Erica T Warner

Massachusetts General Hospital | MGH · Department of Medicine

Introduction: Cancer treatment planning in older adults is complex and requires careful balancing of survival, quality of life benefits, and risk of treatment-related morbidity and toxicity. As a result, treatment selection in this cohort tends to differ from that for younger patients. However, there are very few studies describing cancer treatment...

Background: We studied women enrolled in the Boston Mammography Cohort Study to investigate whether subgroups defined by age, race, or family history of breast cancer experienced differences in trends of screening or diagnostic imaging rates during the COVID-19 lockdown and had slower rebound in trends of these rates during reopening. Methods: We c...

Background Patient navigation is an evidence-based intervention for reducing delays in oncology care among underserved populations. In order to address the financial sustainability of this intervention, information is needed on the cost of implementing patient navigation in diverse healthcare settings. Because patient navigation programs and care s...

Background Breast parenchymal texture features, including grayscale variation (V), capture the patterns of texture variation on a mammogram and are associated with breast cancer risk, independent of mammographic density (MD). However, our knowledge on the genetic basis of these texture features is limited. Methods We conducted a genome-wide associ...

Cancer treatment planning in older adults is complex and requires careful balancing of survival, quality of life benefits, and risk of treatment-related morbidity and toxicity. As a result, treatment selection in this cohort tend to differ from younger patients. However, there are very few studies describing cancer treatment patterns in older cohor...

93 Background: Clinical trials (CT) are important treatment options for patients with cancer, yet enrollment rates among underrepresented minority (URM) patients remain suboptimal. Oncology care teams need to assess barriers and facilitators of CT participation and identify practices and resources to better support patients. As part of a larger mix...

Purpose: To evaluate and quantify potential sociodemographic disparities in breast cancer screening, diagnosis, and treatment due to the COVID-19 pandemic, and the use of telemedicine. Methods: We fielded a 52-item web-based questionnaire from 14 May 2020 to 1 July 2020 in partnership with several U.S.-based breast cancer advocacy groups. Indivi...

Racial/ethnic minorities have been disproportionately impacted by COVID-19. The effects of COVID-19 on the long-term mental health of minorities remains unclear. To evaluate differences in odds of screening positive for depression and anxiety among various racial and ethnic groups during the latter phase of the COVID-19 pandemic, we performed a cro...

Purpose We calculated rates of breast and prostate cancer screening and diagnostic procedures performed during the COVID-19 pandemic through December 2021 compared to the same months in 2019 in a large healthcare provider group in central Massachusetts. Methods We included active patients of the provider group between January 2019 and December 202...

Purpose We aimed to determine the availability of existing web-based educational materials on breast cancer survivorship and assess their readability and understandability. Methods We identified materials eligible for review in two ways: (1) reviews of websites of major cancer-related organizations (e.g., American Cancer Society); (2) Google searc...

Importance: Emerging data suggest gout and hyperuricemia may now be more frequent among Black adults in the US than White adults, especially Black women. However, national-level, sex-specific general population data on racial differences in gout prevalence and potential socioclinical risk factors are lacking. Objective: To identify sex-specific...

Background Breast parenchymal texture features, including gray scale variation (V), capture the patterns of texture variation on a mammogram and are associated with breast cancer risk, independent of mammographic density (MD). However, our knowledge on the genetic basis of these texture features is limited. Methods We conducted a genome-wide assoc...

Purpose of Review Cardiovascular disease is long-term complication of both cancer and anti-cancer treatment and can have significant ramifications for health-related quality of life and mortality. This narrative review explores the current evidence linking cardiovascular disease and cancer, as well as exploring strategies for the prevention and man...

Inverse associations between natural vegetation exposure (i.e., greenness) and breast cancer risk have been reported; however, it remains unknown whether greenness affects breast tissue development or operates through other mechanisms (e.g., body mass index [BMI] or physical activity). We examined the association between greenness and mammographic...

