Chiranjeev Dash

Background: The incidence of early-onset colorectal cancer (EOCRC), defined as CRC diagnosed age et al . (2026) framework to tumor tissue. Associations between MRS and age at CRC onset (EOCRC, n=29; intermediate-onset (IOCRC) 50–64 years, n=69; late-onset, ≥65 years, n=48) were evaluated using linear and polytomous regression, with adjustment and stratification for race, geography, Area Deprivation Index (ADI), and Multi-Environmental Exposure Index (MEEI). Spearman correlations were calculated between MRSes and observed exposures. Results: EOCRC cases were predominately Black (65.5% vs. 31.3% among LOCRC) and resided in higher-deprivation neighborhoods. We found higher odds of EOCRC associated with epigenetic exposure signatures for 2,4-D herbicide, heptachlor, coarse particulate matter (PM), Mediterranean Diet Score, and smoking, and borderline associations for fine PM and nitrogen dioxide. IOCRC was associated with signatures for 2,4-D, lindane, and obesity. Heterogeneity was observed by race and area-level factors, though associations were largely consistent across strata. ADI and MEEI were correlated with multiple pesticide and pollutant epigenetic signatures. Conclusions: In a diverse US cohort, epigenetic exposure signatures distinguish CRC cohorts, particularly EOCRC from later-onset disease, with associations consistent with but not identical to previous research. EOCRC in DANCE was characterized by higher epigenetic exposure signatures for air pollution, smoking, and distinct pesticide exposure profiles. IOCRC had overlapping characteristics with early- and late-onset and were the only group with a significant obesity signature. These findings support the hypothesis that exposome-driven epigenetic changes contribute to EOCRC risk and highlight the importance of studying diverse populations to characterize the full spectrum of environmental risk factors. Graphical Summary results for associations between epigenetic exposure signatures and age of colorectal cancer onset in the DANCE cohort.

Background: Outdoor workers receive significantly more UV radiation exposure than indoor workers, increasing their skin cancer risk. Hispanic individuals comprise a large proportion of the outdoor workforce in the United States, but have limited access to culturally tailored prevention resources. Objective: This exploratory study assessed the perceptions of a culturally tailored narrative video to promote skin cancer prevention among Spanish-speaking Hispanic outdoor workers. Methods: A qualitative study was conducted using two focus groups with Hispanic outdoor workers. Prior to viewing the video, participants completed surveys assessing sociodemographic factors, sun exposure, and protective behaviors. Focus group discussions explored video comprehension, cultural relevance, emotional engagement, and dissemination strategies. Quantitative data were summarized descriptively, and qualitative data were analyzed using rapid qualitative analysis. Results: Among 19 participants, the mean age was 46.5 (SD 15.5) years, and 94.7% (18/19) identified as male. While 47.4% (9/19) reported 6‐9 hours of outdoor work per day, more than half (10/19, 52.6%) reported not engaging in sun protection. Participants described the video as culturally resonant, realistic, and engaging. Identification with characters and family-centered themes increased perceived relevance and message credibility. Many participants reported increased awareness of skin cancer risk and greater confidence in adopting sun-protective behaviors. Dissemination recommendations included workplaces, social media, schools, daycares, clinics, and other community settings. Conclusions: Our video shows promise in improving skin cancer awareness and prevention, reflecting strong acceptability among participants. Future randomized controlled studies are needed to assess its effectiveness in enhancing long-term sun-protective behaviors.

