About

Adana A.M. Llanos, PhD, MPH (she/her) is a cancer and molecular epidemiologist whose research program seeks to understand the molecular and sociobiologic contributors to cancer outcomes inequities, and ultimately identify ways to address them. Dr. Llanos has expertise in contemporary molecular techniques, including biomarker analysis in histologically normal tissues, tumors, and the tumor microenvironment, as well as molecular pathological epidemiology, secondary analysis of cancer surveillance data, the conduct of large, diverse observational studies, and community-based participatory research. A major focus of her research is to examine risk factors that contribute to increased breast cancer incidence at younger ages, increased incidence of more aggressive tumors, and increased mortality among Black women. Her ongoing work also includes investigating associations of adiposity and adiposity-related biomarkers, epigenetics, chronic physiologic stress, personal care products, and sociobiologic factors with cancer outcomes, particularly among minority and medically underserved populations. As a member of the African Caribbean Cancer Consortium (AC3), she collaborates on research to understand variation in cancer incidence and mortality among populations of African ancestry by subgroup. In addition to her scholarship, Dr. Llanos is actively involved in community service through engagement with community-based organizations, particularly those whose mission includes providing public health advocacy, education, outreach, and cancer survivorship support among community members. She has served on a National Community Advisory Board led by Black Ladies Advocating for Cancer Care (BLACC) and the Stanford School of Medicine Office of Community Engagement, and as a Board Member of the Yvonne McCalla Foundation, Inc., a non-profit breast cancer organization in New Jersey.

Research topics

• Medicine
• Internal medicine
• Oncology
• Demography
• Endocrinology

Selected publications

• Evaluating an online-delivered resistance exercise intervention for racially diverse breast cancer survivors using the RE-AIM framework

  Translational Behavioral Medicine · 2026-01-01

  articleOpen access

  BACKGROUND: Breast cancer survivors (BCS) experience persistent physical and psychological effects after treatment, with racially diverse groups demonstrating lower adherence to cancer-specific resistance exercise guidelines. Online resistance exercise interventions show promise for enhancing accessibility and health outcomes among BCS. However, evidence regarding their feasibility of implementation remains limited. Yet, such information is critical for assessing scalability and implementation in non-laboratory settings. PURPOSE: Using the RE-AIM (reach, efficacy, adoption, implementation, and maintenance) framework, this study evaluated the reach, efficacy, adoption, and implementation of a 12-week, supervised, online resistance exercise intervention for racially diverse BCS. METHODS: A mixed methods approach with a pre-post-study design was used. Quantitative outcomes included sociodemographic representativeness (reach), physical function (efficacy), and session fidelity (implementation). Qualitative interviews examined participant experiences, barriers, and facilitators (adoption). RESULTS: The intervention enrolled a racially diverse BCS sample (N = 47; 57.4% White, 23.4% Black, 14.8% Asian) that was mostly representative of the host institution catchment area, though participants had higher education levels. The intervention group demonstrated statistically significant improvements in upper- (P = .009) and lower-body physical function (P = .003) versus control, only. Adoption facilitators included program convenience, accessibility of online delivery, and trainer support, while barriers were equipment challenges, competing priorities, and cancer-related side effects. Program implementation fidelity was high for core components. CONCLUSIONS: Key factors contributed to the feasibility of implementation of the intervention. Future remote exercise interventions should address equipment needs, individualized support, and tailored recruitment to enhance adoption and facilitate scalability in non-laboratory settings. CLINICAL TRIAL INFORMATION: The Clinical Trials Registration #NCT04562233.

  PublisherDOI

• Rationale and study protocol for a pilot study to determine the feasibility and acceptability of a tailored stress management enhanced behavioral weight loss intervention for Black breast cancer survivors with obesity

  Contemporary Clinical Trials · 2025-10-22

  article
  PublisherDOI

• US Cancer Mortality Rates by Detailed Occupation Among Working-Age Adults, 2020-2023

  SSRN Electronic Journal · 2025-01-01

  preprintOpen access
  PublisherDOI

• Feasibility and Acceptability of Assessing Personal Care Product Use and Exposure to Endocrine-Disrupting Chemicals Among Black and Hispanic Breast Cancer Survivors: A Pilot Study

