Tomi Akinyemiju

Overview:

Area of Expertise: Epidemiology

Dr. Akinyemiju is a social and molecular cancer epidemiologist with expertise in epidemiologic methods, translational research, health disparities and global health.  Her research interests focus on identifying the impact of social (such as access to healthcare) and biological factors (such as metabolic dysregulation), on cancer related risk, tumor aggressiveness and survival. She has a specific interest in understanding the causes of cancer disparities among women of African descent in the US and sub-Saharan Africa, given their significantly higher risk of aggressive cancer subtypes relative to other racial groups. To achieve these research aims, she utilizes data from population-based cancer registries, administrative claims, and existing cohort studies. Dr. Akinyemiju also leads several primary epidemiologic research studies. She is the PI of a case-control study of newly diagnosed breast cancer patients and healthy women in Nigeria designed to elucidate the impact of metabolic dysregulation, highly prevalent due to the epidemiologic transition, on hormone-receptor negative breast cancer subtypes and associated epigenetic mechanisms. In addition, Dr. Akinyemiju leads an R01 study designed to characterize racial differences across multiple healthcare access dimensions among US ovarian cancer patients, and evaluate the impact of differential healthcare on quality of initial and supportive treatment, and quality of life. A parallel line of research focuses on identifying lifestyle intervention strategies to improve metabolic health among breast cancer patients as a mortality prevention strategy. Dr. Akinyemiju is also passionate about promoting inclusion and diversity in research, teaching and service, and serves as the Vice-Chair for Inclusion and Diversity at the Duke University Department of Population Health Sciences and as Associate Director for Community Outreach and Engagement at the Duke Cancer Institute. 

Positions:

Associate Professor in Population Health Sciences

Population Health Sciences
School of Medicine

Associate Research Professor of Global Health

Duke Global Health Institute
Institutes and Provost's Academic Units

Instructor in the Department of Obstetrics and Gynecology

Obstetrics and Gynecology
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

Ph.D. 2012

University of Michigan, Ann Arbor

Grants:

Metabolic Syndrome and Epigenetic Markers of Breast Cancer in Nigerian Women

Administered By
Duke Global Health Institute
Awarded By
National Institutes of Health
Role
Principal Investigator
Start Date
End Date

Metabolic Syndrome and Epigenetic Markers of Breast Cancer in Nigerian Women

Administered By
Duke Global Health Institute
Awarded By
National Institutes of Health
Role
Principal Investigator
Start Date
End Date

Metabolic Syndrome and Epigenetic Markers of Breast Cancer in Nigerian Women

Administered By
Duke Global Health Institute
Awarded By
National Institutes of Health
Role
Principal Investigator
Start Date
End Date

Sociome: Integrating Social Determinants of Health and Multi-Omic Data to Predict Cancer Prognosis

Administered By
Population Health Sciences
Awarded By
Carnegie Mellon University
Role
Principal Investigator
Start Date
End Date

Publications:

Ovarian Cancer Epidemiology, Healthcare Access and Disparities (ORCHiD): methodology for a population-based study of black, Hispanic and white patients with ovarian cancer.

