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Article: Investigation of Novel Urinary Biomarkers in Hepatocellular Carcinoma Risk in a Predominantly African American Population: A Case-Control Study.

Shingina, Alexandra / Han, Xijing / Fan, Lei / Murff, Harvey / Coffey, Robert / Milne, Ginger L / Dai, Qi / Shrubsole, Martha

Gastrointestinal tumors

2024 Volume 10, Issue 1, Page(s) 29–37

Abstract: Introduction: African Americans are at increased risk of hepatocellular carcinoma (HCC) compared to other racial and ethnic groups. We investigated the associations of four urinary biomarkers of prostaglandin E: Methods: We conducted a nested case- ... ...

Abstract	Introduction: African Americans are at increased risk of hepatocellular carcinoma (HCC) compared to other racial and ethnic groups. We investigated the associations of four urinary biomarkers of prostaglandin E Methods: We conducted a nested case-control study (50 cases; 43 with HCC, 151 controls) in the Southern Community Cohort Study (SCCS), a large prospective cohort study including over 80,000 study participants, of whom two-thirds are African Americans. Urine samples were collected at enrollment and subsequently analyzed to assess biomarker levels. Multivariable regression models adjusted for age, race, sex, BMI, smoking status, NSAID use, education level, income, and alcohol consumption were used to assess the relationship between the biomarker and HCC risk. Results: Only 11dTxB Conclusion: 11dTXB
Language	English
Publishing date	2024-03-08
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2735769-7
ISSN	2296-3766 ; 2296-3774
ISSN (online)	2296-3766
ISSN	2296-3774
DOI	10.1159/000538131
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Article: The association between neighborhood obesogenic factors and prostate cancer risk and mortality: the Southern Community Cohort Study.

Kumsa, Fekede Asefa / Fowke, Jay H / Hashtarkhani, Soheil / White, Brianna M / Shrubsole, Martha J / Shaban-Nejad, Arash

Frontiers in oncology

2024 Volume 14, Page(s) 1343070

Abstract: Background: Prostate cancer is one of the leading causes of cancer-related mortality among men in the United States. We examined the role of neighborhood obesogenic attributes on prostate cancer risk and mortality in the Southern Community Cohort Study ( ...

Abstract	Background: Prostate cancer is one of the leading causes of cancer-related mortality among men in the United States. We examined the role of neighborhood obesogenic attributes on prostate cancer risk and mortality in the Southern Community Cohort Study (SCCS). Methods: From the total of 34,166 SCCS male participants, 28,356 were included in the analysis. We assessed the relationship between neighborhood obesogenic factors [neighborhood socioeconomic status (nSES) and neighborhood obesogenic environment indices including the restaurant environment index, the retail food environment index, parks, recreational facilities, and businesses] and prostate cancer risk and mortality by controlling for individual-level factors using a multivariable Cox proportional hazards model. We further stratified prostate cancer risk analysis by race and body mass index (BMI). Results: Median follow-up time was 133 months [interquartile range (IQR): 103, 152], and the mean age was 51.62 (SD: ± 8.42) years. There were 1,524 (5.37%) prostate cancer diagnoses and 98 (6.43%) prostate cancer deaths during follow-up. Compared to participants residing in the wealthiest quintile, those residing in the poorest quintile had a higher risk of prostate cancer (aHR = 1.32, 95% CI 1.12-1.57, Conclusion: Living in a lower-nSES area was associated with a higher prostate cancer risk, particularly among Black men. Restaurant and retail food environment indices were also associated with a higher prostate cancer risk, with stronger associations within overweight White individuals. Finally, residing in a low-SES neighborhood or the least walkable areas were associated with a higher risk of prostate cancer mortality.
Language	English
Publishing date	2024-04-09
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2649216-7
ISSN	2234-943X
ISSN	2234-943X
DOI	10.3389/fonc.2024.1343070
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Article ; Online: Association of cardiometabolic comorbidities with mortality among low-income Black and White Americans.