Background: Previous studies have demonstrated poorer survival of Black women with breast cancer. We assessed whether race/ethnicity was associated with disease-free (DFS) and overall survival (OS) among women with breast cancer enrolled in clinical trials for early-stage breast cancer according to tumor subtype, age, and body mass index (BMI). Met...

Abstract 12086 Background: New treatments and early detection measures have led to declines in cancer mortality rates and a growing population of cancer survivors at risk of short- and long-term effects of cancer and cancer treatment (C&CT), including cardiovascular disease (CVD). Although shared risk factors may contribute, several C&CT-related me...

Prospective studies on the association between depression and telomere length have produced mixed results and have been largely limited to European ancestry populations. We examined the associations between depression and telomere length, and the modifying influence of religion and spirituality, in four cohorts, each representing a different race/e...

Although progress has been made, the majority of patients with non–small cell lung cancer are diagnosed at an advanced stage, with disparities being observed by race/ethnicity and socioeconomic status. There is a critical need to understand and ameliorate these disparities and to advance lung cancer equity.

A decline in functional status, an individual’s ability to perform the normal activities required to maintain adequate health and meet basic needs, is part of normal ageing. Functional decline, however, appears to be accelerated in older patients with cancer. Such decline can occur as a result of a cancer itself, cancer treatment-related factors, o...

Worldwide, racial and ethnic minorities have been disproportionately impacted by COVID-19 with increased risk of infection, its related complications, and death. In the initial phase of population-based vaccination in the United States (U.S.) and United Kingdom (U.K.), vaccine hesitancy may result in differences in uptake. We performed a cohort stu...

The COVID-19 pandemic has placed an unprecedented burden on the healthcare system, disrupting routine care including breast cancer screening. We used data from 2392 women without a history of breast cancer enrolled in the Boston Mammography Cohort Study (BMCS) to investigate whether subgroups defined by age, race, or family history of breast cancer...

Purpose Cancer patients who smoke may experience significant stigma due both to their disease, and negative attitudes and beliefs regarding smoking. We investigated whether internalized stigma differed between currently smoking cancer patients diagnosed with lung or head and neck cancers, other smoking related cancers, and non smoking-related cance...

Background: Few epigenetics studies have been conducted within the Black community to examine the impact of diverse psychosocial stressors and resources for resiliency on the stress pathway (hypothalamus-pituitary-adrenal axis). Methods: Among 1000 participants from the Black Women's Health Study, associations between ten psychosocial stressors and...

The association between religion, spirituality, and body weight is controversial, given the methodological limitations of existing studies. Using the Nurses’ Health Study II cohort, follow-up occurred from 2001 to 2015, with up to 35,547 participants assessed for the religious or spiritual coping and religious service attendance analyses. Cox regre...

Objective To assess awareness and implementation of the American College of Surgeons Oncology Group Z0011 trial findings, approaches to axillary nodal imaging, and to identify differences in practice based on respondent characteristics. Methods An online survey was distributed to members of the Society of Breast Imaging. Questions regarded demogra...

Cancer screening rates declined sharply early in the COVID-19 pandemic. The impact of the pandemic may have exacerbated existing disparities in cancer screening due to the disproportionate burden of illness and job loss among racial/ ethnic minorities, and potentially, uneven resumption of care between different racial/ ethnic groups. Using electro...

During the Coronavirus Disease 2019 (COVID-19) epidemic, many health professionals used social media to promote preventative health behaviors. We conducted a randomized controlled trial of the effect of a Facebook advertising campaign consisting of short videos recorded by doctors and nurses to encourage users to stay at home for the Thanksgiving a...

Purpose To investigate religion and spirituality (R/S) as psychosocial factors in type 2 diabetes risk. Methods Using the Nurses’ Health Study II, we conducted a 14-year prospective analysis of 46,713 women with self-reported use of religion or spiritual beliefs to cope with stressful situations, and 42,825 women with self-reported religious servi...

