Translational Research Program in Colorectal Cancer Disparities (TRPCD)

Disparities in colorectal cancer incidence and mortality are sizeable and continue to persist in the United States. These disparities are particularly pronounced among Alaska Native and African American populations, with Alaska Native people experiencing among the highest incidence and mortality rates of colorectal cancer in the world. Colorectal cancer etiology is multi-dimensional and is influenced by diet, lifestyle factors, medical history, gut microbiome, and genetics. However, research to understand the biological bases for colorectal cancer has not adequately represented the several populations experiencing this disease, particularly those at the most elevated risk.

Our Translational Research Program on Colorectal Cancer Disparities (TRPCD) is specifically developed to include data and biospecimens from African American, Alaska Native, Hispanic/Latinx, and non-Hispanic White colorectal cancer patients in research that addresses the following knowledge gaps:

• Molecular and microbial characterization of colorectal cancer across diverse populations
• Identification of patients with elevated mortality risk who could benefit from more frequent surveillance or additional treatment modalities
• Discovery and validation of novel molecular/biological markers related to risk of lethal disease that may serve as potential therapeutic targets.

Using a community-based participatory research framework, we are currently advancing our capacity to conduct translational cancer disparities research by establishing a robust Developmental Research Program, by developing a biospecimen and data repository, and by implementing two high-quality research projects. In Project 1, we will conduct transcriptomic analyses on approximately 840 patient tumors to identify novel tumor-tissue based predictors of lethal colorectal cancer, overall and by racial/ethnic population. We include equal number African American, Alaska Native, Hispanic/Latinx, and non-Hispanic White colorectal cancer patients. In Project 2, we will study the gut microbiome in the same patient tumors to assess the impact of the gut microbiome on colorectal cancer mortality, overall and by racial/ethnic population.

This multi-institutional research effort is based on strong collaborative across the following institutions:

• Alaska Native Tribal Health Consortium, Alaska
• Cedars Sinai Samuel Oschin Comprehensive Cancer Institute, California
• Fred Hutch, Washington
• Ochsner Clinical Foundation, Louisiana

In addition to the scientific opportunities that sizeable racially and ethnically diverse studies provide, it is the responsibility of the scientific community to ensure that studies reflect the diversity of the US population. By including multiple racial and ethnic populations, we will ensure that research knowledge gained will serve a broad range of racial and ethnic populations.