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In this study, we used whole-exome sequencing of a cohort of 45 advanced-stage, treatment-naïve Nigerian (NG) primary prostate cancer tumors and 11 unmatched nontumor tissues to compare genomic mutations with African American (AA) and European American (EA) The Cancer Genome Atlas (TCGA) prostate cancer. NG samples were collected from six sites in central and southwest Nigeria. After whole-exome sequencing, samples were processed using GATK best practices. BRCA1 (100%), BARD1 (45%), BRCA2 (27%), and PMS2(18%) had germline alterations in at least two NG nontumor samples. Across 111 germline variants, the AA cohort reflected a pattern [BRCA1 (68%), BARD1 (34%), BRCA2 (28%), and PMS2 (16%)] similar to NG samples. Of the most frequently mutated genes, BRCA1 showed a statistically (P ≤ 0.05) higher germline mutation frequency in men of African ancestry (MAA) and increasing variant frequency with increased African ancestry. Disaggregating gene-level mutation frequencies by variants revealed both ancestry-linked and NG-specific germline variant patterns. Driven by rs799917 (T>C), BRCA1 showed an increasing mutation frequency as African ancestry increased. BRCA2_rs11571831 was present only in MAA, and BRCA2_rs766173 was elevated in NG men. A total of 133 somatic variants were present in 26 prostate cancer–associated genes within the NG tumor cohort. BRCA2 (27%), APC (20%), ATM (20%), BRCA1 (13%), DNAJC6 (13%), EGFR (13%), MAD1L1 (13%), MLH1 (11%), and PMS2 (11%) showed mutation frequencies >10%. Compared with TCGA cohorts, NG tumors showed statistically significant elevated frequencies of BRCA2, APC, and BRCA1. The NG cohort variant pattern shared similarities (cosign similarities ≥0.734) with Catalogue of Somatic Mutations in Cancer signatures 5 and 6, and mutated genes showed significant (q < 0.001) gene ontology (GO) and functional enrichment in mismatch repair and non-homologous repair deficiency pathways. Here, we showed that mutations in DNA damage response genes were higher in NG prostate cancer samples and that a portion of those mutations correlate with African ancestry. Moreover, we identified variants of unknown significance that may contribute to population-specific routes of tumorigenesis and treatment. These results present the most comprehensive characterization of the NG prostate cancer exome to date and highlight the need to increase diversity of study populations. Significance: MAA have higher rates of prostate cancer incidence and mortality, however, are severely underrepresented in genomic studies. This is the first study utilizing whole-exome sequencing in NG men to identify West African ancestry-linked variant patterns that impact DNA damage repair pathways.

In this study, we used whole-exome sequencing of a cohort of 45 advanced-stage, treatment-naïve Nigerian (NG) primary prostate cancer tumors and 11 unmatched nontumor tissues to compare genomic mutations with African American (AA) and European American (EA) The Cancer Genome Atlas (TCGA) prostate cancer. NG samples were collected from six sites in central and southwest Nigeria. After whole-exome sequencing, samples were processed using GATK best practices. BRCA1 (100%), BARD1 (45%), BRCA2 (27%), and PMS2(18%) had germline alterations in at least two NG nontumor samples. Across 111 germline variants, the AA cohort reflected a pattern [BRCA1 (68%), BARD1 (34%), BRCA2 (28%), and PMS2 (16%)] similar to NG samples. Of the most frequently mutated genes, BRCA1 showed a statistically (P ≤ 0.05) higher germline mutation frequency in men of African ancestry (MAA) and increasing variant frequency with increased African ancestry. Disaggregating gene-level mutation frequencies by variants revealed both ancestry-linked and NG-specific germline variant patterns. Driven by rs799917 (T>C), BRCA1 showed an increasing mutation frequency as African ancestry increased. BRCA2_rs11571831 was present only in MAA, and BRCA2_rs766173 was elevated in NG men. A total of 133 somatic variants were present in 26 prostate cancer–associated genes within the NG tumor cohort. BRCA2 (27%), APC (20%), ATM (20%), BRCA1 (13%), DNAJC6 (13%), EGFR (13%), MAD1L1 (13%), MLH1 (11%), and PMS2 (11%) showed mutation frequencies >10%. Compared with TCGA cohorts, NG tumors showed statistically significant elevated frequencies of BRCA2, APC, and BRCA1. The NG cohort variant pattern shared similarities (cosign similarities ≥0.734) with Catalogue of Somatic Mutations in Cancer signatures 5 and 6, and mutated genes showed significant (q < 0.001) gene ontology (GO) and functional enrichment in mismatch repair and non-homologous repair deficiency pathways. Here, we showed that mutations in DNA damage response genes were higher in NG prostate cancer samples and that a portion of those mutations correlate with African ancestry. Moreover, we identified variants of unknown significance that may contribute to population-specific routes of tumorigenesis and treatment. These results present the most comprehensive characterization of the NG prostate cancer exome to date and highlight the need to increase diversity of study populations.Significance:MAA have higher rates of prostate cancer incidence and mortality, however, are severely underrepresented in genomic studies. This is the first study utilizing whole-exome sequencing in NG men to identify West African ancestry-linked variant patterns that impact DNA damage repair pathways.