  International Journal of Environmental Research and Public Health · 2025-10-16

  articleOpen access

  This pilot study explored the feasibility and acceptability of utilizing silicone wristbands to assess exposure to endocrine-disrupting chemicals (EDCs) among 25 Black and Hispanic breast cancer survivors recruited in Washington, DC, and Hackensack, NJ. Over half of participants (58%) were diagnosed with Stage I breast cancer and the mean age was 58 ± 9 years. Most of the 24 survey respondents (95.83%) reported that the wristband did not interfere with daily activities and few (4) removed the wristband during the 7-day data collection period, demonstrating feasibility of use. Acceptability of passive sampling via silicone wristband was high with 73.91% of survivors reporting being "very satisfied" and 21.74% reporting being "satisfied" with their experience. The wristbands were analyzed via gas chromatography mass spectrometry for approximately 1500 semi-volatile organic compounds. This untargeted approach detected sixty distinct chemicals with an average of 21.8 per wristband. Personal care product, flame retardant, commercial product, and pesticide chemical classifications were detected in every wristband and frequently detected chemicals included biologically active compounds with potential genotoxic or endocrine-disrupting effects. This study demonstrates the feasibility of use and technical feasibility, as well as the acceptability, of utilizing silicone wristbands to assess exposure to semi-volatile organic compounds, including EDCs, among Black and Hispanic breast cancer survivors and lays the foundation towards engaging diverse cancer survivors in environmental health research.

  PublisherDOI

• Association between thoracic adiposity and survival in non-metastatic breast cancer

  Breast Cancer Research · 2025-10-14 · 1 citations

  articleOpen access

  BACKGROUND: Total adiposity measured by abdominal computed tomography (CT) at the third lumbar vertebrae (L3) has been associated with breast cancer survival, but most patients undergo chest CT. If adipose tissues at the thoracic level, including those surrounding the thoracic organs, are associated with survival, they could be used to inform care for significantly more breast cancer patients. METHODS: We included 2127 individuals aged 18-< 90, diagnosed with stage II-III breast cancer at Kaiser Permanente Northern California (2005-2019). Cross-sectional areas of adiposity were quantified at the fourth thoracic vertebrae (T4) and L3. Using multivariable Cox models, we estimated hazard ratios (HRs) and 95% confidence intervals to compare the strength of association of T4-level versus L3-level adiposity with all-cause and cause-specific mortality. RESULTS: Participants were on average 56.2 years old at diagnosis. During an average follow-up of 8.2 years, 593 deaths occurred, with 100 from heart disease and 429 from breast cancer. Positive, moderate-to-strong correlations were observed between adiposity at T4 and L3. After adjusting for covariates including body mass index and muscle, higher intrathoracic and intermuscular adiposity at T4 were associated with increased all-cause (intrathoracic: HR = 1.35[1.06-1.72]; intermuscular: HR = 1.26[1.01-1.59]) and heart disease-specific mortality (intrathoracic: HR = 2.23[1.31-3.78]; intermuscular: HR = 2.25[1.37-3.68]). Greater subcutaneous adiposity at T4 showed a non-significant trend toward increased mortality (overall: HR = 1.24[0.95-1.61]; breast cancer-specific: 1.27[0.93-1.73]). These associations were not observed at L3. CONCLUSIONS: Despite strong correlations with L3, adiposity at T4 was significantly associated with overall and heart disease-specific mortality, while measurements at L3 were not, possibly due to the proximity of T4 to the breast tumor and heart.

  PublisherOA PDFDOI

• Differences in COVID-19-Related Hospitalization, Treatment, Complications, and Death by Race and Ethnicity and Area-Level Measures Among Individuals with Cancer in the ASCO Registry

  Cancers · 2025-03-02

  articleOpen accessSenior authorCorresponding

  Individuals with cancer exposed to SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), are more susceptible to COVID-19-related complications [...].

  PublisherOA PDFDOI

• Cancer mortality rates by detailed occupation among US working-age adults between 2020 and 2023: a population-based study

  The Lancet Oncology · 2025-12-05

  article
  PublisherDOI

• The Power of Strategic Social Media Influencer Communication to Improve Black Women’s Knowledge and Awareness of Environmental Endocrine-Disrupting Chemicals: Surveys of Instagram Users

