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Liver cancer risk factors more prevalent among Mexicans living in US
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Mexican-American individuals residing in the United States had more risk factors for liver cancer than their counterparts living in Mexico, according to study results presented at American Association for Cancer Research Conference on The Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved.
These results may help design and implement more effective health promotion programs to address such risk factors, the researchers noted.
“Public health messages could definitely be tailored to help address the high rates of liver disease/cancer in people of Mexican descent,” Yvonne N. Flores, PhD, professor at UCLA Kaiser Permanente Center for Health Equity, told HemOnc Today. “Of particular concern are the very high rates of obesity and diabetes, as well as heavy/binge drinking observed among Mexicans in both countries. Having a combination of risk factors for liver disease — such as obesity and excessive drinking, or diabetes and hepatitis C virus — has been shown to increase risk for elevated aminotransferase levels and liver cancer.
“Most people are aware that alcohol abuse is associated with liver disease, but more programs are needed to inform Latinos of the increased risk for liver disease/cancer due to obesity,” Flores added.
The incidence of liver cancer is two times higher among U.S. Latinos compared with non-Hispanic white individuals. Latinos also are 1.8 times more likely to die of liver cancer.
Flores and colleagues evaluated the prevalence of risk factors for liver disease and cancer from a sample of Mexican-Americans compared with adults who reside in Mexico.
The researchers obtained data for Mexican-Americans from the 1999 to 2014 National Health and Nutrition Examination Survey. They obtained data on those living in Mexico from the Heath Worker Cohort Study, a longitudinal study of workers and their immediate family members from two large health care centers in Cuernavaca, Mexico.
The total study sample — 13,798 individuals — comprised 9,485 Mexican individuals residing in Mexico, 2,324 U.S.-born Mexican-Americans living in the United States, and 1,989 Mexican-Americans born in Mexico and living in the United States.
Researchers evaluated known risk factors for liver disease and cancer, including elevated aminotransferase levels, infection with hepatitis B or hepatitis C, metabolic syndrome, high total cholesterol, diabetes, obesity, abdominal obesity and heavy alcohol use.
Logistic regression controlled for by age, marital status and education level showed Mexican-American men born in Mexico appeared less likely to have HBV or HCV (OR = 0.2; 95% CI, 0.1-0.6) but more likely to have high cholesterol (OR = 1.4; 95% CI, 1.1-1.8) than men who lived in Mexico.
Mexican-American men born in the United States demonstrated a higher likelihood for metabolic syndrome (OR = 1.4; 95% CI, 1.1-1.9) and diabetes (OR = 3; 95% CI, 1.9-4.8) than men who lived in Mexico. Mexican-American men also appeared more likely to be obese, diabetic, have abdominal obesity, or be heavy/binge drinkers.
“I was surprised that the prevalence of heavy/binge drinking among Mexican-American males was over 70%,” Flores said. “In a previous study that also examined NHANES data, we found a somewhat lower prevalence of heavy/binge drinking among Mexican-American males that ranged from 59% to 66%. It is likely that the combination of alcohol abuse and obesity is a contributing factor to the high rates of liver disease that are observed among Mexican-American males.”
Adjusted multivariate results for females indicated that Mexican-American women had a significantly greater likelihood to be obese, diabetic, have abdominal obesity or be heavy/binge drinkers than their Mexican counterparts.
Prevalence ratios showed that Mexico- and U.S.-born Mexican-American women appeared significantly less likely to be infected with HBV and HCV than women in Mexico.
Other ethnic minority groups may also face an increased risk for liver cancer incidence and mortality than non-Hispanic white individuals.
“More studies are needed to evaluate how the accumulation of specific risk factors may be contributing to the increased risk for chronic liver disease and liver cancer among Mexican-Americans and other populations,” Flores said. “We are currently conducting studies to investigate the role of genetic factors, metabolomics and the gut microbiome as potential contributors to the increased risk for liver disease/cancer observed among Mexicans.” – by Kristie L. Kahl
Reference:
Flores Y, et al. Abstract A34. Presented at: AACR Conference on The Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Sept. 25-28, 2017; Atlanta.
Disclosures: Grants from the Programa de Investigación en Migración y Salud, the Instituto Mexicano del Seguro Social, and the Consejo Nacional de Ciencia y Tecnologia funded the study. Flores reports no relevant financial disclosures.