Supplementary Table 1. Known Germline Variants. Supplementary Table 2. Germline Variants. Supplementary Table 3. Known Somatic Variants. Supplementary Table 4. Somatic Vars in NG Normal. Supplementary Table 5. NG WES QC Metrics. Supplementary Table 6. NG Cohort Description. Supplementary Table 7. TCGA Cohort Description. Supplementary Table 8. AA Germ Var Frequency. Supplementary Table 9. Somatic Variants. Supplementary Table 10. NG Somatic ClueGo Results.

Supplementary Figure 1. WES Analysis Workflow. Supplementary Figure 2. Variant Strand Bias. Supplementary Figure 3. Somatic Variant Filtering. Supplementary Figure 4. Manual Somatic Variant Inspection. Supplementary Figure 5. Genetic Admixture Analysis. Supplementary Figure 6. Comparison of somatic variant count based on normal sample usage. Supplementary Figure 7. TCGA EA Somatic Variant Lollipop Plots. Supplementary Figure 8. NG PCa Novel Somatic Variants. Supplementary Figure 9. Nigerian Germline Variant – Normal/Tumor Comparison Lollipop Plots. Supplementary Figure 10. TCGA PCa Somatic Variant COSMIC Signature Analysis.

In this study, we used whole-exome sequencing of a cohort of 45 advanced-stage, treatment-naïve Nigerian (NG) primary prostate cancer (PCa) tumors and 11 unmatched non-tumor tissues to compare genomic alterations with African American (AA) and European American (EA) TCGA PCa. NG samples were collected from 6 sites in central and southwest Nigeria. After whole-exome sequencing, samples were processed using GATK best practices. BRCA1 (100%), BARD1 (45%), BRCA2 (27%), and PMS2(18%) had germline alterations in at least two NG non-tumor samples. Across 111 germline variants, the AA cohort reflected a pattern [BRCA1 (68%), BARD1 (34%), BRCA2 (28%), and PMS2 (16%)] similar to NG samples. Of the most frequently mutated genes, BRCA1 showed a statistically (p ≤ 0.05) higher germline mutation frequency in men of African ancestry (MAA) and increasing variant frequency with increased African ancestry. Disaggregating gene level mutation frequencies by variants revealed both ancestry-linked and NG-specific germline variant patterns. Driven by rs799917 (T>C), BRCA1 showed an increasing mutation frequency as African admixture increased. BRCA2_rs11571831 was present only in MAAs, and BRCA2_rs766173 was elevated in NG men. 133 somatic variants were present in 26 PCa-associated genes within the NG tumor cohort. BRCA2 (27%), APC (20%), ATM (20%), BRCA1 (13%), DNAJC6 (13%), EGFR (13%), MAD1L1 (13%), MLH1 (11%), and PMS2 (11%) showed mutation frequencies > 10%. Compared to TCGA cohorts, NG tumors showed statistically significant elevated frequencies of BRCA2, APC, and BRCA1. The NG cohort variant pattern shared similarities (cosign similarities ≥ 0.734) with COSMIC signatures 5 and 6, and mutated genes showed significant (q < 0.001) GO and functional enrichment in mismatch repair and non-homologous repair deficiency pathways. Here, we showed that alterations in DNA damage response (DDR) genes were higher in NG PCa samples and that a portion of those alterations correlate with African ancestry. Moreover, we identified variants of unknown significance that may contribute to population-specific routes of tumorigenesis and treatment. These results present the most comprehensive characterization of the NG PCa exome to date and highlight the need to increase diversity of study populations.

