Dr. Paulo Pinheiro Awarded Florida DOH Grant to Study the Epidemiology of Lung and Liver Cancers

The Florida Department of Health has awarded Paulo S. Pinheiro, M.D., Ph.D., a research associate professor, with the Sylvester Comprehensive Cancer Center—part of the University of Miami Miller School of Medicine—a $264,356 grant to study the risk, etiology, and mortality of lung and liver cancers.

Collaborators of this project include clinicians from the Sylvester Comprehensive Cancer Center and Miller School of Medicine, including Gilberto Lopes, M.D., associate director for global oncology, medical director for international programs, and associate professor of clinical medicine, and Patricia Jones, M.D., a hepatologist and assistant professor.

Non-clinical collaborators from the Sylvester Comprehensive Cancer Center and Miller School of Medicine also include Erin Kobetz, Ph.D., M.P.H., vice provost for research at the University of Miami, Tulay Koru-Sengul, Ph.D., research associate professor, Ph.D., Deukwoo Kwon, Ph.D., research assistant professor, and Natasha Schaefer Solle, Ph.D., research assistant professor.

“We propose to study the lung and liver cancer experience for 10 distinct racial and ethnic groups in Florida, beginning with the typically studied major groups, such as Black, Hispanic, and White,” Dr. Pinheiro said. “We will also focus on distinct subgroups with sizable populations in Florida, including U.S. born African-Americans, Afro-Caribbean, Cuban, Puerto Rican, Dominican, Central American/Mexican, and South American.”

Both in the United States and in the State of Florida, lung cancer is the leading cause of cancer death and liver cancer is the fastest-growing cancer. These cancers account for over 13,000 deaths in Florida each year and survival prospects are dismal for both. Currently, only 18 percent of liver cancer patients and 17 percent of lung cancer patients survive five years. Racial and ethnic disparities have been shown for these cancers. For example, Puerto Ricans are disproportionately burdened with liver cancer, and African Americans are diagnosed with both liver and lung cancer at higher rates.

To address these disparities, knowledge about the specific risk factors, genetic mutations, and etiologies driving these cancers needs to be clarified so that actionable public health and clinical interventions can take place, Dr. Pinheiro said.

“This knowledge will enable the development of specific approaches for high-risk populations, including tobacco control, access to curative treatment for early-stage lung cancer, and screening for hepatitis B and/or C, as well as underlying alcohol and metabolic liver disease for liver cancer,” Dr. Pinheiro added.

The project is aimed at determining the incidence and survival of lung cancer for each race and ethnic group and to identify the clinical, biological, and social determinants of lung cancer survival, as well as to determine cause-specific liver cancer incidence and survival, for both major types of liver cancers, hepatocellular carcinoma, and cholangiocarcinoma.

Dr. Pinheiro and his team will also examine the known etiologies of liver cancer, such as hepatitis C, hepatitis B, alcohol liver disease, underlying alcohol and metabolic, diabetes, and rarer genetic, autoimmune/inflammatory and biliary conditions. Special emphasis will be placed on the patterns among baby boomers, known to have higher HCV prevalence and a higher liver cancer burden.

To obtain detailed information on etiology and risk factors for each individual liver and lung cancer case, Florida’s hospital discharge data, viral hepatitis, and mortality data will be linked with cancer registry data to provide unique etiology-specific information for a large, representative statewide cohort of Hispanic and Black minority subgroups.

“This has never been studied with this level of detail anywhere else in the U.S.,” Dr. Pinheiro said.

Over 200,000 lung and 22,000 liver cancer cases over the course of 13 years, from 2005 to 2017, specifically, have been preliminarily identified using the Florida Cancer Data System.

“This project will use unique data and innovative multisource linkages to produce entirely novel information about Florida’s cancer profile, including disparities,” added Dr. Pinheiro. “Community outreach to disseminate our results will provide invaluable information for both public health and clinical practitioners, tasked with combatting the scourge of these two deadly cancers.”

Written by Amanda Torres

July 29, 2020