INTRODUCTION: Less than 40% of patients with ovarian cancer (OC) in the USA receive stage-appropriate guideline-adherent surgery and chemotherapy. Black patients with cancer report greater depression, pain and fatigue than white patients. Lack of access to healthcare likely contributes to low treatment rates and racial differences in outcomes. The Ovarian Cancer Epidemiology, Healthcare Access and Disparities study aims to characterise healthcare access (HCA) across five specific dimensions-Availability, Affordability, Accessibility, Accommodation and Acceptability-among black, Hispanic and white patients with OC, evaluate the impact of HCA on quality of treatment, supportive care and survival, and explore biological mechanisms that may contribute to OC disparities. METHODS AND ANALYSIS: We will use the Surveillance Epidemiology and Ends Results dataset linked with Medicare claims data from 9744 patients with OC ages 65 years and older. We will recruit 1641 patients with OC (413 black, 299 Hispanic and 929 white) from cancer registries in nine US states. We will examine HCA dimensions in relation to three main outcomes: (1) receipt of quality, guideline adherent initial treatment and supportive care, (2) quality of life based on patient-reported outcomes and (3) survival. We will obtain saliva and vaginal microbiome samples to examine prognostic biomarkers. We will use hierarchical regression models to estimate the impact of HCA dimensions across patient, neighbourhood, provider and hospital levels, with random effects to account for clustering. Multilevel structural equation models will estimate the total, direct and indirect effects of race on treatment mediated through HCA dimensions. ETHICS AND DISSEMINATION: Result dissemination will occur through presentations at national meetings and in collaboration with collaborators, community partners and colleagues across othercancer centres. We will disclose findings to key stakeholders, including scientists, providers and community members. This study has been approved by the Duke Institutional Review Board (Pro00101872). Safety considerations include protection of patient privacy. All disseminated data will be deidentified and summarised.
Authors
Akinyemiju, T; Deveaux, A; Wilson, L; Gupta, A; Joshi, A; Bevel, M; Omeogu, C; Ohamadike, O; Huang, B; Pisu, M; Liang, M; McFatrich, M; Daniell, E; Fish, LJ; Ward, K; Schymura, M; Berchuck, A; Potosky, AL
MLA Citation
Akinyemiju, Tomi, et al. “Ovarian Cancer Epidemiology, Healthcare Access and Disparities (ORCHiD): methodology for a population-based study of black, Hispanic and white patients with ovarian cancer.Bmj Open, vol. 11, no. 10, Oct. 2021, p. e052808. Pubmed, doi:10.1136/bmjopen-2021-052808.
URI
https://scholars.duke.edu/individual/pub1498278
PMID
34607872
Source
pubmed
Published In
Bmj Open
Volume
11
Published Date
Start Page
e052808
DOI
10.1136/bmjopen-2021-052808

Association of genetic variants of FBXO32 and FOXO6 in the FOXO pathway with breast cancer risk.

Forkhead box class O (FOXO) transcription factors play a pivotal role in regulating a variety of biological processes, including organismal development, cell signaling, cell metabolism, and tumorigenesis. Therefore, we hypothesize that genetic variants in FOXO pathway genes are associated with breast cancer (BC) risk. To test this hypothesis, we conducted a large meta-analysis using 14 published genome-wide association study (GWAS) data sets in the Discovery, Biology, and Risk of Inherited Variants in Breast Cancer (DRIVE) study. We assessed associations between 5214 (365 genotyped in DRIVE and 4849 imputed) common single-nucleotide polymorphisms (SNPs) in 55 FOXO pathway genes and BC risk. After multiple comparison corrections by the Bayesian false-discovery probability method, we found five SNPs to be significantly associated with BC risk. In stepwise multivariate logistic regression analysis with adjustment for age, principal components, and previously published SNPs in the same data set, three independent SNPs (i.e., FBXO32 rs10093411 A>G, FOXO6 rs61229336 C>T, and FBXO32 rs62521280 C>T) remained to be significantly associated with BC risk (p = 0.0008, 0.0011, and 0.0017, respectively). Additional expression quantitative trait loci analysis revealed that the FBXO32 rs62521280 T allele was associated with decreased messenger RNA (mRNA) expression levels in breast tissue, while the FOXO6 rs61229336 T allele was found to be associated with decreased mRNA expression levels in the whole blood cells. Once replicated by other investigators, these genetic variants may serve as new biomarkers for BC risk.
Authors
Wang, H; Liu, H; Zhao, L; Luo, S; Akinyemiju, T; Hwang, S; Yue, Y; Wei, Q
MLA Citation
Wang, Haijiao, et al. “Association of genetic variants of FBXO32 and FOXO6 in the FOXO pathway with breast cancer risk.Mol Carcinog, vol. 60, no. 10, Oct. 2021, pp. 661–70. Pubmed, doi:10.1002/mc.23331.
URI
https://scholars.duke.edu/individual/pub1487619
PMID
34197655
Source
pubmed
Published In
Molecular Carcinogenesis
Volume
60
Published Date
Start Page
661
End Page
670
DOI
10.1002/mc.23331

Association of Life-Course Educational Attainment and Breast Cancer Grade in the MEND Study.

