UAMS Winthrop P. Rockefeller Cancer Institute Scientist Awarded $1.9 Million to Study Air Pollution, Breast Cancer

By Marty Trieschmann

Ping-Ching Hsu, Ph.D., an associate professor of Environmental Health Sciences in the UAMS Fay W. Boozman College of Public Health and a member of the Cancer Institute’s Cancer Prevention and Population Sciences Research Group, is the first UAMS researcher to receive federal funding for a large, population-based study on environmental exposure and cancer in rural Arkansas communities.

The five-year NIEHS grant will advance Hsu’s study of 26,000 Arkansas women, all study participants in the UAMS Arkansas Rural Community Health (ARCH) Study since 2007. ARCH is a large cohort of women ages 18 to 95 from all 75 counties in Arkansas that began as Spit for the Cure. In leading the study, Hsu has already discovered that the cohort has high proportions of women younger than 50 who were healthy when they enrolled and later developed breast cancer.

“We already know that among women in the cohort who joined that had breast cancer, 45.6% of them have early-onset breast cancer; among those who were healthy when they joined and now have breast cancer, 20% of them have early-onset breast cancer, which is very high,” said Hsu. “We have identified 709 mother-daughter pairs in the cohort — about 1,400 women — and we plan to follow them up, especially those who live close to communities that have high environmental exposures”.

Breast cancer is the most diagnosed cancer in women in the U.S. and in Arkansas. According to the American Cancer Society’s latest report, the mortality rate of breast cancer has declined in the last 30 years by 43%, but studies also revealed that breast cancer recorded the highest rate in early onset cases among all early onset cancers.

While genetics and inherited risk factors contribute to about 10% of all cancers, external factors such as environment and lifestyle may be responsible for a much larger portion of cancer risk and explain the increase in cancer among young adults under the age of 50.

“Arkansas is an agricultural state that might present with unique environmental exposures in different communities,” said Hsu. “The high risk and high exposure seen in this group of women is understudied, especially those living in rural areas.”

Hsu will use data from the EPA National Air Toxins Assessment, U.S. Geological Survey, the Arkansas Cancer Registry and patient-provided surveys, medical records and specimens to conduct an in-depth study of the association between environmental exposure and immune dysfunction in the cohort’s participants.

“There’s a lot of basic cancer research going on but none that’s looking hard at environmental exposure and cancer on a large scale here,” said Michael Birrer, M.D., Ph.D., director of the Winthrop P. Rockefeller Cancer Institute at UAMS. “These studies are critical in helping us understand how to prevent the early onset cancers that we’re seeing in our rural communities.”

The grant will pay for follow-up and outreach to as many as 850 participants among the mother-daughter pairs for additional biospecimen and exposure data with the potential to examine individual levels of heavy metals, pesticides and other chemical exposures that could be contributing to their disease. Recruitment of the participants will be led by the UAMS Rural Research Network and will leverage UAMS’ Regional Campuses across the state for biospecimen collection.

Hsu recently published the results of an initial study of the cohort in the high-impact journal, Environmental Pollution, and found several significant associations between air pollutants and breast cancer risk in the cohort.

“We need to raise awareness about the health risks of environmental exposure,” said Hsu. “Arkansas is feeding everyone in the nation, and we suffer from the exposure.”

One of the nation’s largest rural cancer studies, ARCH is a member of the National Cancer Institute (NCI) Cohort Consortium, which includes only 73 high-quality cohorts from 20 countries. Large, population-based studies like ARCH have been central to understanding the causes of cancer. The NCI Consortium includes more than 9 million study participants with biospecimens available on about 2 million. UAMS joins more than 40 NCI research groups in the consortium studying cancer in large populations.

The grant is supported by the NIEHS under award #1U24ES037082-01. The study is also supported by the UAMS Translational Research Institute, which is providing regulatory and informatics support for survey data collection. The institute is funded by the NIH National Center for Advancing Translational Sciences, Clinical and Translational Science Award #UM1TR004909.