Goding Sauer et al. Page 629

In this contemporary review by Goding Sauer and colleagues, individuals with lower educational attainment and some racial/ethnic minorities have a relatively high prevalence of modifiable risk factors and particularly suboptimal prevalence of screening. Smoking prevalence is six-fold higher among males without a high school (HS) education than female college graduates. Over 50% of black and Hispanic women are obese compared with 38% of whites and 15% of Asians. Breast, cervical, and colorectal cancer screening utilization is 20%–30% lower among those with <HS education compared to college graduates. Enhanced, multilevel efforts are needed to further reduce disparities in potentially modifiable risk factors and improve cancer screening.

Florea et al. Page 659

This study by Florea and colleagues sheds light on racial and ethnic disparities surrounding gastric cancer presentation and screening practices in the United States. Using gastric cancer cases from the SEER-Medicare database, the study found testing for one of the primary causative agents, Helicobacter pylori, to be low, even though noncardia gastric cancer, associated with the bacterial infection, was diagnosed more frequently among minority populations. Furthermore, H. pylori testing was low among those with a history of gastric cancer–related conditions. Future studies can investigate reasons for low testing rates among these patients.

Gerlovin et al. Page 675

Pancreatic cancer incidence is higher in African Americans than in U.S. whites. Poor oral health, which is disproportionately common in African Americans, has been linked to risk of pancreatic cancer in studies of predominantly white populations. Gerlovin and colleagues examined the relation of self-reported oral health to pancreatic cancer incidence in the prospective Black Women's Health Study. Adult tooth loss was associated with a significantly increased risk of pancreatic cancer, particularly among nonsmokers. The poor oral health experienced by many African Americans may contribute to their higher incidence of pancreatic cancer.

Jenkins et al. Page 690

Chemokines and their receptors are key regulators of immune cell recruitment into the tumor microenvironment. This study by Jenkins and colleagues found that Atypical Chemokine Receptor 1 (DARC/ACKR1) expression in breast tumors is associated with circulating and tumor levels of CCL2/MCP-1 and CXCL8/IL8 in breast cancer patients. These were also associated with tumor-associated immune cell landscapes, implicating DARC/ACKR1 as a regulator of tumor immune response. African Americans had lower DARC/ACKR1 tumor expression with distinct immune cell profiles, compared with white Americans. Low DARC expression in tumors is also associated with shorter survival and the African-specific regulatory variants of DARC/ACKR1 likely cause these differences in tumor phenotypes, ultimately contributing to mortality disparities.