US residents of Mexican descent may have a higher risk of liver cancer with each successive generation

PHILADELPHIA – The risk of hepatocellular carcinoma (HCC) among people of Mexican descent living in Los Angeles has increased with each successive generation in the United States, according to findings presented at the 15th AACR Conference on Cancer Science Health Disparities Among Racial/Ethnic Minorities and the Medically Underserved, September 16-19, 2022.

“Hispanics/Latinos represent one of the largest and fastest growing ethnic groups in the United States. Epidemiological trends show an increased incidence of liver and intrahepatic bile duct cancer in this population for both males and females, while we are seeing a decline for many other cancer sites,” said Nicholas Acuna, MPH, doctoral student in epidemiology in the Department of Population & Public Health Sciences at the Keck School of Medicine from USC and lead author of the study, “It’s important to understand the reasons for these trends.”

Studies show that place of birth may influence cancer risk, with US-born Hispanics/Latinos being at greater risk of developing liver cancer than foreign-born Hispanics/Latinos, likely due to acculturation, he said.

Leveraging the Multiethnic Cohort, a large prospective, population-based study of risk factors for cancer and other chronic diseases among more than 215,000 participants from five American racial/ethnic groups in Los Angeles and Hawaii, Acuna and its colleagues studied the impact of generational status on the risk of HCC in people of Mexican descent residing in Los Angeles.

The analysis focused on self-identified Mexicans for whom parental birthplace information was available. Generational status was classified as first generation for people born in Mexico with both parents also born in Mexico; second generation for people born in the United States with at least one parent born in Mexico; and third generation for those born in the United States with both parents also born in the United States

The researchers assessed the risk of HCC after adjusting for age, gender, body mass index (BMI), smoking status, alcohol consumption, history of diabetes and consumption coffee daily.

After an average follow-up of 23.4 years, among 32,239 people of Mexican origin, there were 220 cases of HCC. The study found an increase in age-adjusted HCC incidence rates per 100,000 people with each successive generation, from 20.9 cases in first-generation individuals to 27.5 in second-generation individuals. and 34.7 in third-generation individuals.

Controlling for HCC risk factors, second- and third-generation people of Mexican descent had a significantly increased risk of HCC compared to their first-generation counterparts (35% and 61% higher, respectively).

The study also showed that with successive generations, people of Mexican descent were more likely to be current smokers, to have more alcohol consumption, to consume more coffee and to have a High BMI.

The authors applied a statistical interaction test to assess whether the association between generational status and hepatocellular carcinoma risk differed by smoking status, alcohol consumption, BMI status, or diabetes, but did not found significant differences, possibly because the number of HCC cases was not high.

The researchers also found that third-generation people who did not have diabetes had a much higher risk (82%) of HCC compared to first-generation people who did not have diabetes, indicating that Multiple risk factors come into play to determine the increased risk. of the HCC.

“Interventions targeting acculturation and adoption of negative lifestyle behaviors, such as increased alcohol consumption, unhealthy diets, and smoking, among American-born Mexicans are needed to mitigate risk. increased HCC in this population,” Acuna said.

Limitations of this study include that it did not consider the different etiologies of HCC, including viral hepatitis B and C, alcoholic fatty liver disease, and non-alcoholic fatty liver disease. Additionally, the researchers focused exclusively on participants of Mexican descent, who represent the largest Latino subgroup of the multi-ethnic cohort. Therefore, the results of the study cannot be generalized to other Latin American subgroups and further studies are needed.

This study was funded by the National Cancer Institute. Acuna reports no conflicts of interest.

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