# Project 1: Multilevel Social Stressors and Aggressive Prostate Cancer in African American Men

> **NIH NIH U19** · UNIVERSITY OF SOUTHERN CALIFORNIA · 2021 · $238,510

## Abstract

Abstract – Project 1
African-American (AA) men experience the highest prostate cancer (PCa) incidence and mortality rates of all
U.S. racial/ethnic groups. They are also known to present with more aggressive high-risk disease, especially of
higher Gleason score and PSA levels. Factors contributing to the high burden of PCa among AA men are not
known. AAs are exposed to considerably higher levels of social stressors such as institutional and interpersonal
discrimination, crime, low socioeconomic status, social isolation, and resource-poor environments. These social
stressors exist at multiple levels, from individual to neighborhood to institutional, and across the lifecourse,
leading to chronic stress. Social stressors experienced among AA men may thus be a contributor to the
development of aggressive PCa and high mortality. We will apply recently developed multilevel frameworks that
emphasize the consideration and evaluation of exposures from “cells to society” to understand how “stress gets
under the skin” to cause biological vulnerability, specifically the high burden of PCa among AA men. Our specific
aims are: 1) Examine the associations between exposures to neighborhood social stressors and risk of
aggressive PCa and mortality among AA and non-Hispanic White (WH) men. Among population-based samples
of all AA (N=149,000) and WH (N=668,000) men diagnosed with PCa in the RESPOND catchment areas, we
will link geospatial neighborhood data on segregation, racial composition, socioeconomic deprivation, and other
social and built environment attributes to cancer registry data and examine the associations between these
neighborhood factors and aggressive PCa and risk of mortality; 2) Examine the associations between exposures
to multilevel social stressors across the lifecourse and risk of aggressive PCa among 10,000 AA men in
RESPOND. Each stressor will be examined individually and combined, and for selected time points (early, mid,
adult life) and cumulatively over time; 3) Examine the associations between exposures to multilevel social
stressors across the lifecourse and genetic factors, as well as their combined effects in association with
aggressive PCa. More specifically, we will assess the association between the multilevel social stressors and:
a) proportion of African genetic ancestry, b) frequency and type of somatic profiles, and c) whether social
stressors, germline genetics (including PCa aggressive loci), and somatic profiles are jointly associated with risk
of aggressive disease. To address these aims, we have designed a multilevel study involving cross-sectional,
prospective, and retrospective designs that integrates multilevel data from multiple sources including cancer
registry, patient survey, geospatial (to characterize neighborhood-level stressors) and public record data (to
construct adult residential history), germline genetics from Project 2 and somatic tumor profile data from Project
3. Covering 6 states and 1 metropolitan reg...

## Key facts

- **NIH application ID:** 10249993
- **Project number:** 5U19CA214253-04
- **Recipient organization:** UNIVERSITY OF SOUTHERN CALIFORNIA
- **Principal Investigator:** Scarlett L Gomez
- **Activity code:** U19 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $238,510
- **Award type:** 5
- **Project period:** 2018-07-05 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10249993

## Citation

> US National Institutes of Health, RePORTER application 10249993, Project 1: Multilevel Social Stressors and Aggressive Prostate Cancer in African American Men (5U19CA214253-04). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/10249993. Licensed CC0.

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