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Research of Adana Llanos, PhD, MPH


Adana Llanos, PhD, MPHSpecific research interests in cancer disparities:

  • Cancer in minority and medically underserved populations in the U.S.
  • Cancer trends, patterns, and disparities in the Caribbean
  • Molecular and genetic epidemiology of breast cancer subtypes
  • Obesity, energy balance, and related biomarkers in relation to tumor heterogeneity and disparities in cancer outcomes
  • Interventions to address cancer disparities


Ongoing Cancer Disparities Studies (as Prinicpal Investigator)


Adipokines, adipokine receptors, and disparities in breast cancer clinicopathological features (Funding: K01 CA193527, National Cancer Institute)

The aim of this study is to uncover potential mechanisms linking obesity and breast cancer among a cohort of breast cancer cases enrolled in the Women’s Circle of Health Study (WCHS), exploring associations among breast adipokine and adipokine receptor expression and genetic variation, and breast tumor clinicopathological characteristics (eg, size, grade and breast cancer molecular subtype [ER+/PR+/Her2-, ER+/PR+/Her2+, ER-/PR-/Her2+, ER-/PR-/Her2-]). This study also aims to comprehensively examine the correlates of the TNBC phenotype and explore racial differences, which are hypothesized to be related to adiposity and breast adipokine expression and genomic profiles.

Neighborhood characteristics and breast cancer clinicopathological features among African Americans (Funding: Pending, National Cancer Institute)

The specific aims of this study are: 1) to examine the association between characteristics of the neighborhood of residence and breast tumor clinicopathologic features; using both census-derived measures of neighborhood factors (including measures of poverty, population density and racial segregation) and perceptions of the neighborhood collected via questionnaire (including collective efficacy, quality, and safety); and 2) to examine mediation of this association by select socio-biologic factors.

Retrospective collection and validation of HER2 data for invasive breast cancers diagnosed in New Jersey from 2008-2013: a pilot study (Funding: New Investigator Award, Cancer Institute of New Jersey)

This pilot study will retrospectively collect and validate HER2 data (specifically for years 2008 and 2009) through the New Jersey State Cancer Registry to establish a population-based cohort of female breast cancer cases diagnosed from 2008-2013 and examine the distribution of and factors associated with breast cancer subtypes in New Jersey during this time period. Two major goals of this study are to assess whether there is an association between breast cancer subtype and patient outcomes (i.e., mortality, survival) and determine if differences exist by racial/ethnic group, age, treatment, and/or neighborhood socioeconomic characteristics among incident BC cases diagnosed in New Jersey.

Cervical cancer control and high-risk HPV infection prevalence among low-income uninsured/underinsured women in New Jersey: a pilot study (Funding: Pilot Award, Cancer Institute of New Jersey)

The broad aim of this pilot study is to characterize women in New Jersey who seek cervical cancer screening and follow-up care services through the New Jersey Cancer Early Education and Detection Program, to understand factors associated with high risk human papilloma virus infection and losses to follow-up after an abnormal cervical cancer screening test.

Cancer disparities in Trinidad and Tobago (Funding: None)

The vast majority of cancer epidemiology studies to date have focused on cancer in higher income countries, where incidence and mortality rates are decreasing (or at least remaining stable) for many diseases, whereas studies are limited among lower income countries, where incidence and mortality are projected to continue increasing in the next few decades, including in countries of the Caribbean. This study will examine patterns and trends of cancer incidence and mortality in the Caribbean nation of Trinidad and Tobago and explore cancer disparities by ancestry and geographical residence (i.e., by Regional Health Authority responsible for provision of cancer care based on where a patient lives) among incident cases reported to the Trinidad and Tobago cancer registry between January 1995 and December 2009 (most recent data currently available).

