# Examining differential effects of obesity on inflammation in ex-smokers to understand racial disparities in cancer risk

> **NIH NIH R21** · UNIVERSITY OF CHICAGO · 2020 · $297,374

## Abstract

PROJECT SUMMARY/ABSTRACT
Although African Americans smoke at similar or lower rates than non-Hispanic whites, their rates of lung
cancer incidence and mortality are significantly higher. Cigarette smoking contributes to approximately 80-90%
of lung cancer deaths; however, it does not fully elucidate racial disparities in lung cancer development.
Understanding mechanisms that contribute to racial disparities in lung cancer is a public health priority. Chronic
inflammation is a well-known pathway that directly links cigarette use to lung cancer carcinogenesis, and
smokers have an elevated level of C-reactive protein (CRP), a biomarker for systemic inflammation. Although
smoking cessation leads to a reduction in CRP over time, studies have shown that CRP does not fully return to
levels similar to never smokers. Thus, increased levels of CRP are associated with elevated risk of lung cancer
in former smokers. Several studies have shown that African Americans in the general population have higher
levels of CRP than non-Hispanic whites. However, no studies have documented race differences in long-
term change in CRP levels among those who have quit smoking. Research is needed to understand
differences in the mechanisms that predict how CRP levels change and eventually increase disease risk.
Although African Americans have similar smoking rates than non-Hispanic whites, they experience
disproportionate rates of obesity and post-cessation weight gain, or weight gain attributable to quitting
smoking. This weight gain may compound inflammation-related disease risk in former smokers, underlying
disparities seen in lung cancer development. The objective of our proposed study is to examine changes in
obesity and inflammation in African American and non-Hispanic white ex-smokers. We aim to: a) characterize
race differences in inflammation over time, b) examine race differences in the effect of obesity on inflammation
change, and c) explore associations of race, obesity, and inflammation with lung cancer incidence. Data will be
drawn from the Health and Retirement Study, a longitudinal panel study on middle-aged to older adults. Using
random effects multilevel modeling, we will compare different types of obesity (i.e., general vs. abdominal) to
determine whether there are unique effects on inflammation between races. We will use propensity scores to
isolate effects of race. These advanced statistical techniques will strengthen causal inference and control for
confounding of socio-demographic and behavioral factors. By isolating the obesity-inflammation effect in ex-
smokers, we will be able to determine bio-behavioral mechanisms that may contribute to racial disparities in
cancer risk, and ultimately incidence, taking into account lasting effects of smoking. Our results will help to
elucidate the currently unknown mechanisms of lung cancer disparities and inform interventions and screening
guidelines to target racial/ethnic minority groups at high-risk for lung ...

## Key facts

- **NIH application ID:** 10058695
- **Project number:** 1R21CA249357-01A1
- **Recipient organization:** UNIVERSITY OF CHICAGO
- **Principal Investigator:** Marcia McNutt Tan
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $297,374
- **Award type:** 1
- **Project period:** 2020-08-01 → 2023-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10058695

## Citation

> US National Institutes of Health, RePORTER application 10058695, Examining differential effects of obesity on inflammation in ex-smokers to understand racial disparities in cancer risk (1R21CA249357-01A1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10058695. Licensed CC0.

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