Background: There is limited prior investigation of the combined influence of personal and community-level socioeconomic factors on racial/ethnic disparities in individual risk of coronavirus disease 2019 (COVID-19). Methods: We performed a cross-sectional analysis nested within a prospective cohort of 2,102,364 participants from March 29, 2020...

Genomic risk prediction models for breast cancer (BC) have been predominantly developed with data from women aged 40–69 years. Prospective studies of older women aged ≥70 years have been limited. We assessed the effect of a 313-variant polygenic risk score (PRS) for BC in 6339 older women aged ≥70 years (mean age 75 years) enrolled into the ASPREE...

During the COVID-19 epidemic, many health professionals started using mass communication on social media to relay critical information and persuade individuals to adopt preventative health behaviors. Our group of clinicians and nurses developed and recorded short video messages to encourage viewers to stay home for the Thanksgiving and Christmas Ho...

Importance: Social distancing is critical to the control of COVID-19, which has disproportionately affected the Black community. Physician-delivered messages may increase adherence to these behaviors. Objectives: To determine whether messages delivered by physicians improve COVID-19 knowledge and preventive behaviors and to assess the differenti...

During the COVID-19 epidemic, many health professionals started using mass communication on social media to relay critical information and persuade individuals to adopt preventative health behaviors. Our group of clinicians and nurses developed and recorded short video messages to encourage viewers to stay home for the Thanksgiving and Christmas Ho...

During the COVID-19 epidemic, many health professionals started using mass communication on social media to relay critical information and persuade individuals to adopt preventative health behaviors. Our group of clinicians and nurses developed and recorded short video messages to encourage viewers to stay home for the Thanksgiving and Christmas Ho...

Given the continued burden of COVID-19 worldwide, there is a high unmet need for data on the effect of social distancing and face mask use to mitigate the risk of COVID-19. We examined the association of community-level social distancing measures and individual face mask use with risk of predicted COVID-19 in a large prospective U.S. cohort study o...

Background Religion and spirituality (R/S) are important resources for coping with stress and are hypothesized to influence health outcomes via modulation of the hypothalamic-pituitary-adrenal (HPA) axis, though this has not been evaluated extensively. In this study, we examined associations between several measures of religiosity or spirituality (...

Background Genomic risk prediction models for breast cancer (BC) have been predominantly developed with data from women aged less than 70 years. Prospective studies of women aged 70 years or older have been limited. Methods We assessed the effect of a 313-variant polygenic risk score (PRS) for BC in 6,339 women of European ancestry aged ≥70 years....

Percent mammographic density (PMD) is a strong breast cancer risk factor, however, other mammographic features, such as V, the standard deviation (SD) of pixel intensity, may be associated with risk. We assessed whether PMD, automated PMD (APD), and V, yielded independent associations with breast cancer risk. We included 1900 breast cancer cases an...

Background: Racial and ethnic minorities have been disproportionately impacted by COVID-19. In the initial phase of population-based vaccination in the United States (U.S.) and United Kingdom (U.K.), vaccine hesitancy and limited access may result in disparities in uptake. Methods: We performed a cohort study among U.S. and U.K. participants in the...

This paper describes the development and initial psychometric testing of the baseline Spirituality Survey (SS-1) from the Study on Stress, Spirituality, and Health (SSSH). The SS-1 contains a mixture of items selected from validated existing scales and new items generated to measure important constructs not captured by existing instruments, and our...

Purpose Mammography screening encounters may represent ideal opportunities to identify high-risk women for risk-based screening. During mammography appointments, radiology practices evaluate breast density and ascertain known breast cancer risk factors. Our purpose was to evaluate the potential for mammographic screening encounters to identify high...

Objective This study aimed to uncover genetic contributors to adiposity in early life. Methods A genome‐wide association study of childhood body fatness in 34,401 individuals within the Nurses’ Health Studies and the Health Professionals Follow‐up Study was conducted. Data were imputed to the 1000 Genomes Phase 3 version 5 reference panel. Resu...

