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:

Metabolic Syndrome and Risk of Breast Cancer by Molecular Subtype: Analysis of the MEND Study.

BACKGROUND: Metabolic syndrome (MetS) is characterized by a cluster of biological irregularities. The purpose of this analysis was to examine the association of MetS with BC among Nigerian women, and for the first time evaluate this association by molecular subtype. MATERIALS AND METHODS: MetS was defined as having at least 3 out of 5 of: high blood pressure (≥ 130/85 mm Hg), reduced HDL (< 50 mg/dL), elevated triglyceride (> 150 mg/dL), high waist circumference (≥ 80 cm), and prior diagnosis of diabetes or elevated fasting glucose level (≥ 100 mg/dL). Among 296 newly diagnosed BC cases and 259 healthy controls, multivariable logistic regression models were utilized to estimate adjusted odds ratios (aOR) and 95% confidence intervals (95% CI) for the association between MetS and BC overall. Multinomial logistic regression models were used to evaluate each molecular subtype (Luminal A, Luminal B, HER2-enriched and triple-negative or TNBC). RESULTS: After adjusting for age, socio-demographic and reproductive risk factors, there was a positive association between MetS and BC (aOR: 1.84, 95% CI: 1.07, 3.16). In stratified analyses, MetS was associated with BC regardless of BMI status; however, the estimate was significant only among normal weight women (aOR: 3.85; 95% CI: 1.25, 11.90). MetS was significantly associated with TNBC subtype (aOR: 4.37, 95% CI: 1.67, 11.44); associations for other molecular subtypes were not statistically significant. CONCLUSION: MetS appears to be a robust risk factor for BC, particularly for TNBC. Public health and clinical interventions can provide substantial benefits in reducing the burden of MetS and preventing BC among Nigerian women.
Authors
Akinyemiju, T; Oyekunle, T; Salako, O; Gupta, A; Alatise, O; Ogun, G; Adeniyi, A; Deveaux, A; 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,; Daramola, A
MLA Citation
Akinyemiju, Tomi, et al. “Metabolic Syndrome and Risk of Breast Cancer by Molecular Subtype: Analysis of the MEND Study.Clin Breast Cancer, vol. 22, no. 4, June 2022, pp. e463–72. Pubmed, doi:10.1016/j.clbc.2021.11.004.
URI
https://scholars.duke.edu/individual/pub1505329
PMID
34980540
Source
pubmed
Published In
Clin Breast Cancer
Volume
22
Published Date
Start Page
e463
End Page
e472
DOI
10.1016/j.clbc.2021.11.004

Racial Differences in Survival Among Advanced-stage Non-small-Cell Lung Cancer Patients Who Received Immunotherapy: An Analysis of the US National Cancer Database (NCDB).

Lung cancer is the most common cause of cancer death among men and women in the United States, with significant racial disparities in survival. It is unclear whether these disparities persist upon equal utilization of immunotherapy. The purpose of this study was to evaluate the association between race and all-cause mortality among non-small-cell lung cancer (NSCLC) patients who received immunotherapy. We obtained data from the 2016 National Cancer Database on patients diagnosed with advanced-stage (III-IV) NSCLC from 2015 to 2016. Multivariable Cox proportional hazards models were used to calculate hazard ratios (HR) and 95% confidence intervals (95% CI) by race/ethnicity. A total of 2940 patients were included. Non-Hispanic (NH)-Black patients had a lower risk of death relative to NH-White patients (HR: 0.85; 95% CI: 0.73, 0.98) after adjusting for sociodemographic, clinical, and treatment factors. Formal tests of interaction evaluating race with Charlson-Deyo comorbidity score and race with area-level median income were nonsignificant. However, in stratified analyses, NH-Black versus NH-White patients had a lower risk of death in models adjusted for sociodemographic factors among those with at least 1 comorbidity (HR: 0.75; 95% CI: 0.57, 0.97), and those living in regions within the 2 lowest quartiles of median income (HR: 0.82; 95% CI: 0.68, 0.99). Among advanced-stage NSCLC patients who received immunotherapy, NH-Black patients experienced higher survival compared with NH-White patients. We urge the implementation of policies and interventions that seek to equalize access to care as a means of addressing differences in overall NSCLC survival by race.
Authors
Gupta, A; Zhang, D; Braithwaite, D; Karanth, SD; Tailor, TD; Clarke, JM; Akinyemiju, T
MLA Citation
Gupta, Anjali, et al. “Racial Differences in Survival Among Advanced-stage Non-small-Cell Lung Cancer Patients Who Received Immunotherapy: An Analysis of the US National Cancer Database (NCDB).J Immunother, vol. 45, no. 2, Feb. 2022, pp. 132–37. Pubmed, doi:10.1097/CJI.0000000000000400.
URI
https://scholars.duke.edu/individual/pub1500610
PMID
34747372
Source
pubmed
Published In
J Immunother
Volume
45
Published Date
Start Page
132
End Page
137
DOI
10.1097/CJI.0000000000000400