Background: Nigeria reports the highest age-standardized mortality rate for breast cancer (BC) among African countries and disproportionately high rates of high-grade cancer. Histological grade is a strong predictor of mortality, and evidence suggests that educational attainment influences cancer outcomes. Objective: We characterize the association between educational trends across the life-course and BC grade at diagnosis. Methods: Data on 224 BC patients enrolled in the Mechanisms for Established and Novel Risk Factors for Breast Cancer in Nigerian Women (MEND) study was analyzed. Participant and parental (mother and father) education was categorized as low (primary school or less) or high (secondary school or greater). Accordingly, the educational trend across the life-course was determined for each participant relative to each parent: stable high, increasing, decreasing, or stable low. BC grade was classified as high (grade 3) or low (grades 1-2). Findings: About 34% of participants, 71% of fathers, and 85% of mothers had low education. Approximately one-third of participants were diagnosed with high-grade BC. Participants with low-grade BC were more likely to have highly educated fathers (p = 0.04). After adjusting for age, comorbidities, marital status and mammogram screening, participants with highly educated fathers were 60% less likely to have high-grade BC (aOR 0.41; 95% CI 0.20 to 0.84) compared to those with less-educated fathers. Stable high life-course education relative to father was also associated with a significantly lower likelihood of having high-grade BC (aOR 0.36; 95% CI 0.15 to 0.87) compared to stable low life-course education. No significant associations were observed for the participant's education, mother's education, or life-course education relative to mother. Conclusions: Early-life socioeconomic status (SES) may influence BC grade. This deserves further study to inform policies that may be useful in reducing high-grade BC in Nigeria.
Authors
Gupta, A; Jones, K; Deveaux, A; Bevel, M; Salako, O; Daramola, A; Hall, A; Alatise, O; Ogun, G; Adeniyi, A; Ojo, A; Ayandipo, O; Olajide, T; Olasehinde, O; Arowolo, O; Adisa, A; Afuwape, O; Olusanya, A; Adegoke, A; Tollefsbol, TO; Arnett, D; Newgard, CB; Akinyemiju, T
MLA Citation
Gupta, Anjali, et al. “Association of Life-Course Educational Attainment and Breast Cancer Grade in the MEND Study.Ann Glob Health, vol. 87, no. 1, 2021, p. 59. Pubmed, doi:10.5334/aogh.3142.
URI
https://scholars.duke.edu/individual/pub1488654
PMID
34277361
Source
pubmed
Published In
Annals of Global Health
Volume
87
Published Date
Start Page
59
DOI
10.5334/aogh.3142

Association of body composition with odds of breast cancer by molecular subtype: analysis of the Mechanisms for Established and Novel Risk Factors for Breast Cancer in Nigerian Women (MEND) study.

