Faculty Summaries
Carolyn Y. Fang, PhD
Carolyn Y. Fang, PhD
Associate Professor
  • Co-Leader, Cancer Prevention and Control
  • Adjunct Professor, Department of Public Health, College of Health Professions, Temple University
Office Phone: 215-728-4062
Fax: 215-728-2707
Office: 4th Floor, Young Pavilion
  • Biobehavioral Pathways in HPV-Related Cancers

    In a series of studies, we have been examining basic biobehavioral mechanisms underlying the stress response within a paradigm of human papillomavirus (HPV) infection. In this research, we have demonstrated that psychosocial factors are associated with markers of HPV-specific immune functioning. Specifically, our data indicate that women reporting higher levels of perceived stress are less likely to show a T-cell proliferative response to HPV16. The finding that higher levels of stress are associated with impaired HPV-specific immune response suggests a potential mechanism by which stress may be related to HPV persistence and cervical disease progression. Because accumulating data suggest that HPV infection of the upper aerodigestive tract may contribute to the development of a subset of head and neck cancers, we have been examining similar interrelations among patients with precancerous oral lesions and head and neck cancer. Together, these data will help define potential psychosocial, behavioral, and immunologic pathways underlying HPV-related cancer risk and development.

  • Biobehavioral pathways in cervical cancer risk

    We are currently investigating how psychological responses to stress are associated with in vitro markers of immune function among women at risk for cervical cancer. In a series of studies, we have been focusing on T-cell responses to HPV16 E6 and E7 oncoproteins, which are known to interact and interfere with the functions of tumor suppressor proteins p53 and retinoblastoma protein (pRb), respectively. Results from an initial study conducted by our team established that T-cell proliferative response to HPV16 peptides in vitro distinguished between healthy women and women with cervical intraepithelial neoplasia (CIN) – specifically, women with CIN were less likely to have a proliferative response to HPV16 compared to healthy women without cervical disease. Moreover, among women with CIN, we found that higher levels of self-reported perceived stress were associated with impaired T-cell proliferative response to HPV16, which is one of the first studies to identify a relationship between perceived stress and specific deficits in immune response to HPV16 among women at risk for cervical cancer. Based on these findings, we recently launched a 5-year study to evaluate the effects of a stress reduction intervention on immune response to HPV16 among women with CIN. Data from this randomized, controlled trial will make a significant contribution to our understanding of potential mind-body pathways in an at-risk population.

  • Human papillomavirus in head and neck cancers

    In two related studies, our team has been investigating the interrelations among HPV status, cell-mediated immunity to HPV, and psychosocial and behavioral correlates of immune response to HPV in patients with precancerous oral lesions and head and neck cancers. In these studies, we are obtaining tissue samples for HPV-typing using quantitative real time polymerase chain reaction (QRT-PCR) techniques. Preliminary analyses indicate that patients with HPV+ tumors are less likely to have T-cell responses to HPV16 compared to patients with HPV-negative tumors, which is consistent with our findings from women with CIN. In addition, logistic regression analyses indicate that higher levels of depressive symptoms are associated with a deficient T-cell response to HPV16. Our next step is to assess whether the observed relationship has implications for long-term clinical outcomes, including progression of precancerous oral lesions to cancer and/or disease recurrence.

  • Investigating neural pathways in the biobehavioral model of cancer risk

    We are beginning to examine how neural pathways that are activated during meditation may modulate immune response to oncogenic viruses, such as HPV. Recent neuroimaging studies are beginning to identify consistent patterns of brain activation during meditation practice, particularly in regions known to be involved in attention, emotion regulation, and in the control of the autonomic nervous system. Activation of specific regions of the cerebral cortex is highly relevant as animal studies have demonstrated cortical modulation of immune activity. Thus, our team is conducting a series of studies to explore whether neural regions activated during meditation are associated with HPV-specific immune responses among women with CIN. Data from these studies will allow us to further develop and pursue a novel paradigm for understanding how neurocognitive responses to stress modulate specific immunologic processes that contribute to cervical cancer risk.

  • Cancer Health Disparities in Underserved Asian Americans

    Asian Americans are one of the fastest growing ethnic/racial groups in the U.S. today, representing about 4% of the U.S. population. Yet, even though cancer is the leading cause of death in Asian American women, Asian Americans continue to be the least studied population in the area of cancer prevention and control. To address this empirical gap, our lab has been collaborating with Dr. Grace Ma and the Center for Asian Health at Temple University on several studies to evaluate culturally-specific interventions to reduce cancer health disparities among specific Asian American populations.

  • Cervical cancer in Asian American women

    Vietnamese and Korean American women have some of the highest incidence rates of cervical cancer, but the lowest rates of cervical cancer screening compared to other ethnic and racial subgroups. Yet, few programs have been developed to address this disparity. Towards this end, we have been evaluating the effects of an intervention that combines psychoeducational counseling with patient navigation in order to address both psychosocial and access barriers to screening. Preliminary results suggest that multifaceted approaches can be extremely effective in reducing the psychosocial, access, and language barriers that contribute to cancer health disparities in this underserved population. It is hoped that this research will not only inform future public health efforts designed to address cancer risk in these populations, but also reduce cervical cancer morbidity and mortality among Asian American women.

  • Hepatitis B screening and vaccination in Vietnamese Americans

    Hepatitis B (HBV) infection plays a primary role in the development of liver cancer, contributing to nearly 80% of liver cancer cases. Vietnamese males have the highest incidence of liver cancer of any ethnic group, and HBV infection is a serious and prevalent health problem among Vietnamese immigrants. Our preliminary data suggest that a number of factors influence Hepatitis B screening vaccination behaviors in this population. Thus, we have been collaborating with Dr. Grace Ma and the Center for Asian Health on a study to investigate the effects of a culturally-tailored and multifaceted intervention on Hepatitis B screening and vaccination behaviors among Vietnamese men and women. These community-based programs are designed to address both psychosocial and access barriers to screening and vaccination in order to enhance screening and vaccination rates in this underserved population.