Abstract PO-107: Racial differences in survival among advanced-stage non-small cell lung cancer patients who received immunotherapy: An analysis of the U.S. National Cancer Database (NCDB)

<jats:title>Abstract</jats:title> <jats:p>Background: Lung cancer is the most common cause of cancer death among men and women in the United States, with 85% of all cases characterized as non-small cell lung cancer (NSCLC). These cancers are often diagnosed at advanced stage due to inapparent clinical symptoms. In 2015, the Food and Drug Administration approved the first use of immunotherapy for NSCLC, and it has since become a standard modality for treatment among advanced-stage NSCLC patients. Although significant racial disparities have been documented in overall NSCLC survival, it is unclear whether these disparities persist upon equal utilization of immunotherapy. The purpose of this study was to evaluate the association between race and all-cause mortality among advanced-stage non-small cell lung (NSCLC) cancer patients who received immunotherapy. Methods: We obtained data from the 2016 National Cancer Database on patients diagnosed with advanced-stage (III-IV) NSCLC from 2015-2016. The NCDB is a joint project of the American Cancer Society and the Commission on Cancer of the American College of Surgeons, and captures 70% of all patients with newly diagnosed cancer in the United States. Multivariable Cox proportional hazards models were used to calculate hazard ratios (HR) and 95% confidence intervals (95% CI) by race/ethnicity. Additionally, we evaluated the interaction of race/ethnicity with Charlson-Deyo comorbidity score and area-level median income using stratified models and formal tests of interaction. Results: A total of 3,068 patients were included. NH-Black patients had a lower risk of death relative to NH-White patients (HR 0.85; 95% CI 0.74, 0.98) after adjusting for sociodemographic, clinical, and treatment factors. Formal tests of interaction evaluating race with Charlson-Deyo comorbidity score and race with area-level median income were nonsignificant. However, in stratified analyses, NH-Black vs. NH-White patients had a lower risk of death in models adjusted for sociodemographic factors among those with at least one comorbidity (HR 0.76; 95% CI 0.59, 0.98), and those living in regions within the two lowest quartiles of median income (HR 0.82; 95% CI 0.69, 0.98). Conclusions: Among advanced-stage NSCLC patients who received immunotherapy, NH-Black patients experienced higher survival compared to NH-White patients. We urge the implementation of policies and interventions that seek to equalize access to care as a means of addressing differences in overall NSCLC survival by race.</jats:p> <jats:p>Citation Format: Anjali Gupta, Tomi Akinyemiju. Racial differences in survival among advanced-stage non-small cell lung cancer patients who received immunotherapy: An analysis of the U.S. National Cancer Database (NCDB) [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-107.</jats:p>
MLA Citation
Gupta, Anjali, and Tomi Akinyemiju. “Abstract PO-107: Racial differences in survival among advanced-stage non-small cell lung cancer patients who received immunotherapy: An analysis of the U.S. National Cancer Database (NCDB).” Cancer Epidemiology, Biomarkers &Amp; Prevention, vol. 31, no. 1_Supplement, American Association for Cancer Research (AACR), 2022. Crossref, doi:10.1158/1538-7755.disp21-po-107.
URI
https://scholars.duke.edu/individual/pub1522196
Source
crossref
Published In
Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology
Volume
31
Published Date
DOI
10.1158/1538-7755.disp21-po-107

Abstract PO-113: Overall survival in ovarian cancer patients seeking care at more than one treatment facility

<jats:title>Abstract</jats:title> <jats:p>Purpose: Ovarian cancer is the most lethal gynecological cancer and despite advances in treatment, most patients are diagnosed at an advanced stage with poor prognosis. Black women have a lower 5 year survival than White women when diagnosed at the same stage, and while there are a number of contributing factors, quality of treatment center may play a significant role. Choice in treatment facility may be limited by insurance coverage, availability of high-volume hospitals or specialists, or ability to access high-quality facilities, and it is unclear how a change in treatment facility may impact ovarian cancer survival. Methods: Participant usage files from the National Cancer Database were used to interrogate the characteristics of patients that seek treatment at more than one Commission on Cancer accredited facility in the United States to determine the effect on overall survival. Multivariable Cox regression analysis models were used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CI) to determine risk of mortality for patients receiving all of their first course treatment at one facility vs those receiving first course treatment at more than one facility. The fully-adjusted model was then stratified by race/ethnicity (Non-Hispanic White, Non-Hispanic Black, Hispanic) and by facility type (Community, Comprehensive Community, Academic/Research, Integrative Network). Results: A total of 211,937 women were included in the analysis. Patients were more likely to receive all of their first course treatment at one facility (81%). Patents treated at more than one facility had a 26% increase in ovarian cancer mortality compared with those treated at a single facility (HR: 1.26, 95% CI: 1.24-1.28). When stratified by race, NH-Black patients had the lowest increase in overall survival (HR: 1.08, 95% CI: 1.03-1.14) when compared with NH-White (HR: 1.27, 95% CI: 1.25-1.29) and Hispanic (HR: 1.33, 95% CI: 1.28-1.39) patients. Stratification by facility type showed that among women receiving treatment at more than one facility, those switching to an academic research center had the highest mortality (HR: 1.31, 95% CI: 1.28-1.34). Conclusions: Ovarian cancer patients that received treatment at more than one facility had a higher rate of mortality than those who were treated at a single center. Our findings suggest the need for further investigation into the effects of continuity of care, including how race, facility type, and other socioeconomic factors may modulate those effects.</jats:p> <jats:p>Citation Format: April Deveaux, Jessica Islam, Tomi Akinyemiju. Overall survival in ovarian cancer patients seeking care at more than one treatment facility [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-113.</jats:p>
Authors
Deveaux, A; Islam, J; Akinyemiju, T
MLA Citation
Deveaux, April, et al. “Abstract PO-113: Overall survival in ovarian cancer patients seeking care at more than one treatment facility.” Cancer Epidemiology, Biomarkers &Amp; Prevention, vol. 31, no. 1_Supplement, American Association for Cancer Research (AACR), 2022. Crossref, doi:10.1158/1538-7755.disp21-po-113.
URI
https://scholars.duke.edu/individual/pub1522197
Source
crossref
Published In
Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology
Volume
31
Published Date
DOI
10.1158/1538-7755.disp21-po-113

