Liver cancer in Hispanic and Latino communities

Liver cancer is cancer that starts in any part of the liver. The most common type of liver cancer is called hepatocellular carcinoma (HCC). Liver cancer rates are rising in the United States. In men, HCC is the fifth most common cause of cancer-related deaths. For women, he ranks seventh.

According to American Cancer Society, Hispanics and Latinos have higher rates of liver cancer than non-white Hispanics. They also have higher death rates from liver cancer.

Many cases of liver cancer can be prevented. Better access to preventive care could reduce the risk. Language barriers and lack of health insurance are challenges to receiving care for many Latinos.

The liver is a large organ that has many jobs in the body. It plays a role in digestion. It also filters the blood to remove harmful substances.

Liver cancer is cancer that starts in any part of the liver. The most common form of liver cancer is HCC. This type of cancer starts in the cells that make up the body of the liver. Cancer can also start in the ducts of the liver, but this is less common. HCC rate keep going up in the USA.

In 2020, 4.7% of new cancer diagnoses worldwide were liver cancer. He represented 8.3% cancer deaths. In the United States, it is estimated that there will be approximately 41,260 people diagnosed with liver cancer in 2022. This is expected to increase.

Cirrhosis is a major risk factor for developing liver cancer. On 80 percent of people with liver cancer have cirrhosis.

Anything that damages the liver can increase the risk of cirrhosis and liver cancer. Whenever the liver is damaged, it tries to repair itself. Over time, the cycle of damage and repair causes scar tissue.

Cirrhosis is severe scarring of the liver. When there is too much damage and scar tissue builds up, the liver no longer functions properly.

Risk factors for cirrhosis and liver cancer include:

  • hepatitis B or C infection
  • heavy drinking
  • exposure to aflatoxin from contaminated food, water, or soil
  • smoking tobacco
  • non-alcoholic steatohepatitis (NASH)

Hispanics have much higher rates of liver cancer than non-Hispanic whites in the United States. Data from 2014 to 2019 shows that they have double non-Hispanic rates. Data from 2018 shows that 1 out of 5 people with liver cancer in the United States is Hispanic.

Although liver cancer rates are on the rise in all groups, they are much higher among Hispanics. This group saw a 4.7% increase per year since 2000.

Hispanics are also diagnosed with more advanced stages of liver cancer. This means there are often fewer treatment options available. Compared to non-Hispanic whites, Hispanics have lower rates liver transplants. One theory to explain the lower rate of transplants is lower rates health insurance.

There are differences in liver cancer survival among blacks, Hispanics, and whites. A 2019 study found that the median survival time was highest for whites at 16.3 months. Median survival time was lowest for blacks at 10.6 months. The survival time for Hispanics was 14.4 months.

A number of factors may contribute to higher rates of liver cancer in Hispanic and Latino populations.

Hepatitis C

Hepatitis C infection remains a major cause of liver cancer. In Florida, hepatitis C is the main cause cases of liver cancer among Hispanics. In the USA, 50 to 60 percent of people with liver cancer are living with hepatitis C.

Overall, hepatitis C infections are stable or declining. The exception is that from 2014 to 2018 there was an increase of 2 percent in Hispanic women.

Hepatitis C is a treatable disease. For many people, however, there are major barriers to accessing testing and treatment. Treatment is expensive, and many people don’t know they have it until it’s advanced.

Chronic hepatitis C can lead to cirrhosis and sometimes liver cancer. Without regular access to health care, hepatitis C may go undetected and untreated.

Non-alcoholic fatty liver disease

Another risk factor for liver cancer is non-alcoholic fatty liver disease (NAFLD). NAFLD can progress to another condition called non-alcoholic steatohepatitis (NASH). NASH is an advanced stage of fatty liver disease. Fat builds up around the liver, causing inflammation and scarring.

NAFLD is on the rise, affecting approximately 75 to 100 million people in the United States.