The events of 2020 threw into stark relief the long-standing inequities in healthcare and the disproportionate toll they exert on communities of color. We asked physicians and scientists to share their experiences in confronting and tackling health disparities, and their Voices highlight the need for concerted and widespread action.

Patient navigation has been shown to improve cancer care in underserved populations. Since November 2017, we have enrolled newly diagnosed cancer patients from three community health centers into a patient navigation study. Most of our patients receive primary care in Chelsea, a city that had the highest rate of COVID-19 infection in Massachusetts....

Given the continued burden of severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) disease (COVID-19) across the U.S., there is a high unmet need for data to inform decision-making regarding social distancing and universal masking. We examined the association of community-level social distancing measures and individual masking with risk of...

Introduction We examined whether abuse in childhood and/or adolescence was associated with shorter telomere length in a pooled analysis of 3,232 participants from five diverse cohorts. We also assessed whether religion or spirituality (R/S) could buffer deleterious effects of abuse. Methods Physical and sexual abuse in childhood (age <12) and adol...

Introduction: The COVID-19 pandemic has altered the health care delivery system. The purpose of this study was to determine the impact of the COVID-19 pandemic on breast cancer screening, diagnosis, and treatment. Methods: Potential survey respondents were identified through partnerships with breast cancer organizations including Dr. Susan Love Fou...

BACKGROUND: Data for front-line health-care workers and risk of COVID-19 are limited. We sought to assess risk of COVID-19 among front-line health-care workers compared with the general community and the effect of personal protective equipment (PPE) on risk. METHODS: We did a prospective, observational cohort study in the UK and the USA of the gene...

Background Data for front-line health-care workers and risk of COVID-19 are limited. We sought to assess risk of COVID-19 among front-line health-care workers compared with the general community and the effect of personal protective equipment (PPE) on risk. Methods We did a prospective, observational cohort study in the UK and the USA of the gener...

Background Racial and ethnic minorities have disproportionately high hospitalization rates and mortality related to the novel coronavirus disease 2019 (Covid-19). There are comparatively scant data on race and ethnicity as determinants of infection risk. Methods We used a smartphone application (beginning March 24, 2020 in the United Kingdom [U.K.]...

Objectives: In this pilot study, we developed and assessed acceptability of a brochure for women with dense breasts. Material and methods: We measured Flesch-Kincaid Readability of 22 existing breast density educational materials. We then developed a brochure and tested it in two populations of women: 44 safety net hospital patients and 13 Breas...

Background: Half of women undergoing mammography have dense breasts. Mandatory dense breast notification and educational materials have been shown to confuse women, rather than empower them. Objective: This study used a mixed method, multi-stakeholder approach to assess acceptability of an interactive, computer-animated agent that provided breas...

Background: The V measure captures grayscale intensity variation on a mammogram and is positively associated with breast cancer risk, independent of percent mammographic density(PMD), an established marker of breast cancer risk. We examined whether anthropometrics are associated with V, independent of PMD. Methods: The analysis included 1,700 pr...

The association between religious service attendance, religious coping, and hypertension is unclear. Prospective research and assessment of potential mediators is needed to understand this relationship. From 2001-2013, we prospectively followed 44,281 non-hypertensive women who provided information on religious service attendance and religious copi...

Background: Lower socioeconomic status (SES) associates with a higher risk of major adverse cardiac events (MACE) via mechanisms that are not well understood. Objectives: Because psychosocial stress is more prevalent among those with low SES, this study tested the hypothesis that stress-associated neurobiological pathways involving up-regulated...

Despite demonstrated reduction in lung cancer mortality, lung cancer screening uptake has been low. We investigated differences in discussions with physicians about lung cancer screening and awareness using repeated cross-sectional data from three cycles [4.2 (2013); 4.4(2014)and 5.1 (2017)]of the Health Information National Trends Survey. We inclu...

Rationale and objectives: To determine awareness and knowledge of breast density and breast density legislation among women receiving routine mammography following passage of Massachusetts breast density legislation. Materials and methods: A survey assessing breast density awareness and knowledge was administered to all women receiving screening...