Abstract PO-178: Metabolic syndrome and risk of breast cancer by molecular subtype: Analysis of the Mechanisms for Novel and Established Risk Factors for Breast Cancer in Women of Nigerian Descent (MEND) study

<jats:title>Abstract</jats:title> <jats:p>Background: The African continent experiences the highest age-standardized breast cancer mortality globally, with Nigeria reporting the highest rate within the continent. Breast cancer in Nigeria is characterized by several striking epidemiological features. These cancers are disproportionately pre-menopausal, diagnosed at late-stages with high-grade disease, and characterized by the highly-aggressive triple-negative subtype. However, few studies have focused on understanding the differentially patterned risk factors associated with high breast cancer burden among Nigerian women. Metabolic syndrome is characterized by a cluster of biological irregularities and is known to be a significant predictor of breast cancer incidence. The purpose of this analysis was to examine the association of metabolic syndrome with breast cancer and molecular subtypes among Nigerian women for first time. Methods: Metabolic syndrome was defined as having at least 3 out of 5 of: high blood pressure (≥130/85 mm Hg), reduced HDL (&amp;lt;50 mg/dL), elevated triglyceride (&amp;gt;150 mg/dL), high waist circumference (≥80 cm), and prior diagnosis of diabetes or elevated fasting glucose level (≥100 mg/dL). Among 296 newly diagnosed breast cancer cases and 259 healthy controls, multivariable logistic regression models were utilized to estimate adjusted odds ratios (aOR) and 95% confidence intervals (95% CI) for the association between metabolic syndrome and breast cancer overall. Multinomial logistic regression models were used to evaluate each molecular subtype (Luminal A, Luminal B, HER2-enriched and triple-negative). Results: Cases compared to controls were significantly more likely to have metabolic syndrome (30% vs. 17%; p&amp;lt;0.001). After adjusting for age, socio-demographic and reproductive risk factors, there was a positive association between metabolic syndrome and breast cancer (aOR: 1.84, 95% CI: 1.07, 3.16). In stratified analyses, metabolic syndrome was associated with breast cancer regardless of BMI status; however, the estimate was significant only among normal weight women (aOR: 3.85; 95% CI: 1.25, 11.90). Metabolic syndrome was significantly associated with the triple-negative breast cancer subtype (aOR: 4.37, 95% CI: 1.67, 11.44); associations for other molecular subtypes were not statistically significant. Conclusions: Metabolic syndrome appears to be a robust risk factor for breast cancer, particularly for triple-negative breast cancer. Public health and clinical interventions can provide substantial benefits in reducing the burden of metabolic syndrome and preventing breast cancer among Nigerian women.</jats:p> <jats:p>Citation Format: Tomi Akinyemiju. Metabolic syndrome and risk of breast cancer by molecular subtype: Analysis of the Mechanisms for Novel and Established Risk Factors for Breast Cancer in Women of Nigerian Descent (MEND) study [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-178.</jats:p>
Authors
MLA Citation
Akinyemiju, Tomi. “Abstract PO-178: Metabolic syndrome and risk of breast cancer by molecular subtype: Analysis of the Mechanisms for Novel and Established Risk Factors for Breast Cancer in Women of Nigerian Descent (MEND) study.” Cancer Epidemiology, Biomarkers &Amp; Prevention, vol. 31, no. 1_Supplement, American Association for Cancer Research (AACR), 2022. Crossref, doi:10.1158/1538-7755.disp21-po-178.
URI
https://scholars.duke.edu/individual/pub1522198
Source
crossref
Published In
Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology
Volume
31
Published Date
DOI
10.1158/1538-7755.disp21-po-178

Research Areas:

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