INTRODUCTION The Prostate Cancer Transatlantic Consortium (CaPTC) has the goal of better understanding the burden of prostate cancer among Black men of West African descent. While prostate cancer disproportionately affects Blacks around the world, little research is done to understand what mental health and social support play a role in prostate cancer risk factors. The purpose of this 10-year longitudinal study is to establish a cohort of U.S.-born Black men, West African-born Black men who reside in the U.S, and West African Black men in Africa who would be prospectively and longitudinally followed to better understand the cause of prostate cancer and how different factors might influence it. METHODS Study staff partnered with community-based organizations, events, and stakeholders to engage with the priority population. Snowball sampling was also used for recruitment. All participants were made aware of the longitudinal nature of the study and that they would be contacted every two years for follow-up. Informed consent was done in community settings electronically and on paper. Once consent was received, participants completed the survey with a unique identifier and filled out a Cohort Contact sheet. They were given the option to complete this on their own or with the help of the study staff. Study Staff would then measure participants’ weight, height, and waistline, to be recorded on the survey form. After this, participant saliva was collected and tracked with the unique identifier. All collected data was stored on RedCap and a Chi-squared test was utilized to identify statistical significance. RESULTS 803 participants are included in this data with 77 in Cameroon, 663 in Nigeria, and 59 in the United States. When asked about emotional support, 13.6% (US) 11.8% (Nigeria), and 14.3% (Cameroon) indicated never or rarely having emotional support. 5.8% of those in the United States, 5.6% of those in Nigeria, and 7.8% of those in Cameroon felt dissatisfied or very dissatisfied with their lives. The p-value for both was found to be Citation Format: Jessica Otero, Emeka Iweala, Ademola Popoola, Paul Jibrin, Mohammed Faruk, Anthonia Sowumi, Omolara Fatiregun, Nkegoum Blaise, Catherine Oladoyinbo, Ifeoma Okoye, Abdulkadir Ayo Salako, Abidemi Omonisi, Iya Eze Bassey, Kayode Adenji, Nggada Haruna Asura, Ernest Kaninjing, Oluwole Kukoyi, Parisa Fathi, Ruth Enuka, Oluwaseyi Toye, Jennifer Crook, Folakemi Odedina. Quality of life indicators including mental health factors in CaPTC prostate cancer familial cohort study of men of African Ancestry in Nigeria, Cameroon, and United States [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B073.

BACKGROUND Black populations are disproportionately affected by prostate cancer globally. The leading countries in prostate cancer mortality are found in Africa and the Caribbean. This data is being presented as part of the Prostate Cancer Transatlantic Consortium (CaPTC) Prostate Cancer Familial Cohort Study of African Ancestry study with the purpose of identifying the various factors that influence prostate cancer risk factors. Access to care, a known cancer risk factor, not only affects a person’s ability to receive treatment but to receive accurate health information, preventative care, diagnoses, and more. Researching exactly how different social determinants, such as this one, affect cancer risk factors for specific populations is imperative to reducing their cancer burden. METHODS: This ten-year prospective study started in 2017 and has been conducted in Nigeria, Cameroon, and the United States. Participants have been recruited in clinics and different community settings. Upon consent, participants were asked to complete a validated survey with a unique identifier on epidemiological, behavioral, clinical, and anthropometric variables. They were then asked to provide a saliva sample that was also given a unique identifier. Associations of characteristics from the survey were evaluated using logistic regression models. Others were tested for statistical significance using a Chi-Squared test. RESULTS: A total of 803 responses are included in this dataset. Of these participants, 9.6% were from Cameroon, 82.6% from Nigeria, and 7.3% from the United States. More than half of the participants (54.9%) shared they did not have healthcare coverage. In addition, a chi-squared test showed 10.2% in the United States, 13.9% in Nigeria and 35.1% in Cameroon were unable to see a physician due to cost with a p-value of less than .001 indicating statistical significance. While participants in the United States did not report any cancer diagnoses, logistical regression found a significant inverse relationship between health literacy and increased risk of a cancer diagnosis. CONCLUSION Research shows a relationship between health access factors and cancer risk factors, but little research is done for specific populations. Further research should be done to measure the exact impact access to care has on cancer diagnoses for specific communities. It is very important that health equity researchers assess exactly how these factors affect the specific populations they work with to tailor evidence-based interventions to their needs. Citation Format: Jessica Otero, Emeka Iweala, Ademola Popoola, Paul Jibrin, Mohammed Faruk, Anthonia Sowumi, Omolara Fatiregun, Nkegoum Blaise, Catherine Oladoyinbo, Ifeoma Okoye, Abdulkadir Ayo Salako, Abidemi Omonisi, Iya Eze Bassey, Kayode Adenji, Nggada Haruna Asura, Ernest Kaninjing, Oluwole Kukoyi, Parisa Fathi, Ruth Enuka, Oluwaseyi Toye, Jennifer Crook, Folakemi Odedina. Influence of access to care on cancer diagnoses in the CaPTC Prostate Cancer Familial Cohort Study of African Ancestry in Nigeria, Cameroon, and the United States [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B072.

