colorectal cancer (CRC) only among NHBs (per‐quartile RR = 1.11, 95% CI 1.02–1.21). ADI significantly attenuated the relationship between race and hormone receptor positive, HER2‐negative breast cancer (proportion attenuated = 8.5%, 95% CI 4.1–16.6%) and CRC cancer (proportion attenuated = 7.3%, 95% CI 3.7 to 12.8%), and there was a significant interaction between race and ADI for lung (interaction RR = 1.22, p < 0.0001) and prostate cancer (interaction RR = 1.09, p = 0.00092). Conclusions: Area‐level socioeconomic disadvantage is associated with risk of common cancers in a racially diverse population and plays a role in racial differences in cancer incidence. [ABSTRACT FROM AUTHOR]

Background: Lesbian, gay, bisexual, transgender, and other LGBTQIA cancer patients experience significant disparities in cancer-related outcomes. Their relationships may not be acknowledged in care systems designed to serve primarily heterosexual and cisgender (H/C) patients, and resources for partners and caregivers of H/C patients may not address the needs of LGBTQIA caregivers. Tailored interventions are needed to address disparities in LGBTQIA patients and caregivers. Methods: To address this gap, researchers from Karmanos Cancer Institute in Detroit, MI and Wilmot Cancer Institute in Rochester, NY worked with a cancer action council (CAC) of LGBTQIA stakeholders with lived experience of cancer in a community-academic partnership. This group used the ADAPT-ITT model to guide their process of assessing needs in this community, identifying evidence-based interventions that could be adapted to meet those needs, and beginning the process of adapting an existing intervention to meet the needs of a new population. Results: In the Assessment phase of the model, CAC members shared their own experiences and concerns related to cancer and identified cancer caregiving as a priority area for intervention. In the Decision-Making phase of the model, researchers and CAC members performed a review of the literature on interventions that reported outcomes for cancer caregiver, identifying 13 promising interventions. Each of these interventions was evaluated over a series of meetings using a scoring rubric. Based on this rubric, the FOCUS intervention was established as an appropriate target for adaptation to the LGBTQIA population. In the first stage of the Adaptation phase, CAC members reacted to the intervention content and identified principal components for adaptation. Conclusion: While the FOCUS intervention adaptation is still in process, this manuscript can serve as a guide for others establishing community-academic partnerships to adapt interventions, as well as those developing interventions and resources for LGBTQIA persons coping with cancer. [ABSTRACT FROM AUTHOR]

Background: Coronavirus disease 2019 (COVID‐19) has had profound effects on population health to date. African American cancer survivors are particularly vulnerable to developing severe consequences; therefore, understanding the impact of the virus on this patient population is critical. Methods: The Detroit Research on Cancer Survivors cohort is a unique effort to understand the determinants of poor outcomes in African American cancer survivors. To date, more than 4500 cancer survivors and nearly 950 primary caregivers have been enrolled; participation includes a survey and the collection of biospecimens, medical records, and tumor tissue. Beginning in the spring of 2020, a supplemental survey focusing on the impact of COVID‐19 was offered to enrolled participants. The analysis included 890 survivors. Results: Nearly all survivors (>99%) reported changes in their daily activities in an effort to reduce the risk of infection. More than 40% of the survivors reported some disruption in their access to medical care. A substantial proportion of the survivors (>40%) reported feeling anxious, depressed, and/or isolated during the COVID‐19 pandemic. Approximately 40% of the patients reported changes in health behaviors shown to negatively affect survivorship outcomes (physical inactivity, smoking, and alcohol use) as a result of the pandemic. Conclusions: The influence of the COVID‐19 pandemic on African American cancer survivors is substantial: it has affected both their physical and mental health. Coupled with changes in health behaviors, these factors will likely affect outcomes in this high‐risk patient population, and this makes further study and interventions necessary to mitigate the long‐term impact of the pandemic on cancer outcomes. The COVID‐19 pandemic has had a profound impact on the physical and mental health of African American cancer survivors living in Detroit, Michigan. Strategies focusing on health behaviors such as physical activity would improve patient health and quality of life. [ABSTRACT FROM AUTHOR]

Background: Extant evidence links neighborhood walkability with obesity‐related health in the general population. This association likely exists in cancer survivors, but research is limited. Furthermore, a disproportionate obesity burden in African American cancer survivors warrants subgroup‐specific analyses. Methods: This study analyzed data from 2089 African American cancer survivors participating in the Detroit Research on Cancer Survivors (ROCS) cohort. On the basis of built environment data summarized within 1‐km radial buffers around census block centroids, a multidimensional neighborhood walkability index (NWI) was constructed. Survivors' residential addresses at Detroit ROCS enrollment were geocoded, and addresses were linked to NWI scores via the census block of residence. At study enrollment, survivors reported height and weight; these data were used to calculate their body mass index (BMI). Associations between NWI quartiles and BMI overall and by cancer type, biological sex, and physical activity engagement were evaluated. Results: BMI was found to be inversely associated with increasing NWI quartile (P for trend <.01). This inverse relationship was observed in men (P for trend <.01) and in survivors reporting any regular physical activity (P for trend <.01). Conclusions: This study's findings suggest that among African American cancer survivors, higher neighborhood walkability is associated with lower BMI. As health care systems in the United States increasingly consider the role of the neighborhood environment in their patients' health, these findings provide additional evidence supporting health systems' incorporation of neighborhood walkability as an obesity‐related health indicator for this cancer survivor subgroup and potentially for cancer survivors from other vulnerable populations. This study evaluates the relationship between neighborhood walkability and body size in a population‐based sample of African American cancer survivors in Metropolitan Detroit. A cross‐sectional link between higher neighborhood walkability and lower body mass index is demonstrated. [ABSTRACT FROM AUTHOR]

Background: The benefit of regular exercise in improving cancer outcomes is well established. The American Cancer Society (ACS) released a recommendation that cancer survivors should engage in at least 150 minutes of moderate to vigorous physical activity (PA) per week; however, few report meeting this recommendation. This study examined the patterns and correlates of meeting ACS PA recommendations in the Detroit Research on Cancer Survivors (ROCS) cohort of African American cancer survivors. Methods: Detroit ROCS participants completed baseline and yearly follow‐up surveys to update their health and health behaviors, including PA. This study examined participation in PA by select characteristics and reported health‐related quality of life (HRQOL) as measured with the Functional Assessment of Cancer Therapy and Patient‐Reported Outcomes Measurement Information System instruments. Results: Among the first 1500 ROCS participants, 60% reported participating in regular PA, with 24% reporting ≥150 min/wk. Although there were no differences by sex, prostate cancer survivors were the most likely to report participating in regular PA, whereas lung cancer survivors were the least likely (P =.022). Survivors who reported participating in regular PA reported higher HRQOL (P <.001) and lower depression (P =.040). Conclusions: Just 24% of African American cancer survivors reported meeting the ACS guidelines for PA at the baseline, but it was encouraging to see increases in activity over time. Because of the established benefits of regular exercise observed in this study and others, identifying and reducing barriers to regular PA among African American cancer survivors are critical for improving outcomes and minimizing disparities. Regular exercise is critically beneficial in improving quality of life and in reducing anxiety and depression in African American cancer survivors. Eliminating barriers to participation in physical activity will be important in reducing cancer disparities. [ABSTRACT FROM AUTHOR]