Pradhan, Pranoti / Wen, Wanqing / Shrubsole, Martha / Steinwandel, Mark / Han, Xijing / Powers, Alvin C / Lipworth, Loren / Zheng, Wei

Journal of the National Medical Association

2024 Volume 116, Issue 2 Pt 1, Page(s) 189–201

Abstract: Methods: Investigated the association of multiple cardiometabolic comorbidities with total/major cause-specific mortality and evaluate if this association might be modified by race among predominantly low-income Black and White participants.: Methods!# ...

Abstract	Methods: Investigated the association of multiple cardiometabolic comorbidities with total/major cause-specific mortality and evaluate if this association might be modified by race among predominantly low-income Black and White participants. Methods: The Southern Community Cohort Study, prospective cohort study. Participants (40-79 years) recruited predominantly from community health centers across 12 states in southeastern United States. Enrollment began in 2002 and concluded in 2009, follow-up until 2020. Cardiometabolic comorbidities (diabetes, hypertension, myocardial infarction, stroke) ascertained at the baseline survey. Cox proportional hazard models used. Results: Study included 76,721 participants; 16,197, 41,944, 5,247, and 4,919 participants with prior diagnosis of diabetes, hypertension, myocardial infarction, and stroke, respectively at baseline. Compared to individuals with no comorbidity, individuals with any single comorbidity experienced a significantly 30 to 90% increased rate of death due to any causes. The increase in mortality was elevated with an increasing number of comorbidities, with HR of 3.81 (95% CI: 3.26-4.46) and a cumulative risk of 62.5% at age 75 years for total mortality for those with four comorbidities. The risk was high for death due to cardiovascular diseases (HR: 6.18, 95% CI: 5.12-7.47). These associations were stronger among Blacks than Whites. Individuals with four comorbidities at age 40 years were estimated to have a 16-year loss in life expectancy compared with those without any comorbidity. Conclusion: Cardiometabolic comorbidities were associated with increases in all-cause and major cause-specific mortality, particularly Black Americans. This study calls for effective measures to prevent cardiometabolic comorbidities to reduce premature deaths in underserved Americans.
MeSH term(s)	Humans ; United States/epidemiology ; Aged ; Adult ; Black or African American ; Cohort Studies ; Prospective Studies ; White ; Comorbidity ; Diabetes Mellitus ; Myocardial Infarction ; Stroke/epidemiology ; Hypertension/epidemiology
Language	English
Publishing date	2024-01-30
Publishing country	United States
Document type	Journal Article
ZDB-ID	419737-9
ISSN	1943-4693 ; 0027-9684
ISSN (online)	1943-4693
ISSN	0027-9684
DOI	10.1016/j.jnma.2024.01.009
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Article ; Online: Supplement use and gastric cancer risk in the Southern Community Cohort Study.

Goodwin, Jessica C / Wang, Qichen / Lin, Pao-Hwa / Shrubsole, Martha J / Epplein, Meira

Cancer causes & control : CCC

2023 Volume 34, Issue 10, Page(s) 897–907

Abstract: Purpose: Gastric cancer remains a racial health disparity in the US, but few studies have examined supplements as a potential protective factor. We examined associations between regular supplement use and gastric cancer risk among the predominantly ... ...