Men of African ancestry (MAA) have the highest global incidence and mortality of prostate cancer (PCa); however, the biology underlying this harsh disease presentation remains poorly understand, largely due to Africans and people within the African diaspora being under-represented in genomics research. MAA are younger at diagnosis, have higher tumor volume at diagnosis and have higher tumor aggression compared to European American men. Additionally, genomic profiling continues to show that PCa etiology and phenotype are influenced by higher amounts of African ancestry and that West African ancestry is associated with unique genomic alterations. Herein we utilize whole exome sequencing of a unique cohort of 45 advanced stage, treatment naïve Nigerian primary PCa tumors and 11 unmatched non-tumor tissue to compare genomic variants with African (AA) and European (EA) American TCGA PCa tumors. Nigerian samples were collected from 6 sites in central and southwest Nigeria. After whole exome sequencing, samples were processed using GATK best practices. Four genes [BRCA1 (100%), BARD1 (45%), BRCA2 (27%) and PMS2 (18%)] had germline variants in at least two Nigerian non-tumor samples. Across 111 germline variants, the AA cohort reflected a pattern [BRCA1 (68%), BARD1 (34%), BRCA2 (28%) and PMS2 (16%)] similar to Nigerian samples. Of the most frequently mutated genes, BRCA1 showed a statistically (p ≤ 0.05) higher mutation frequency in MAA. Disaggregating gene level mutation frequencies by variant revealed both ancestry linked and Nigerian specific germline variant patterns. Driven by rs799917, BRCA1 showed increasing mutation frequency as African admixture increased. BRCA2_rs11571831 was only present in MAA and BRCA2_rs766173 was increased in Nigerian men. 133 somatic variants were present in 26 PCa associated genes within the Nigerian tumor cohort. Nine genes [BRCA2 (27%), APC (20%), ATM (20%), BRCA1 (13%), DNAJC6 (13%), EGFR (13%), MAD1L1 (13%), MLH1 (11%) and PMS2 (11%)] showed mutation frequencies above 10%. Compared to TCGA cohorts, BRCA2, APC and BRCA1 showed statistically significant increases in Nigerian tumors. The Nigerian cohort variant pattern shared similarities (cosign similarities ≥ 0.734) with COSMIC signatures 5 and 6 and mutated genes showed significant (q < 0.001) GO and functional enrichment in mismatch repair and non-homologous repair deficiency (HRD) pathways. Here, we show that variants in DDR genes are increased in Nigerian PCa and that a portion of those variants correlate with increased African ancestry. Moreover, we identify variants of unknown significance that may contribute to population specific routes of tumorigenesis and treatment. These results present the most comprehensive characterization of the Nigerian PCa exome to date and further highlight the need to increase study population diversity. Citation Format: Jason A. White, Ernest Kaninjing, Kayode A. Adeniji, Paul Jibrin, John O. Obafunwa, Chidiebere N. Ogo, Mohammed Faruk, Solomon Rotimi, Ademola Popoola, Omolara A. Fatiregun, Olabode P. Oluwole, Balasubramanyam Karanam, Wei Tang, Stefan Ambs, Folake T. Odedina, Damali N. Martin, Clayton Yates. Tumor only analysis of whole exome sequencing from a multi-institutional Nigerian prostate cancer cohort reveals DNA repair genes associated with African ancestry [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 1507.

Background: Cryptococcosis is a global disease problem. Although seen more frequently in the severely immuno-suppressed, it can also be seen in patients without apparent immuno-suppression. Patients with pulmonary Cryptococcosis typically present with cryptococcal pneumonia while brain cryptococcosis present with meningitis. Case presentation: Here we present our experience in the management of a 33-year-old immunocompetent man, diagnosed of invasive pulmonary Cryptococcal disease with spread to the brain. This case is unique because the patient was previously treated for tuberculosis and presented with typical bronchopulmonary (difficulty in breathing and cough), thoracic (diminished breath sounds and dull percussion notes), extra-thoracic (intra-cranial space occupying lesion) as well as Computed Tommography (CT) Scan features attributable to lung cancer. Diagnosis of Cryptococcosis was made by identification of oval thick-walled yeast on histology of lung biopsy specimen.Conclusions: We conclude that invasive Cryptococcosis affecting the lung and brain may present with a clinical picture similar to metastatic lung cancer. We recommend routine fungal stains and fungal culture in suspected cases.

Background. Peptic ulcer disease (PUD) remains one of the most prevalent gastrointestinal diseases and has been linked to Helicobacter pylori (H. pylori) infection. This condition may be suspected on clinical grounds, but diagnosis is established using upper gastrointestinal endoscopy. Aims. To determine the correlation between the endoscopic and pathological findings among suspected PUD patients who have been referred for diagnostic upper gastrointestinal endoscopy in National Hospital Abuja. Methods. This is a hospital-based prospective study conducted among suspected PUD patients at National Hospital Abuja over a one-year period. Clinical, endoscopic, and histological findings were ascertained and documented. Data obtained were analyzed using SPSS version 21.0. Tests of significance were done using the chi-square test and Student t -test at 95% confidence intervals. Results. One hundred and thirty-two patients were included in the study. The ages ranged from 15 to 87 years, mean age 43.30 ± 11.94 years. Seventy-seven (58.3%) patients had abnormal endoscopic findings, of whom 37 (28.0%) had PUD. Prevalence of H. pylori infection was 42.2% and was found in 81.1% of PUD patients. H. pylori was significantly associated with confirmed PUD ( p < 0.001 ) and abnormal endoscopic findings ( p < 0.001 ). No association was found between normal endoscopic findings and histological findings ( p = 0.924 ). Conclusion. There is a poor correlation between clinical and endoscopic diagnoses of PUD. H. pylori was found to be significantly associated with PUD and abnormal endoscopic findings. Endoscopic facilities should therefore be made available and accessible for proper PUD diagnosis. Empirical treatment of H. pylori in patients with diagnosed PUD is strongly recommended.