BACKGROUND: The association between obesity and breast cancer (BC) has been extensively studied among US, European and Asian study populations, with often conflicting evidence. However, despite the increasing prevalence of obesity and associated conditions in Africa, the continent with the highest age-standardized BC mortality rate globally, few studies have evaluated this association, and none has examined in relation to molecular subtypes among African women. The current analysis examines the association between body composition, defined by body mass index (BMI), height, and weight, and BC by molecular subtype among African women. METHODS: We estimated odds ratios (ORs) and 95% confidence intervals (95% CI) for the association between measures of body composition and BC and molecular subtypes among 419 histologically confirmed cases of BC and 286 healthy controls from the Mechanisms for Established and Novel Risk Factors for Breast Cancer in Women of Nigerian Descent (MEND) case-control study. RESULTS: Higher BMI (aOR: 0.79; 95% CI: 0.67, 0.95) and weight (aOR: 0.83; 95% CI: 0.69, 0.98) were associated with reduced odds of BC in adjusted models, while height was associated with non-statistically significant increased odds of BC (aOR: 1.07, 95% CI: 0.90, 1.28). In pre/peri-menopausal, but not post-menopausal women, both higher BMI and weight were significantly associated with reduced odds of BC. Further, higher BMI was associated with reduced odds of Luminal A, Luminal B, and HER2-enriched BC among pre/peri-menopausal women, and reduced odds of triple-negative BC among post-menopausal women. CONCLUSIONS: Higher BMI and weight were associated with reduced odds of BC overall and by molecular subtype among West African women. Larger studies of women of African descent are needed to definitively characterize these associations and inform cancer prevention strategies.
Authors
Akinyemiju, T; Jones, K; Gupta, A; Oyekunle, T; Saraiya, V; Deveaux, A; Salako, O; Hall, A; Alatise, O; Ogun, G; Adeniyi, A; Ayandipo, O; Olajide, T; Olasehinde, O; Arowolo, O; Adisa, A; Afuwape, O; Olusanya, A; Adegoke, A; Tollefsbol, TO; Arnett, D; H3 Africa Kidney Research Network,; Daramola, A
MLA Citation
URI
https://scholars.duke.edu/individual/pub1497607
PMID
34563146
Source
pubmed
Published In
Bmc Cancer
Volume
21
Published Date
Start Page
1051
DOI
10.1186/s12885-021-08775-8

Social determinants of health and cancer mortality in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort study.

BACKGROUND: Social determinants of health (SDOHs) cluster together and can have deleterious impacts on health outcomes. Individually, SDOHs increase the risk of cancer mortality, but their cumulative burden is not well understood. The authors sought to determine the combined effect of SDOH on cancer mortality. METHODS: Using the Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort, the authors studied 29,766 participants aged 45+ years and followed them 10+ years. Eight potential SDOHs were considered, and retained SDOHs that were associated with cancer mortality (P < .10) were retained to create a count (0, 1, 2, 3+). Cox proportional hazard models estimated associations between the SDOH count and cancer mortality through December 31, 2017, adjusting for confounders. Models were age-stratified (45-64 vs 65+ years). RESULTS: Participants were followed for a median of 10.6 years (interquartile range [IQR], 6.5, 12.7 years). Low education, low income, zip code poverty, poor public health infrastructure, lack of health insurance, and social isolation were significantly associated with cancer mortality. In adjusted models, among those <65 years, compared to no SDOHs, having 1 SDOH (adjusted hazard ratio [aHR], 1.39; 95% CI, 1.11-1.75), 2 SDOHs (aHR, 1.61; 95% CI, 1.26-2.07), and 3+ SDOHs (aHR, 2.09; 95% CI, 1.58-2.75) were associated with cancer mortality (P for trend <.0001). Among individuals 65+ years, compared to no SDOH, having 1 SDOH (aHR, 1.16; 95% CI, 1.00-1.35) and 3+ SDOHs (aHR, 1.26; 95% CI, 1.04-1.52) was associated with cancer mortality (P for trend = .032). CONCLUSIONS: A greater number of SDOHs were significantly associated with an increased risk of cancer mortality, which persisted after adjustment for confounders.
Authors
Pinheiro, LC; Reshetnyak, E; Akinyemiju, T; Phillips, E; Safford, MM
MLA Citation
URI
https://scholars.duke.edu/individual/pub1496106
PMID
34478162
Source
pubmed
Published In
Cancer
Published Date
DOI
10.1002/cncr.33894

Research Areas:

Cancer
Epidemiology
Epigenetics
Global health
Health Disparities
Molecular Epidemiology
Social Determinants of Health