Hispanics have the highest rates of NAFLD compared to other ethnic groups. Various studies showed that between 8.4% and 45% of Hispanics have NAFLD. They are also more likely to progress to NASH, which increases the risk of cirrhosis and liver cancer.

A condition called metabolic syndrome is also associated with NAFLD. Metabolic syndrome is a group of conditions. These can include high blood pressure, diabetes or prediabetes, and low levels of HDL or good cholesterol. In the United States, Hispanics have the highest rates metabolic syndrome.

Cirrhosis

Liver cirrhosis is associated with 80 percent cases of liver cancer. There are different causes of cirrhosis. These include:

  • heavy drinking
  • NASH
  • hepatitis C infection

Hispanics have higher cirrhosis rates than other groups. A large study has shown that Hispanics have a 37 percent increased risk of cirrhosis compared to Caucasians. Hispanics are more likely have alcohol-related cirrhosis or NASH.

Liver cancer is usually not diagnosed at an early stage. Symptoms often only appear at an advanced stage, when it is more difficult to treat. In later stages, there are larger and more tumors, or the cancer has spread to other parts of the body.

When liver cancer is detected early, there are more treatment options. That’s why regular checkups and routine screenings are important, especially for people at high risk of developing liver cancer.

Access to appropriate care is necessary to prevent and manage liver cancer risk factors. However, research shows that Hispanics are less likely to access preventive care.

A number of factors can prevent Hispanic and Latino people with liver cancer from receiving proper care and treatment. These may include:

  • Socioeconomic status
  • lack of health insurance
  • Language barrier
  • lack of access to culturally appropriate care

People living in poverty have a much harder time getting the health care they need. In the USA, 16 percent of Hispanics lived in poverty in 2019, compared to 7% of non-Hispanic whites.

Hispanics are also the most likely to be uninsured. Among those aged 18 to 64, 26 percent lack health insurance. On 9 percent non-Hispanic whites are uninsured.

The Affordable Care Act has helped improve access for many people. It reduced the number of uninsured Hispanics by 11.9%. Medicaid is run by each state, so there are differences in criteria and access.

Over the past decade, several states have expanded their Medicaid programs. Other states have not, including Florida and Texas, which have large Hispanic populations. This leaves even more people without access to health insurance.

The cost of drugs is another issue in the United States. A large survey of Hispanics showed that 12.5% were unable to afford prescription drugs.

Lack of access to culturally appropriate care is also a potential barrier to liver cancer care for Hispanic and Latino people. Cultural competence means that healthcare professionals can provide care that meets the social, cultural and linguistic needs of their patients.

Hispanics and Latinos come from many countries. They have different traditions, foods and languages. Care and recommendations for people of one race or background will not work for everyone. Too often, people receive recommendations that don’t match their traditions.

Many things need to be improved for Hispanics and Latinos to have better access to health care. Access to culturally appropriate care can improve screening and preventive care. This may help reduce risk factors associated with cirrhosis and liver cancer.

In areas with large Hispanic or Latino populations, better access to health insurance coverage could reduce barriers to receiving care to help prevent and treat cancer.

To overcome language barriers, the services of an interpreter would be helpful. Another huge gap in care is the lack of Hispanic and Latino healthcare professionals. Hispanics and Latinos make up approximately 5 percent of physicians in the United States.

It is much less than the 17.4% of people in the United States who identify as Hispanic or Latino. We need ways to help more Hispanic and Latino people get started in medical careers. Getting treatment from someone who speaks your language and understands your culture can make a big difference.

Hispanic and Latino people have higher rates of liver cancer and liver cancer death. There are several possible reasons for this. Hispanic and Latino people have higher rates of metabolic syndrome, NAFLD, and NASH. These increase the risk of cirrhosis and liver cancer.

Hepatitis C is a treatable disease that increases the risk of liver cancer. Hispanic and Latino people are not always able to access the right care or get treatment for hepatitis C.

Language barriers, poverty and lack of health insurance can prevent access to health care.

Increasing culturally competent care and removing cost and language barriers can help. Through strategies to improve access to care, many cases of liver cancer can be prevented or treated.

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