Background Men who have sex with men (MSM) living with HIV are at increased risk for anal cancer. We evaluated satisfaction with first-time anal cancer screening using high resolution anoscopy (HRA) as a cross sectional survey among men who have sex with men (MSM) attending a community-engaged clinic in Abuja, Nigeria. Methods Between March and August 2017, 342 MSM underwent screening and 307 (89%) completed a satisfaction survey that evaluated 8 domains related to expectations, convenience, staff interpersonal skills, physical surroundings, technical competence, pain/discomfort, general satisfaction, and intention to re-screen if symptomatic. The 22-item questionnaire used 5-point Likert scales ranging from 1 (strongly disagree) to 5 (strongly agree). For each domain, responses to specific items were averaged, aggregated, and converted to a 100-point scaled score (SS) with 25 and 75 corresponding to disagree and agree, respectively. Results Median age was 24 years (interquartile range [IQR]: 22–28), median years since anal coital debut was 7 (IQR: 4–12), and 58% (95% confidence interval [CI]: 52–64%) were living with HIV. Despite respondents reporting pre-procedure anxiety (SS:73), most were comfortable with the setting and procedure and reported overall satisfaction (SS:74–76). Willingness to undergo future screening had the lowest score (SS:69) within the general satisfaction domain. The lowest scoring domains were pain/discomfort (SS:57) and agreement to re-screen if symptomatic (SS:59), which correlated with lower overall satisfaction (p p > 0.006) or number of anal biopsies (all p > 0.05). Conclusions Overall, HRA was satisfactory for those naïve to screening but moving forward necessitates monitoring levels of discomfort with pain scales and normalizing dialogue around clinical symptoms of anal cancer and overall anal health to sustain future screening.

PURPOSE Anal cancer risk is substantially higher among HIV-infected men who have sex with men (MSM) as compared with other reproductive-age adults, but screening is rare across sub-Saharan Africa. We report the use of high-resolution anoscopy (HRA) as a first-line screening tool and the resulting early outcomes among MSM in Abuja, Nigeria. METHODS From August 2016 to August 2017, 424 MSM enrolled in an anal cancer screening substudy of TRUST/RV368, a combined HIV prevention and treatment cohort. HRA-directed biopsies were diagnosed by histology, and ablative treatment was offered for high-grade squamous intraepithelial lesions (HSIL). HRA proficiency was assessed by evaluating the detection of squamous intraepithelial lesions (SIL) over time and the proportion biopsied. Prevalence estimates of low-grade squamous intraepithelial lesions and HSIL with 95% CIs were calculated. Multinomial logistic regression was used to identify those at the highest risk of SIL. RESULTS Median age was 25 years (interquartile range [IQR], 22-29), median time since sexual debut was 8 years (IQR, 4-12), and 59% (95% CI, 54.2% to 63.6%) were HIV infected. Rate of detection of any SIL stabilized after 200 screenings, and less than 20% had two or more biopsies. Preliminary prevalence estimates of low-grade squamous intraepithelial lesions and HSIL were 50.0% (95% CI, 44.7% to 55.3%) and 6.3% (95% CI, 4.0% to 9.3%). HIV infection, at least 8 years since anal coital debut, concurrency, and external warts were independently statistically associated with SIL. CONCLUSION Proficiency with HRA increased with experience over time. However, HSIL detection rates were low, potentially affected by obstructed views from internal warts and low biopsy rates, highlighting the need for ongoing evaluation and mentoring to validate this finding. HRA is a feasible first-line screening tool at an MSM-friendly health care facility. Years since anal coital debut and external warts could prioritize screening.

Background: Prostate cancer (PCa) is the leading cause of cancer death among Nigerian men, with most men presenting late and with high grade disease. Furthermore, improved PCa diagnosis and treatment could rely on genomics-driven precision approaches. Mounting evidence supports potential population enriched molecular features of cancer, however the extent of which is hampered due to a dearth of genomic data in diverse cohorts. This study, therefore, aims at utilizing transcriptomics analysis to deduce transcriptional states in PCa from Nigerian men. Methodology: RNA was extracted from macro-dissected prostate tumor and adjacent normal tissue from 35 archival formalin fixed paraffin-embedded (FFPE) blocks from Gleason 8-9 cancers, of which 25 had cribriform morphologic architecture. High resolution hybrid-capture mRNA-seq libraries were sequenced using Illumina NovaSeq 6000 system and generated an average of 124 million read pairs per sample. Raw reads were processed using a custom pipeline based upon industry standard algorithms along with the deduction of genetic ancestry. Molecular annotation was also performed to investigate tumor and immune cell heterogeneity. Result: The Nigerian data were compared with high grade PCa data of Caucasian obtained from TCGA. The Nigerian PCa tumors where characterized with uniquely enriched immune-inflammatory microenvironment which include crosstalk between dendritic cells and natural killer cells, and natural killer cell signaling. While the Nigerian tumors share more features of distal metastatic tumor, their enrichment in NKT Cells is a unique feature. Conclusion: This represents the first report of RNA-seq analysis of PCa in Sub-Saharan Africa and the unique transcriptomics features of Nigerian PCa presents opportunities for precision intervention in addressing its burden in Nigeria. Citation Format: Solomon Oladapo Rotimi, Abidemi E. Omonisi, Faruk Mohammed, Paul Jibrin, Babatunde Duduyemi, Daniel B. Olusina, Yili Xu, Yuxin Jin, Xiyu Liu, Guang Q. Xiao, Folakemi Odedina, John Carpten, Renee Reams, Zarko Manojlovic. Transcriptomics analysis reveals unique immunoinflammatory signatures of nigerian prostate cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 862.

