Cancer Knows No Bounds, and Neither Should Equitable Cancer Research or Treatment

By Laura Romano, PhD

Hawaii, composed of a group of islands located in the central Pacific Ocean, joined the United States as the 50th state in 1959. Despite this, Native Hawaiians/Pacific Islanders (NH/PI) face disparities in cancer compared to the rest of the United States population, particularly in the incidence and mortality rates of colorectal cancer (CRC) (1, 2). These statistics caught the attention of Yuanyuan Fu, PhD, a Postdoctoral Fellow in the laboratory of Youping Deng, PhD, professor in the Department of Quantitative Health Sciences at the University of Hawaii John A. Burns School of Medicine. According to Dr. Fu, “NH/PI have poor representation in clinical, translational, genetic, and genomic cancer research, which not only limits our understanding of CRC among NH/PI, but also restricts the development of more effective and genetically targeted diagnoses and therapies among NH/PI.” 

“My passion for addressing cancer disparities is rooted in a strong belief in the fundamental right to equitable healthcare and a desire to contribute to the development of comprehensive strategies that foster inclusive and accessible cancer care for all individuals, irrespective of their background or socio-economic status,” Dr. Fu stated. This passion led her to study genetic factors that contribute to colorectal cancer disparities among NH/PI during her postdoctoral training, which began in 2019 under the mentorship of Dr. Deng. 

In 2022, Dr. Fu was awarded the AACR-Merck Cancer Disparities Fellowship for her project titled “Targeting colorectal cancer disparity in Native Hawaiians/Pacific Islanders.” This project seeks to utilize RNA-seq data from NH/PI and Caucasian Americans with CRC to uncover genetic differences unique to NH/PI. Identifying the genetic factors in NH/PI that contribute to CRC has the potential to uncover novel biomarkers for early detection and can reveal unique etiological pathways in NH/PI that contribute to their high rates of CRC. Importantly, these data may mitigate the CRC disparities faced by NH/PI compared to the rest of the U.S. population. 

“The AACR-Merck Cancer Disparities Research Fellowship has played a pivotal role in enabling me to pursue research endeavors that would not have been feasible without the support of this grant,” Dr. Fu explained. The financial support of this fellowship has given Dr. Fu access to critical resources, such as next-generation sequencing technologies and bioinformatics tools, to collect and perform in-depth analyses of genomic data from CRC patients. 

While the project is ongoing, potential biomarkers and underlying cancer development pathways have been identified thus far. Moreover, Dr. Fu stated that she has “uncovered key molecular signatures and genetic variations that are associated with disparate survival rates.” Thinking about the overall implications of her findings, Dr. Fu added that the results “will not only provide crucial insights into the underlying biological mechanisms driving CRC disparities, but also lay the foundation for the development of tailored, precision medicine approaches that aim to address these disparities and improve the clinical outcomes among NH/PI CRC patients.” 

However, to translate such advancements to patients and close the gap in cancer disparities, Dr. Fu acknowledged the need for collaboration across numerous sectors. As Dr. Fu shared, “collaborative efforts among researchers, clinicians, community leaders, and policymakers are needed to develop strategies that foster health equity and eliminate disparities in cancer care and outcomes.” Importantly, in cancer disparities research, it is critical to “ensure that the benefits of cutting-edge research are accessible to all individuals, regardless of their socio-economic status or geographic location,” Dr. Fu added. 

Reflecting on her experience as an AACR grantee, Dr. Fu shared that receiving this grant was a significant milestone in her career, and the external recognition of her work from fellow scientists reaffirmed the importance of her research in addressing cancer disparities. “This grant has truly been a catalyst for my continued commitment to addressing cancer disparities and promoting equitable access to quality cancer care for all individuals,” Dr. Fu commented. Recognition of early-stage scientists is critical to build the next generation of independent investigators. In Dr. Fu’s case, she shared that receiving this fellowship “opened significant opportunities for additional funding and collaborations.” Upon receiving this fellowship, Dr. Fu established key clinical and community partnerships and proceeded to apply for funding from the National Institutes of Health, which will be instrumental in launching her career as an independent researcher in the cancer health disparities field.  

The AACR will soon welcome applications for the 2024 AACR Cancer Disparities Research Fellowship. Dr. Fu encourages applicants to keep in mind the importance of their research to close gaps in cancer disparities. Dr. Fu shared that applicants should “embrace this opportunity to make a meaningful impact on the improvement of health outcomes for all individuals, irrespective of their background or socio-economic status. Your dedication to addressing disparities can pave the way for a more equitable and accessible future in cancer care.”  

References 

1. Siegel RL, Miller KD, Sauer AG, Fedewa SA, Butterly LF, Anderson JC, et al. Colorectal cancer statistics, 2020. CA Cancer J Clin. 2020;70:145-164. doi: 10.3322/caac.21601. 

2. Hawai’i Tumor Registry, University of Hawai’i Cancer Center. Hawai’i cancer at a glance 2014-2018. 2022. Available from: https://www.uhcancercenter.org/research/hawaii-cancer-statistics