Sugar-sweetened beverage (SSB) consumption is linked to increased metabolic syndrome (MetS) and breast cancer risk. This cross-sectional study examined associations between SSB intake and MetS by family history of breast cancer among postmenopausal Black women with obesity. Baseline data of 210 participants from the Focused Intervention on Exercise to Reduce CancEr (FIERCE) clinical trial were used. SSB intake was assessed with the Block 2005 Food Frequency Questionnaire, and family history of breast cancer was collected via a self-report questionnaire. Women with a family history of breast cancer who had high (vs. low) SSB intake had higher triglycerides (29.69 mg/dL higher, P = 0.011), lower high-density lipoprotein cholesterol (7.94 mg/dL lower, P = 0.027), and a higher MetS z-score (1.89 U higher, P < 0.001). Adjusting for relevant covariates, greater SSB intake predicted a higher MetS z-score (b = 0.01, Pinteraction = 0.031) and fasting glucose (b = 0.02, Pinteraction = 0.013) compared with lower SSB intake, only in women with a family history of breast cancer. Greater consumption of SSB subtypes (sugary juices, iced tea, and others) were associated with higher triglycerides, fasting glucose, and/or MetS z-score compared with lower consumption, only in women with a family history of breast cancer (Pinteractions < 0.05). Higher SSB consumption is linked to higher fasting glucose, triglycerides, and overall MetS risk in postmenopausal Black women with a family history of breast cancer. Targeted multilevel interventions to reduce SSB consumption and improve metabolic health in this population are warranted.Significance:Higher SSB consumption was linked to higher fasting glucose, triglycerides, and overall MetS risk in postmenopausal Black women with a family history of breast cancer, but not in women without this family history. Findings highlight important heterogeneity in metabolic vulnerability and the need for culturally informed multilevel interventions, such as those targeting healthcare providers and individual decision making, to reduce SSB intake in vulnerable populations with a family history of breast cancer.

Prevalence of any daily SSB intake, stratified by family history of breast cancer, in the FIERCE study population of postmenopausal Black women.

Baseline characteristics by family history of breast cancer in the FIERCE study population of postmenopausal Black women.

Interaction between total energy-adjusted SSB intake and family history of breast cancer on MetS z-score in the FIERCE study population of postmenopausal Black women. Total energy-adjusted SSB intake was standardized using the following formula: (average daily intake of SSB in grams/average total daily food energy intake in kilocalories) × 1,000. The model was adjusted for age, smoking status, income, and dietary factors (alcohol, red meat, and saturated fat intake).

Participant flow diagram for the FIERCE trial and present study analytic sample.

Multivariable-adjusted associations of SSB intake and SSB subtypes with continuous MetS outcomes by family history of breast cancer in the FIERCE study population of postmenopausal Black women.

Differences in MetS z-score and continuous MetS components by high vs. low SSB intake, stratified by family history of breast cancer in the FIERCE study population of postmenopausal Black women.

Sugar-sweetened beverage (SSB) consumption is linked to increased metabolic syndrome (MetS) and breast cancer risk. This cross-sectional study examined associations between SSB intake and MetS by family history of breast cancer among postmenopausal Black women with obesity. Baseline data of 210 participants from the Focused Intervention on Exercise to Reduce CancEr (FIERCE) clinical trial were used. SSB intake was assessed with the Block 2005 Food Frequency Questionnaire, and family history of breast cancer was collected via a self-report questionnaire. Women with a family history of breast cancer who had high (vs. low) SSB intake had higher triglycerides (29.69 mg/dL higher, P = 0.011), lower high-density lipoprotein cholesterol (7.94 mg/dL lower, P = 0.027), and a higher MetS z-score (1.89 U higher, P < 0.001). Adjusting for relevant covariates, greater SSB intake predicted a higher MetS z-score (b = 0.01, Pinteraction = 0.031) and fasting glucose (b = 0.02, Pinteraction = 0.013) compared with lower SSB intake, only in women with a family history of breast cancer. Greater consumption of SSB subtypes (sugary juices, iced tea, and others) were associated with higher triglycerides, fasting glucose, and/or MetS z-score compared with lower consumption, only in women with a family history of breast cancer (Pinteractions < 0.05). Higher SSB consumption is linked to higher fasting glucose, triglycerides, and overall MetS risk in postmenopausal Black women with a family history of breast cancer. Targeted multilevel interventions to reduce SSB consumption and improve metabolic health in this population are warranted. Significance: Higher SSB consumption was linked to higher fasting glucose, triglycerides, and overall MetS risk in postmenopausal Black women with a family history of breast cancer, but not in women without this family history. Findings highlight important heterogeneity in metabolic vulnerability and the need for culturally informed multilevel interventions, such as those targeting healthcare providers and individual decision making, to reduce SSB intake in vulnerable populations with a family history of breast cancer.