Background: Men of African ancestry experience higher burden from prostate cancer compared to men of other ancestral backgrounds. Limitations in the availability of high-quality biospecimens have hindered the inclusion of this population in genetic studies of prostate cancer. The use of formalin-fixed paraffin-embedded (FFPE) tissues represents a potential rich source of genetic material particularly in some international settings, where fresh frozen tissue is difficult to obtain. Methods: A total of 976 FFPE blocks were collected between 2002 and 2017 from six international sites in Africa and the Caribbean. Genomic DNA was checked for quality and quantity. Differences in mean quality control (QC) for pre and post pathology training were assessed using t-test. Pearson chi-square with trend analysis examined association between time-category and QC success status. Association of continuous DNA quality (Q129/Q41 ratio) and time of specimen collection was estimated with linear regression. Samples with a DNA quantity >0.2µg and a Q129/Q41 ratio >0.00225 were submitted for whole exome sequencing (WES). Findings: Specimens from 2002 to 2010 and 2011 to 2017 had an average total DNA yield of 1.4 μg and 2.4 ug, respectively. There was a statistical positive difference in the quality of DNA samples over time indicating an improvement in quality of specimens. For the samples Insert size, mean mapping quality and alignment error rate significantly (p≤0.05) improved for samples submitted for WES, post pathology training. Interpretation: FFPE samples from low-resource settings could potentially provide sufficient DNA for WES. Improvements in biospecimen collection for research are needed in these settings. Citation Format: Ernest Kaninjing, Damian Francis, Katy Brignole, Keyode Adeniji, William Aiken, Cherif Dial, Mohammed Faruk, Omolara Fatiregun, Andrew Gachii, Denise Gibbs, Serigne Gueye, Maria Jackson, Mohamed Jalloh, Paul Jibrin, B. Karanam, Jyoti Kumar Shravana, Mamadou Ndoye, Ogo Chidiebere Ndukwe, John Obafunwa, Folakemi Odedina, Ademola Popoola, Camile Ragin, Jason White, Clayton Yates, Damali N. Martin. Utility of formalin-fixed, paraffin embedded prostate biospecimens from low-resource international settings for use in next generation sequencing studies in African-descent populations [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-135.

INTRODUCTION Prostate Cancer (CaP) disproportionately overburden men of African ancestry, especially Black men (BM). Unfortunately, few CaP studies have focused on the heterogeneity of BM within the US as well as the source population of US BM in Africa. The Prostate Cancer Transatlantic Consortium (CaPTC) team has documented differences in CaP-related behavioral factors, health-seeking behaviors and experiences between US-born and foreign-born Blacks since 2005. The CaPTC familial cohort study was developed to understand the genetic, environmental and behavioral etiology of CaP in West African men (WAm). This presentation focuses on the impact of migration on prostate health factors among WAm. Methodology The CaPTC cohort study in a longitudinal study and is still ongoing. The inclusion criteria are WAm, age 35-70 years, and residing in the US, Nigeria and Cameroon. Participants were recruited in diverse community settings. Data were collected from participants who provided informed consent using the CaPTC-AC3 Global Prostate Cancer Measure. The variables included in this presentation are general demographics, cultural beliefs and values, health beliefs, sun exposure, vitamins, body shape, and baldness. In addition, self-reported measures of prostate health were assessed. In addition to descriptive analyses, ANOVA/comparative analyses was used to examine differences among WAm in the US, Nigeria and Cameroon. Results The scales employed for the construct were highly reliable (alpha over 0.80). By December 2018, the sample size was 704 WAm with 81% recruited in Nigeria, 10% recruited in Cameroon and 9% recruited in the US. The average age was 48. Most of the WAm live in Nigeria, are married, middle-income level, Christian by faith and had never been screened for CaP. There was statistically significant differences among the WAm based on their country of residence with respect to CaP history (Nigeria), skin color (darker skin color in Cameroun), vitamin use (mostly by WAm in US), and pattern of baldness at age 30 (WAm in Nigeria). In addition, there was statistically significantly differences relative to cultural beliefs and values (cancer fatalism, religiosity, temporal orientation) and health beliefs (perceived barrier, perceived benefit). Cancer fatalism was lowest among WAm in US; religiosity was highest among WAm in Nigeria; WAm in the US were more future-oriented and WAm in Cameroun more present-oriented; perceived barrier was lowest for WAm in US; and perceived benefit highest for WAm in the US. Conclusion The increasing number of the African immigrant group in the US underscores the need to study within group difference among Blacks in the US. Unfortunately, this group is understudied and may offer a novel approach to fully understand cancer disparities in Blacks. Studying the impact of migration on CaP burden in this population provides several advantages, including identification of CaP risk factors. Our study confirms that migration impacts prostate health factors among WAm. Note: This abstract was not presented at the conference. Citation Format: Folakemi Odedina, Getachew Dagne, Adaora Ezeani, Ernest Kaninjing, Catherine Badejo, Anthonia Sowunmi, Omolara Fatiregun, Ayo Salako, Ademola Popoola, Mohammed Faruk, Emeka Iweala, Iya Bassey, Chidiebere Ogo, HA Nggada, Paul Jibrin, Oluwole Kukoyi, Ifeoma Okoye, Abidemi Omonisi, Iheanyi Okpala, Kayode Adeniji, Ruth Agaba, Oluwaseyi Adeniji, Desiree Rivers, Renee Reams, Clayton Yates. Impact of migration on prostate health factors among West African men in US, Nigeria and Cameroon: Findings from the CaPTC familial cohort study [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr C024.