Relevant Publications in Cancer Disparities

  1. Xu S, Markson C, Costello KL, Xing CY, Demissie K, Llanos AAM. Leveraging Social Media to Promote Public Health: Example of Cancer Awareness via Twitter. J Med Internet Res (in press)
  2. Mayo E, Llanos AA, Yi X, Duan SZ, Zhang L. Prognostic value of tumor deposit and perineural invasion status in colorectal cancer patients: a SEER-based population study. Histopathology (in press)
  3. Llanos AA, Chandwani S, Bandera V, Hirshfield KM, Lin Y, Ambrosone CB, Demissie K. Association between sociodemographic and clinicopathological factors and breast cancer subtypes in a population-based study. Cancer Causes Control 2015;26(12):1737-1750.
  4. Warner WA, Morrison RL, Lee TY, Williams TM, Ramnarine S, Roach V, Slovacek S, Maharaj R, Bascombe N, Bondy ML, Ellis MJ, Toriola AT, Roach A, Llanos AA. Associations among race/ethnicity, geography, and breast cancer incidence and mortality in Trinidad and Tobago. Cancer Med 2015;4(11):1742-1753.
  5. Roach AN, Warner WA, and Llanos AA. Building capacity for human genetics and genomics research in Trinidad and Tobago. Rev Panam Salud Publica 2015;38(5):425-30.
  6. Rodday AM, Parsons SK, Snyder F, Simon MA, Llanos AA, Warren-Mears V, Dudley D, Lee J-H, Patierno SR, Markossian TW, Sanders M, Whitley E, Freund KM. Impact of patient navigation in eliminating economic disparities in cancer care. Cancer 2015;121(22):4025-4034.
  7. Plascak JJ, Llanos AA, Pennell ML, Paskett ED. Neighborhood factors associated with time to resolution following an abnormal breast or cervical cancer screening test. Cancer Epidemiol Biomarkers Prev 2014;23(12):2819-2828.
  8. Llanos AA, Pennell ML, Young GS, Tatum CM, Katz ML, Paskett ED. No Association between colorectal cancer worry and within-guidelines screening behaviors among residents of Appalachian Ohio. J Public Health 2015;37(2):322-327.
  9. Llanos AA, Krok JL, Peng J, Pennell ML, Olivo-Marston SE, Vitolins MZ, Degraffinreid CR, Paskett ED. Favorable effects of low-fat and low-carbohydrate dietary patterns on serum leptin, but not adiponectin, among overweight and obese premenopausal women: a randomized trial. SpringerPlus 2014; 3:175-185
  10. Llanos AA, Krok JL, Peng J, Pennell ML, Vitolins MZ, Degraffinreid CR, Paskett ED. Effects of a walking intervention using mobile technology and interactive voice response on serum biomarkers of obesity among postmenopausal women at increased breast cancer risk. Horm Cancer 2014; 5(2):98-103.
  11. Llanos AA, Peng J, Pennell ML, Krok J, Vitolins MZ, Degraffinreid CR, Paskett ED. Effects of tomato and soy on serum adipokine concentrations in postmenopausal women at increased breast cancer risk: a cross-over dietary intervention trial. J Clin Endocrinol Metab 2014; 99(2):625-632
  12. Reiter PL, Katz ML, Oliveri JM, Young GS, Llanos AA, Paskett ED. Validation of self-reported colorectal cancer screening behaviors among Appalachian residents. Public Health Nursing 2013; 30(4): 312-322.
  13. Paskett ED, Llanos AA, Young GS, Pennell ML, Lee C-J, Katz ML. Correlates of colorectal cancer screening among residents of Ohio Appalachia. J Community Health 2013; 38(4): 609-618.
  14. Sheppard VB, Llanos AA, Taylor TR, Adams-Campbell LL. Correlates of depressive symptomatology in African American breast cancer patients. J Cancer Surviv 2013; 7(3):292-299.
  15.  Llanos AA, Makambi KH, Tucker CA, Wallington SF, Shields PG, Adams-Campbell LL. Cholesterol, lipoproteins, and breast cancer risk in African American women. Ethn Dis 2012; 22(3):281-287. 
  16. Llanos AA, Makambi KH, Tucker CA, Shields PG, Adams-Campbell LL. Alcohol, anthropometrics, and breast cancer risk in African American women. Breast J 2012; 18(4):394-395.
  17. Bright-Gbebry M, Makambi KH, Rohan JP, Llanos AA, Rosenberg L, Palmer JR, Adams-Campbell LL. Use of multivitamins, folic acid and herbal supplements among breast cancer survivors: The Black Women’s Health Study. BMC Compliment Altern Med 2011; 11:30-35.