Background: Lung cancer is the leading cause of cancer death in U.S. men and women with just a 17.7% five-year survival rate. Based largely on the results of the National Lung Screening Trial, the U.S. Preventive Services Task Force recommends, and Medicare now covers, low-dose computed tomography for current and former smokers age 55 or older with...

Purpose: To date, 32 states have passed legislation requiring that the estimated 50% of women with dense breast tissue receive written notification after a mammogram. We investigated whether there are sociodemographic disparities in breast density notification, receipt of supplemental MRI and ultrasound screening, and the association of breast dens...

Objective: To determine whether there were gender differences in likelihood of receiving a first National Institutes of Health (NIH) R01 award among 5445 instructors and assistant professors at Harvard Medical School (HMS). Materials and methods: Data on R01 award principal investigators were obtained from NIH ExPORTER and linked with faculty da...

Purpose: Gender inequalities in the careers of faculty in academic medicine could partially be attributed to an organizational climate that can exclude or be nonsupportive of women faculty. This study explores the climate for women faculty from a systems perspective at the organizational and individual levels based on the perceptions of women facu...

Background: Urinary melatonin levels have been associated with a reduced risk of breast cancer in postmenopausal women, but this association might vary according to tumor melatonin 1 receptor (MT1R) expression. Methods: We conducted a nested case-control study among 1,354 postmenopausal women in the Nurses' Health Study, who were cancer free whe...

Background: In 2009, the US Preventive Services Task Force recommended that the decision to initiate screening mammography before age 50 years should be individualized. Herein, the authors examined whether health care providers are communicating regarding mammography decision making with women and whether communication is associated with screening...

Height and body size in childhood and young adulthood have been consistently associated with breast cancer risk; whether associations differ across molecular subtypes is unclear. In a pooled analysis of the Nurses' Health Studies, we prospectively examined the association of four exposures: height, body mass index (BMI) at the age of 18 years, chil...

Results: Plasma 25(OH)D levels were not associated with breast cancer risk overall (top ({greater than or equal to}32.7ng/mL) vs. bottom (<17.2ng/mL) quintile RR=0.87, 95% CI (0.67-1.13), p-trend=0.21). 25(OH)D measured in summer (May-October) was significantly inversely associated with risk (top vs. bottom quintile RR=0.66, 95% CI (0.46-0.94), p-...

Previous studies demonstrated poor response to neoadjuvant systemic therapy (NST) for breast cancer among black women and women who are overweight or obese, but this may be due to chemotherapy underdosing. We assessed associations of race, ethnicity, and body mass index (BMI) with pathologic complete response (pCR) in clinical trial populations. 17...

Purpose: Young women are at increased risk for developing more aggressive subtypes of breast cancer. Although previous studies have shown a higher risk of breast cancer recurrence and death among young women with early-stage breast cancer, they have not adequately addressed the role of tumor subtype in outcomes. Methods: We examined data from wo...

Introduction: In 2009 the US Preventive Services Task Force (USPSTF) recommended against routine annual mammograms among women aged 40-49. However, mammography utilization appears unchanged since that time. We examined whether women, particularly those ages 40-49, are having discussions about mammography with their healthcare providers and how this...

s: Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; November 13-16, 2015; Atlanta, Georgia Introduction: Adverse childhood experiences (ACE) have been implicated in several adult chronic diseases. ACE may also be associated with reproductive and lifestyle factors and biomarkers...

Business literature has demonstrated the importance of networking and connections in career advancement. This is a little-studied area in academic medicine. To examine predictors of intra-organizational connections, as measured by network reach (the number of first- and second-degree coauthors), and their association with probability of promotion a...

To evaluate the relationship between race/ethnicity and breast cancer-specific survival according to subtype and explore mediating factors. Participants were women presenting with stage I to III breast cancer between January 2000 and December 2007 at National Comprehensive Cancer Network centers with survival follow-up through December 2009. Cox pr...