Background Healthcare disparities among racial and ethnic groups have been well documented across all aspects of clinical healthcare, and disparities in attainment of preventive services are particularly prevalent. African immigrants may be particularly susceptible to factors that contribute to healthcare disparities but little is known about this population. The purpose of this study was to assess patient-provider concordance and trust of health care providers among West African immigrants in the US. In addition, we explored the relationship between these variables and the prostate cancer (CaP) screening behavior of participants. Methods Data collection was part of a global study of prostate cancer in West African men. A study questionnaire was used to collect data from West African male immigrants in the US between the ages of 35 and 70 years. Survey scales for this study included country of birth, years since immigration, patient–provider concordance, trust of healthcare provider, attitude and cues towards CaP screening (PSA and DRE), and CaP screening history. Results There were 38 African immigrants from Cameroon, Nigeria, Sierra Leone, and Ghana. Participants’ average age was 46.2 years and they had spent an average of 13.9 years in the US. Most of the participants (over 60%) stated that they had no preference in regards to their provider race, ethnicity or gender. Over 70% indicated that their physician was of different ethnicity and race while 50% indicated that their physician was of a different gender. Furthermore, most respondents noted that they trusted their physicians with health decisions. However, 61% and 68% of participants did not complete PSA or DRE testing, respectively. Most stated that they did not discuss the advantages or disadvantages of prostate cancer screening with their physicians, noting they mostly received cues to getting tested from reading information, radio, and/or TV. Conclusion Although health disparities can be explained by socioeconomic status such as lack of insurance and various other observable impediments to accessing health care, others barriers persist. It is important to explore other contributing factors such as patient-physician relationships. This study suggests that patient-provider concordance may not be a priority. Emphasis should be placed on encouraging physician-initiated discussion on CaP screening. Unfortunately, current physician guidelines do not stress CaP screening and fail to account for the documented increased risk and early onset of CaP in Black men. Citation Format: Nissa Askins, Ruth Agaba, Oluwaseyi Adeniji, Adaora Ezeani, Ernest Kaninjing, Folakemi Odedina, Catherine Badejo, Anthonia Sowunmi, Omolara Fatiregun, Ayo Salako, A. A Popoola, Mohammed Faruk, Emeka Iweala, Iya Bassey, Chidiebere Ogo, O. P. Oluwole, H. A. Nggada, Paul Jibrin, Ifeoma Okoye, Abidemi Omonisi, Iheanyi Okpala, A Adeniji, Toye Adeniji. Patient and provider concordance and trust in providers among West African Immigrants: Findings from the CaPTC Familial Cohort Study [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr D034.