  Journal of Medical Internet Research · 2025-04-29

  articleOpen access

  Background: Black women are disproportionately affected by hormone-related health conditions, which may result from higher exposures to endocrine-disrupting chemicals (EDCs) in consumer products. EDCs are chemicals that interfere with the body's natural hormones. Objective: The Product Options in Women-Engaged Research project was developed to educate Black women about EDCs. We assessed the impact of strategic social media influencer (SMI) communication on knowledge and awareness of EDCs and intentions to change product-use behaviors. Methods: We recruited 7 SMIs to engage with their audiences about EDC-related information on Instagram. The SMIs attended a workshop to learn about EDCs in consumer products and then created Instagram content to share with their audiences. We surveyed SMIs at baseline and 1 month after they shared EDC-related content. SMI audiences were surveyed cross-sectionally before and after the SMIs posted EDC-related social media content. We evaluated social media engagement and analyzed the impact of these communications on SMIs and their audience. Results: The social media posts reached over 16,000 accounts and elicited over 28,000 engagements (eg, views, likes, and shares). SMIs' EDC knowledge and awareness increased after attending the workshop and sharing newly created content, and the SMIs had greater intentions to avoid EDCs at follow-up than at baseline. Engagement with the social media content about EDCs also led to positive outcomes among SMI audiences and particularly impacted intentions to engage in exposure reduction behaviors. In total, 80% of follow-up survey respondents reported that, in the future, they will always consider a company's chemical policy (n=68) and product ingredients when shopping (n=73) compared to 26.8% (n=63) and 46.9% (n=115), respectively, of baseline survey respondents who already reported doing so (P<.001). More follow-up respondents than baseline respondents self-reported an intention to avoid parabens (n=33, 32.7% vs n=39, 15.3%; P<.001), bisphenol A (n=25, 24.8% vs n=38, 14.9%; P=.03), per- and polyfluoroalkyl substances (n=17, 16.8% vs n=9, 3.5%; P<.001), and fragrance (n=6, 5.9% vs n=5, 2.0%; P=.08). Conclusions: Our findings demonstrate that strategic SMI partnerships incorporating a culturally tailored training program can be used to reach large audiences of Black women, improve knowledge about EDCs, and promote intentions to change behaviors to reduce exposures to EDCs.

  PublisherDOI

• Risk Factors and COVID-19 Survival Among Cancer Survivors in New Jersey: A Population-based study

  Research Square · 2025-10-12

  preprintOpen access
  PublisherOA PDFDOI

• Racial and ethnic variation in body composition and prognosis of nonmetastatic breast cancer

  Cancer · 2025-06-06 · 2 citations

  articleOpen access

  BACKGROUND: The disproportionate burden of obesity among Black women may contribute to disparities in breast cancer survival; yet, associations of body mass index (BMI), a proxy for total adiposity, are inconsistent. METHODS: To examine racial/ethnic differences in body composition and evaluate associations with breast cancer-specific and all-cause mortality, this study identified 3898 women 18 to <90 years old, diagnosed in 2005-2019 with stage II-III breast cancer at Kaiser Permanente Northern California. The authors measured subcutaneous, visceral, and intermuscular adipose tissue area from computed tomography scans. RESULTS: Body composition differed by race: compared to other race/ethnicity groups, Black women had higher skeletal muscle and subcutaneous adipose, but lower visceral adipose tissues, whereas Asian/Pacific Islander women had lower intermuscular and subcutaneous adipose tissue. BMI was not significantly associated with mortality in any group. Among Black women, higher subcutaneous adipose tissue was associated with breast cancer-specific mortality (hazard ratio [HR], 1.24; 95% confidence interval [CI], 1.02-1.52) and all adipose tissue measures were associated with increased all-cause mortality (intermuscular HR, 1.26; 95% CI, 1.09-1.46; subcutaneous HR, 1.25; 95% CI, 1.05-1.48; and visceral HR, 1.32; 95% CI, 1.03-1.68, respectively). By contrast, only increased intermuscular adipose tissue was associated with all-cause mortality among White women (HR, 1.08; 95% CI, 1.00-1.16), with null associations for Hispanic and Asian/Pacific Islander women. CONCLUSIONS: BMI obscures variation in body composition, particularly for Black women, who have more subcutaneous adipose and skeletal muscle but less visceral adipose tissue at higher BMIs. These findings from routine imaging highlight opportunities for tailored lifestyle interventions to improve survivorship and mitigate disparities.

  PublisherOA PDFDOI

Recent grants

• Adipokines, adipokine receptors, and disparities in breast cancer clinicopathological features

  NIH · $692k · 2015–2022

Frequent coauthors

• Elisa V. Bandera

  107 shared

• Cătălin Marian

  Victor Babeș University of Medicine and Pharmacy Timișoara

  99 shared

• Peter G. Shields

  The Ohio State University

  96 shared

• Bo Qin

  Chengdu University of Traditional Chinese Medicine

  78 shared

• Ramona G. Dumitrescu

  Victor Babeș University of Medicine and Pharmacy Timișoara

  76 shared

• Jo L. Freudenheim

  73 shared

• Antoinette M. Stroup

  Rutgers, The State University of New Jersey

  70 shared

• Kitaw Demissie

  SUNY Downstate Health Sciences University

  68 shared