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:

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

Early Medicaid Expansion and Cancer Mortality.

BACKGROUND: While Medicaid expansion is associated with decreased uninsured rates and earlier cancer diagnoses, no study has demonstrated an association between Medicaid expansion and cancer mortality. Our primary objective was to quantify the relationship between early Medicaid expansion and changes in cancer mortality rates. METHODS: We obtained county-level data from the National Center for Health Statistics for adults ages 20-64 who died from cancer from 2007-2009 (pre-expansion) and 2012-2016 (post-expansion). We compared changes in cancer mortality rates in early Medicaid expansion states (CA, CT, DC, MN, NJ, and WA) vs. non-expansion states through a difference-in-differences (DID) analysis using hierarchical Bayesian regression. An exploratory analysis of cancer mortality changes associated with the larger-scale 2014 Medicaid expansions was also performed. RESULTS: In adjusted DID analyses, we observed a statistically significant decrease of 3.07 (95% credible interval = 2.19 to 3.95) cancer deaths per 100,000 in early expansion vs. non-expansion states, which translates to an estimated decrease of 5,276 cancer deaths in the early expansion states during the study period. Expansion-associated decreases in cancer mortality were observed for pancreatic cancer. Exploratory analyses of the 2014 Medicaid expansions showed a decrease in pancreatic cancer mortality (-0.18 deaths per 100,000, 95% confidence interval = -0.32 to -0.05) in states that expanded Medicaid by 2014 compared to non-expansion states. CONCLUSION(S): Early Medicaid expansion was associated with reduced cancer mortality rates, especially for pancreatic cancer, a cancer with short median survival where changes in prognosis would be most visible with limited follow-up.
Authors
Barnes, JM; Johnson, KJ; Boakye, EA; Schapira, L; Akinyemiju, T; Park, EM; Graboyes, EM; Osazuwa-Peters, N
MLA Citation
Barnes, Justin M., et al. “Early Medicaid Expansion and Cancer Mortality.J Natl Cancer Inst, July 2021. Pubmed, doi:10.1093/jnci/djab135.
URI
https://scholars.duke.edu/individual/pub1488984
PMID
34259321
Source
pubmed
Published In
J Natl Cancer Inst
Published Date
DOI
10.1093/jnci/djab135

A two-stage approach for combining gene expression and mutation with clinical data improves survival prediction in myelodysplastic syndromes and ovarian cancer.

Motivation: Many traditional clinical prognostic factors have been known for cancer for years, but usually provide poor survival prediction. Genomic information is more easily available now which offers opportunities to build more accurate prognostic models. The challenge is how to integrate them to improve survival prediction. The common approach of jointly analyzing all type of covariates directly in one single model may not improve the prediction due to increased model complexity and cannot be easily applied to different datasets. Results: We proposed a two-stage procedure to better combine different sources of information for survival prediction, and applied the two-stage procedure in two cancer datasets: myelodysplastic syndromes (MDS) and ovarian cancer. Our analysis suggests that the prediction performance of different data types are very different, and combining clinical, gene expression and mutation data using the two-stage procedure improves survival prediction in terms of improved concordance index and reduced prediction error. Availability and implementation: The two-stage procedure can be implemented in BhGLM package which is freely available at http://www.ssg.uab.edu/bhglm/. Contact: nyi@uab.edu.
Authors
Li, Y; Zhang, X; Akinyemiju, T; Ojesina, AI; Szychowski, JM; Liu, N; Xu, B; Yi, N
MLA Citation
URI
https://scholars.duke.edu/individual/pub1494119
PMID
34377946
Source
pubmed
Published In
J Bioinform Genom
Volume
1
Published Date
DOI
10.18454/jbg.2016.1.1.2

Association of high-sensitivity C-reactive protein and odds of breast cancer by molecular subtype: analysis of the MEND study.

Breast cancer (BC) in Nigeria is characterized by disproportionately aggressive molecular subtypes. C-reactive protein (CRP) is associated with risk and aggressiveness for several types of cancer. We examined the association of high-sensitivity CRP (hsCRP) with odds of BC by molecular subtype among Nigerian women. Among 296 newly diagnosed BC cases and 259 healthy controls, multivariable logistic regression models were used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (CI) for the association between hsCRP and odds of BC overall and by molecular subtype (luminal A, luminal B, HER2-enriched and triple-negative or TNBC). High hsCRP (> 3 mg/L) was observed in 57% of cases and 31% of controls and was associated with 4 times the odds of BC (aOR: 4.43; 95% CI: 2.56, 7.66) after adjusting for socio-demographic, reproductive, and clinical variables. This association persisted regardless of menopausal status and body mass index (BMI) category. High hsCRP was associated with increased odds of TNBC (aOR: 3.32; 95% CI: 1.07, 10.35), luminal A BC (aOR: 4.03; 95% CI: 1.29, 12.64), and HER2-enriched BC (aOR: 6.27; 95% CI: 1.69, 23.25). Future studies are necessary in this population to further evaluate a potential role for CRP as a predictive biomarker for BC.
Authors
Gupta, A; Oyekunle, T; Salako, O; Daramola, A; Alatise, O; Ogun, G; Adeniyi, A; Deveaux, A; Saraiya, V; Hall, A; Ayandipo, O; Olajide, T; Olasehinde, O; Arowolo, O; Adisa, A; Afuwape, O; Olusanya, A; Adegoke, A; Tollefsbol, TO; Arnett, D; Muehlbauer, MJ; Newgard, CB; H3 Africa Kidney Research Network,; Akinyemiju, T
MLA Citation
Gupta, Anjali, et al. “Association of high-sensitivity C-reactive protein and odds of breast cancer by molecular subtype: analysis of the MEND study.Oncotarget, vol. 12, no. 13, June 2021, pp. 1230–42. Pubmed, doi:10.18632/oncotarget.27991.
URI
https://scholars.duke.edu/individual/pub1487936
PMID
34194621
Source
pubmed
Published In
Oncotarget
Volume
12
Published Date
Start Page
1230
End Page
1242
DOI
10.18632/oncotarget.27991

Research Areas:

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