Background African immigrants represent one of the fastest growing groups of immigrants in the US, resulting in increased diversity of Blacks in the US. Therefore, there is a growing need to assess the healthcare needs and practices of this population. The main public health concern has been on infectious disease but priority should also focus on chronic disease. Specifically, the literature has yet to provide consistent results regarding the “healthy immigrant effect”, specifically that immigrants are in relatively better health on arrival before their health converges with native-born levels after time. Using the data collected by the Prostate Cancer Transatlantic Consortium (CaPTC), this study explores chronic disease history and healthy behaviors of male immigrants from West Africa with length of residence in the US. Methods A study questionnaire was used to collect data on West African (WA) Black men residing in Nigeria, Cameroon, and the United States. Data from 709 respondents, Black men between the ages of 35-70 years, recruited from community settings, was collected. Variables analyzed included age, education level, income, smoking and alcohol use, weight, height, physical activity levels, country of birth, country of residence, years since immigration, chronic disease history, and health insurance status. Descriptive analysis was used to determine the frequency of each condition among participants. Results There were 37 respondents, WA males, residing in the US; 26 born in Cameroon, 10 born in Nigeria, 1 born in Sierra Leone, 1 born in Ghana. The average age was 46.2 years and the average length of residency was 13.9 years. Participants were placed in two groups: length of residence in the US of less than or equal to 10 years (LT10Y) and greater than 10 years (GT10Y). This study focused on the most common chronic diseases in the US: high blood pressure (HB), high cholesterol (HC), diabetes (D), stroke/transient ischemic attack (ST), COPD, Alzheimer’s (AZ), and arthritis (AT). Although there was no statistical significant differences between participants who lived greater than 10 years in the US compared to those who resided 10 years or less, there was practical differences. For example, 39% in the LT10Y group had been diagnosed with HBP versus 42% in the GT10Y group. With larger sample size, it is likely that there may be statistical differences. There was statistical significant differences in HC diagnosis with 5% in LT10Y and 22.2% in GT10Y. The GT10Y group showed decreased alcohol use, increased frequency of physical activity, and frequent annual physician visits and had higher income and education level. Conclusion Based on our results, we found length of stay of WA Black males in the US to impact HC diagnosis, alcohol use, physical activity, and physician visits. The “healthy immigrant” phenomenon is likely to be moderated by several factors and need to be studied more among African immigrants. Citation Format: Adaora Ezeani, Ernest Kaninjing, Folakemi Odedina, Catherine Badejo, Anthonia Sowunmi, Omolara Fatiregun, Ayo Salako, A. A. Popoola, Mohammed Faruk, Emeka Iweala, Iya Bassey, Chidiebere Ogo, O. P. Oluwole, H. A Nggada, Paul Jibrin, Oluwole Kukoyi, Ifeoma Okoye, Abidemi Omonisi, Iheanyi Okpala, Lasebikan Nwamaka, A. Adeniji, Nissa Askins, Ruth Agaba, Oluwaseyi Adeniji. The effect of length of residence in the US on risk of developing chronic disease in West African male immigrants [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr C086.

Background/aims: Intracranial tumours demonstrate characteristic diagnostic histopathological features. Our aims were to look at the histo-pathological pattern of intracranial tumours in our environment including their age and sex distribution. Methods: The histology request forms and slides of all intracranial specimens submitted to the histo-pathology department of National Hospital, Abuja, over an 11 year period (2005 and 2015) were retrospectively reviewed. Results: Intracranial specimens and intracranial tumours accounted for 0.6% and 0.5% respectively of all samples submitted. Meningiomas accounted for the most frequent diagnosis for all intracranial specimens and intracranial tumours at 35% and 41% respectively followed by pituitary adenoma at 19% and 22%, and astrocytoma at 13% and 20%. The male female ratio for all diagnoses was 1:1. The mean age at diagnosis was 35 ± 17.1 years. The frequency of intracranial tumours in children was 11.8% with a mean age of 8.3 ± 4.4 years and an equal sex distribution. In children, glioma and embryonal tumours were the most frequent diagnosis at 25%. Conclusion: The histo-pathological pattern of intracranial tumours in our environment showed that meningioma is the most common intracranial tumour in adults, while glioma and embryonal tumours are the most common intracranial tumours in children. Keywords: Histo-pathological pattern, intracranial tumour, meningioma, glioma, embryonal tumours.

Background: The risk for anal cancer is 52-fold higher in men who have sex with men (MSM) living with HIV but screening is not available in Nigeria. This study trained clinicians to screen and treat using high resolution anoscopy (HRA) and evaluate the prevalence of anal precancer. Methods: TRUST/RV368 recruited MSM for anal cancer screening in Abuja, Nigeria. Between Aug/2016-Aug/2017, 426 men completed a screening questionnaire, had a digital anorectal exam and underwent HRA. Participants could enroll in the study's initial training phase, the pilot study, or both. The most severe diagnosis on histology or cytology determined the final result. All men diagnosed with high-grade squamous intraepithelial lesions (HSIL) were offered ablative treatment with a hyfrecator. Results: Median age was 24 years (interquartile range [IQR]: 22–29) and median years since sexual debut was 6 (IQR:3–11). More HIV-infected MSM participated in the training phase as compared to the pilot (80% vs. 59%). For the 121 MSM screened during training, 9.9% (95% CI: 5.2–16.7) had low-grade squamous intraepithelial lesions (LSIL). For the 362 participants seen during the pilot study, 50.2% (95% CI:45.0–55.5) had LSIL, and 6.3% (95% CI:4.1–9.4) had HSIL. HSIL was not detected during training but it was more often detected among HIV-infected as compared to HIV-uninfected (8% vs. 4%, p

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