Abstract	Purpose: Gastric cancer remains a racial health disparity in the US, but few studies have examined supplements as a potential protective factor. We examined associations between regular supplement use and gastric cancer risk among the predominantly Black participants in the Southern Community Cohort Study (SCCS). Methods: Of the 84,508 individuals recruited in the SCCS from 2002 to 2009, 81,884 responded to the baseline question: any vitamin or supplement taken at least once per month in the past year. Secondary analyses assessed specific supplement use. Associations with incident gastric cancer were examined using adjusted Cox proportional hazards models, stratified by histologic subtype and secondarily by healthy eating index (HEI). Results: Approximately half of the participants (47%, n = 38,318) reported any regular supplement use. Among the 203 incident gastric cancers over the follow-up period (median, 7 years), 142 were non-cardia (NCGC), 31 cardia (CGC), and 30 unknown. Regular supplement use was associated with a 30% decreased risk of NCGC (hazards ratio (HR) 0.70; 95% confidence interval (CI) 0.49-0.99). Among participants below the HEI median, any regular supplement and multivitamin use were associated with a 52% and 70% decrease in risk of NCGC (HR 0.48; 95%CI 0.25-0.92 and HR 0.30; 95%CI 0.13-0.71), respectively. No associations were found for CGC. Conclusion: Regular supplement use, including multivitamins, was associated with a decreased risk of NCGC in the SCCS, particularly among participants with a lower quality diet. Inverse associations of supplement use and NCGC incidence provide support for clinical trials among high-risk populations in the US.
MeSH term(s)	Humans ; Cohort Studies ; Stomach Neoplasms/epidemiology ; Dietary Supplements ; Risk Factors ; Vitamins
Chemical Substances	Vitamins
Language	English
Publishing date	2023-06-13
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1064022-8
ISSN	1573-7225 ; 0957-5243
ISSN (online)	1573-7225
ISSN	0957-5243
DOI	10.1007/s10552-023-01734-7
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Article ; Online: Consumption of ultra-processed foods and all-cause and cause-specific mortality in the Southern Community Cohort Study.

Wang, Lei / Pan, Xiong-Fei / Munro, Heather M / Shrubsole, Martha J / Yu, Danxia

Clinical nutrition (Edinburgh, Scotland)

2023 Volume 42, Issue 10, Page(s) 1866–1874

Abstract: Background & aims: Higher intake of ultra-processed foods (UPF) has been linked with higher risks of cancer, cardiovascular disease, and diabetes, as well as all-cause mortality. However, studies on UPF and cause-specific mortality remain limited, ... ...

Abstract	Background & aims: Higher intake of ultra-processed foods (UPF) has been linked with higher risks of cancer, cardiovascular disease, and diabetes, as well as all-cause mortality. However, studies on UPF and cause-specific mortality remain limited, especially among disadvantaged populations. We aimed to examine associations of UPF intake with all-cause and cause-specific mortality among low-income Americans. Methods: In the Southern Community Cohort Study (SCCS), a prospective cohort of mostly low-income Black and White Americans, we included 77,060 participants who completed a food frequency questionnaire (FFQ) at baseline (2002-2009) and had at least 1 year follow-up. All 89 items in the FFQ were categorized using the Nova classification. UPF intake was calculated as % of daily foods intake by weight (grams). Cox regression was used to estimate HR (95% CI) for the association of UPF intake (quartile or per 10% increase) with total and cause-specific mortality (cancer, coronary heart disease [CHD], stroke, and diabetes) after adjusting for sociodemographics, lifestyles, and disease history. Results: Of 77,060 participants, 46,175 (59.9%) were women, 49,857 were Black (64.7%), and mean age was 52.4 (SD: 8.8) years at baseline. The mean intake of UPF was 41.0% (SD: 15.7%). UPF intake was inversely associated with Healthy Eating Index and intakes of fiber, minerals, and vitamins but positively associated with intakes of sugars and fats (all P Conclusions: Among predominantly low-income Black and White American adults, UPF intake was associated with increased diabetes mortality, especially for individuals with limited education or hypercholesterolemia. Our findings suggest the potential impact of increasing access and intake of un/minimally processed food to replace UPF on reducing diabetes-related mortality among populations facing socioeconomic and health disparities.
MeSH term(s)	Adult ; Humans ; Female ; Middle Aged ; Male ; Cohort Studies ; Food, Processed ; Diet ; Prospective Studies ; Cause of Death ; Hypercholesterolemia ; Neoplasms ; Stroke ; Fast Foods/adverse effects
Language	English
Publishing date	2023-08-18
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	604812-2
ISSN	1532-1983 ; 0261-5614
ISSN (online)	1532-1983
ISSN	0261-5614
DOI	10.1016/j.clnu.2023.08.012
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Article ; Online: Diet quality and lung cancer incidence in a low-income population in the United States.

