Abstract 3562: Associations between premature aging and cancer among middle-class Black and White women in the US: A case-control NHANES analysis

Abstract Although overall cancer mortality rates have decreased, Black women in the U.S. continue to have higher mortality rates from cancer than their White counterparts. Recent studies reveal that both genetic and environmental factors combine to contribute to these racial disparities in cancer, and may be modulated by differences in tumor biology. With cancer being an aging-related disease, it has previously been hypothesized that racial disparities in cancer outcomes are exacerbated by prolonged exposures to social and economic stressors that lead to premature aging. Our study aims to explore these effects on cancer status among U.S. Black and White women with annual household incomes of > $75K/year. Using data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2021, we quantified social and economic stressors using three factors: (1) allostatic load (AL) score to predict confounding stress factors on an individual’s health, (2) telomere length to predict premature aging, and (3) validated epigenetic aging markers from NHANES methylation data. We calculated the total AL score by summing the individual components for a score ranging from 0 to 9. Participants with high AL have a score ≥3. Mean telomere length was measured continuously. All aging metrics represent different aspects of accelerated epigenetic aging (Horvath Age and Hannum Age), phenotypic age (PhenoAge), pacing of aging (DunedinPoAm), and predicted age of mortality (GrimAge2Mort). Adjusted regression models were used to identify associations between these metrics, any cancer status, and race. We restricted our study sample to women with annual household incomes >$75K/year, resulting in a final NHANES cohort of 3, 690 women (cancer cases, n=302; controls, n=3, 388). In this cross-sectional study of Black (n=850) and White (n=2, 840) women, increasing allostatic load was associated with decreased odds of cancer case status overall (odds ratio (OR)=0.89, 95%CI=0.81, 0.98, p=0.02) and specifically for White women (OR=0.89, 95%CI=0.80, 0.99, p=0.03). Increasing Horvath Age was associated with a 20% increased odds of cancer case status overall (OR=1.20, 95%CI=1.01, 1.43, p=0.04) and significantly for White women (OR=1.36, 95%CI=1.11, 1.166, p=0.003), but not Black women. We also found that AL and telomere length were both associated with several accelerated aging metrics in cases and controls. Our results suggest that increasing allostatic load had a protective effect in this cohort of high-earning women, specifically among White women. Increasing epigenetic aging metrics correlated to odds of a cancer diagnosis overall and with race specific implications. Some differences by race may be attributed to the low sampling of Black women in this cohort with corresponding telomere and methylation data, emphasizing the need for future epigenetic studies to include more Black populations. Citation Format: Kayla S. Ingram, Brittany Jenkins-Lord, Kassandra L. Alcaraz, Avonne E. Connor. Associations between premature aging and cancer among middle-class Black and White women in the US: A case-control NHANES analysis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 3562.