Targeting Chronic Stress for Reducing Risk Factors for Colorectal Cancer

Many neighborhoods in Chicago experience daily exposure to stressors including economic inopportunity and violent crime in public spaces. There is mounting evidence that chronic psychosocial stress can facilitate carcinogenesis by modulating the gut microbiome and immune system. The proposed research aims to study the practice of mindfulness to mitigate CPS and reduce colorectal cancer risk factors among Black American women at elevated risk.

Inclusion Criteria: * Female based on sex assigned at birth * Self-identify as Black * Age 45-65 years old * Completed a colonoscopy in the past 24 months, * Classify as elevated risk of CRC defined as: any colorectal adenoma detected in past 24 months * Own and use a smartphone, computer, or tablet with access to the Internet * Score ≥ 14 on the PSS at screening * Reside in a Chicago community with high violent crime Exclusion Criteria: * History of CRC * Antibiotics (oral/IV) in the past 2 months * Inflammatory bowel disease or genetic predisposition to CRC * Cancer diagnosis or cancer treatment in the past 12 months * Consume \> 50 grams of ethanol daily * Use combustible tobacco * Bariatric surgery or bowel resection * Immunodeficiency/autoimmune disease * Uncontrolled diabetes (HbA1c \> 9% based on EHR) * Fiber or pre-/probiotic supplements \> 3 days per week * Serrated adenoma at the recent colonoscopy given the molecular features are distinct * Significant health conditions or take medications that impact participation or expected outcomes (e.g., β-blocker, Cushing's syndrome, and corticosteroids - inhaled, topical, oral in the past month given effects on hair cortisol measurement)