Munro, Heather M / Yu, Danxia / Zheng, Wei / Blot, William J / Cai, Qiuyin / Shrubsole, Martha J

British journal of cancer

2023 Volume 129, Issue 4, Page(s) 626–635

Abstract: Background: Although tobacco smoking is the leading cause of lung cancer, interest in the relationship of diet quality on risk has been growing.: Methods: We examined the association between Healthy Eating Index-2010 (HEI-10) at enrollment and lung ... ...

Abstract	Background: Although tobacco smoking is the leading cause of lung cancer, interest in the relationship of diet quality on risk has been growing. Methods: We examined the association between Healthy Eating Index-2010 (HEI-10) at enrollment and lung cancer incidence among 70,802 participants in a predominantly African American and low-income prospective cohort in the southern United States. Outcomes were ascertained through linkages with state cancer registries and the National Death Index (NDI). Hazard ratios by HEI-10 quartiles were assessed using Cox proportional hazard models adjusted for potential confounders. Results: During ≤16 years of follow-up, 1454 incident lung cancers were identified. The lowest HEI-10 quartile compared to the highest was adversely associated with lung cancer risk (HR: 1.89, 95% CI 1.16-3.07) among male former smokers and female never smokers (HR: 2.58, 95% CI 1.06-6.28). Conclusions: Low-quality diet was associated with increased lung cancer risk among male former smokers and female never smokers but cautious interpretation of the findings should be taken due to the small number of lung cancers among never smokers and the possibility of residual confounding by smoking in ever smokers.
MeSH term(s)	Humans ; Male ; United States/epidemiology ; Female ; Risk Factors ; Prospective Studies ; Incidence ; Diet/adverse effects ; Poverty ; Lung Neoplasms/epidemiology ; Lung Neoplasms/etiology ; Proportional Hazards Models
Language	English
Publishing date	2023-07-03
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	80075-2
ISSN	1532-1827 ; 0007-0920
ISSN (online)	1532-1827
ISSN	0007-0920
DOI	10.1038/s41416-023-02342-7
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Article ; Online: Smoking Quit Rates Among Menthol vs Nonmenthol Smokers: Implications Regarding a US Ban on the Sale of Menthol Cigarettes.

Munro, Heather M / Shrubsole, Martha J / Zheng, Wei / Wen, Wanqing / Blot, William J

Journal of the National Cancer Institute

2022 Volume 114, Issue 7, Page(s) 953–958

Abstract: Background: A ban on the sale of menthol cigarettes in the United States is currently under consideration. A justification is that menthol cigarettes are harder to quit, particularly for African American smokers who use menthols much more frequently ... ...

Abstract	Background: A ban on the sale of menthol cigarettes in the United States is currently under consideration. A justification is that menthol cigarettes are harder to quit, particularly for African American smokers who use menthols much more frequently than White smokers, but epidemiologic data are limited. Methods: In a cohort of 16 425 mostly low-income African American and White current cigarette smokers enrolled during 2002-2009, we computed smoking quit and reuptake rates at 3 follow-ups conducted means of 4.6, 7.7, and 11 years after entry. Generalized estimation equations were used to compute odds ratios (ORs) and 95% confidence intervals (CIs) for quitting and resuming smoking for menthol vs nonmenthol smokers adjusted for race, age, education, income, and smoking pack-years. Results: Crude annual quit rates among current smokers were 4.3% for menthol and 4.5% for nonmenthol smokers, with adjusted odds ratios of quitting for menthol vs nonmenthol smokers of 1.01 (95% CI = 0.91 to 1.11) overall, 0.99 (95% CI = 0.87 to 1.12) among African American smokers, and 1.02 (95% CI = 0.88 to 1.20) among White smokers. Crude annual smoking reuptake rates were somewhat higher among menthol smokers (8.4%) than nonmenthol smokers (7.1%), with an adjusted odds ratio of 1.19 (95% CI = 0.97 to 1.47), but net quit rates remained similar (OR = 1.01, 95% CI = 0.90 to 1.13 overall; OR = 1.00, 95% CI = 0.86 to 1.15 among African American participants; and OR = 1.04, 95% CI = 0.87 to 1.24 among White participants). Conclusions: This large-scale prospective survey revealed similar quit rates among menthol and nonmenthol smokers. Results contribute to policy discussions, especially if, as a meta-analysis suggests, lung cancer risk is higher for nonmenthol smokers and a ban leads menthol smokers to switch to nonmenthol cigarettes.
MeSH term(s)	Humans ; Menthol ; Prospective Studies ; Smokers ; Smoking/adverse effects ; Smoking/epidemiology ; Smoking Cessation/methods ; Tobacco Products/adverse effects ; United States/epidemiology
Chemical Substances	Menthol (1490-04-6)
Language	English
Publishing date	2022-04-19
Publishing country	United States
Document type	Journal Article ; Meta-Analysis ; Research Support, N.I.H., Extramural
ZDB-ID	2992-0
ISSN	1460-2105 ; 0027-8874 ; 0198-0157
ISSN (online)	1460-2105
ISSN	0027-8874 ; 0198-0157
DOI	10.1093/jnci/djac070
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Article ; Online: Racial Disparities in Associations of Alcohol Consumption With Liver Disease Mortality in a Predominantly Low-Income Population: A Report From the Southern Community Cohort Study.

Fan, Lei / Zhu, Xiangzhu / Shingina, Alexandra / Kabagambe, Edmond K / Shrubsole, Martha J / Dai, Qi

The American journal of gastroenterology

2022 Volume 117, Issue 9, Page(s) 1523–1529

Abstract: Consistent with previous cross-sectional studies, in the Southern Community Cohort Study, the largest cohort for Black Americans conducted in a predominantly low-income population with 81,694 participants, we found that moderate alcohol drinking was ... ...

Abstract	Consistent with previous cross-sectional studies, in the Southern Community Cohort Study, the largest cohort for Black Americans conducted in a predominantly low-income population with 81,694 participants, we found that moderate alcohol drinking was associated with a significantly increased risk of mortality due to liver disease in Black Americans (hazard ratio = 2.06; 95% confidence interval: 1.08-3.94) but not in White Americans (hazard ratio = 0.87; 95% confidence interval: 0.52-1.44). We found that heavy drinking was significantly associated with an increased risk of mortality due to liver disease in both Black and White Americans. Future studies are warranted to understand the mechanism involving such racial disparity.
MeSH term(s)	Alcohol Drinking/epidemiology ; Cohort Studies ; Humans ; Liver Diseases ; Poverty ; White People
Language	English
Publishing date	2022-04-13
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	390122-1
ISSN	1572-0241 ; 0002-9270
ISSN (online)	1572-0241
ISSN	0002-9270
DOI	10.14309/ajg.0000000000001768
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Article ; Online: Assessing the role of the gut microbiome at the interface between environmental chemical exposures and human health: Current knowledge and challenges.

Campana, Anna Maria / Laue, Hannah E / Shen, Yike / Shrubsole, Martha J / Baccarelli, Andrea A

Environmental pollution (Barking, Essex : 1987)

2022 Volume 315, Page(s) 120380

Abstract: The explosion of microbiome research over the past decade has shed light on the various ways that external factors interact with the human microbiome to drive health and disease. Each individual is exposed to more than 300 environmental chemicals every ... ...

Abstract	The explosion of microbiome research over the past decade has shed light on the various ways that external factors interact with the human microbiome to drive health and disease. Each individual is exposed to more than 300 environmental chemicals every day. Accumulating evidence indicates that the microbiome is involved in the early response to environmental toxicants and biologically mediates their adverse effects on human health. However, few review articles to date provided a comprehensive framework for research and translation of the role of the gut microbiome in environmental health science. This review summarizes current evidence on environmental compounds and their effect on the gut microbiome, discusses the involved compound metabolic pathways, and covers environmental pollution-induced gut microbiota disorders and their long-term outcomes on host health. We conclude that the gut microbiota may crucially mediate and modify the disease-causing effects of environmental chemicals. Consequently, gut microbiota needs to be further studied to assess the complete toxicity of environmental exposures. Future research in this field is required to delineate the key interactions between intestinal microbiota and environmental pollutants and further to elucidate the long-term human health effects.
MeSH term(s)	Humans ; Gastrointestinal Microbiome ; Environmental Exposure ; Microbiota ; Environmental Pollutants/toxicity ; Hazardous Substances/toxicity
Chemical Substances	Environmental Pollutants ; Hazardous Substances
Language	English
Publishing date	2022-10-08
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	280652-6
ISSN	1873-6424 ; 0013-9327 ; 0269-7491
ISSN (online)	1873-6424
ISSN	0013-9327 ; 0269-7491
DOI	10.1016/j.envpol.2022.120380
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Article ; Online: Psychosocial impact of COVID-19 among adults in the southeastern United States.

Richmond, Jennifer / Sanderson, Maureen / Shrubsole, Martha J / Holowatyj, Andreana N / Schlundt, David G / Aldrich, Melinda C

Preventive medicine

2022 Volume 163, Page(s) 107191

Abstract: Limited research has explored the mental health impact of coronavirus disease 2019 (COVID-19) in the U.S., especially among Black and low-income Americans who are disproportionately affected by COVID-19. To address this gap in the literature, we ... ...

Abstract	Limited research has explored the mental health impact of coronavirus disease 2019 (COVID-19) in the U.S., especially among Black and low-income Americans who are disproportionately affected by COVID-19. To address this gap in the literature, we investigated factors associated with depressive and anxiety symptoms during the pandemic. From October to December 2020, over 4400 participants in the Southern Community Cohort Study (SCCS) completed a survey about the impact of the pandemic. The SCCS primarily enrolled adults with low income in 12 southeastern states. We used polytomous unconditional logistic regression to investigate factors associated with depressive and anxiety symptoms. About 28% of respondents reported mild or moderate/severe depressive symptoms and 30% reported mild or moderate/severe anxiety symptoms. Respondents in fair/poor health had significantly higher odds of moderate/severe depression and anxiety than those in very good/excellent health (depression: odds ratio (OR) = 4.72 [95% confidence interval (CI): 3.57-6.23]; anxiety: OR = 4.77 [95%CI: 3.63-6.28]). Similarly, living alone was associated with higher odds of moderate/severe depression and anxiety (depression: OR = 1.74 [95%CI: 1.38-2.18]; anxiety: OR = 1.57 [95%CI: 1.27-1.95]). Individuals whose physical activity or vegetable/fruit consumption decreased since the start of the pandemic also had higher odds of moderate/severe depression and anxiety. Results overall suggest that individuals in fair/poor health, living alone, and/or experiencing decreased physical activity and vegetable/fruit consumption have higher risk of depressive and anxiety symptoms. Clinical and public health interventions are needed to support individuals experiencing depression and anxiety during the pandemic.
MeSH term(s)	Adult ; Anxiety/epidemiology ; Anxiety/psychology ; COVID-19/epidemiology ; Cohort Studies ; Depression/epidemiology ; Depression/psychology ; Humans ; Pandemics ; SARS-CoV-2 ; United States/epidemiology
Language	English
Publishing date	2022-08-11
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, P.H.S. ; Research Support, Non-U.S. Gov't
ZDB-ID	184600-0
ISSN	1096-0260 ; 0091-7435
ISSN (online)	1096-0260
ISSN	0091-7435
DOI	10.1016/j.ypmed.2022.107191
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