Liver and Other Gastrointestinal Cancers Are Frequent in Mexican Americans
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Disease patterns in Mexican American health-disparity populations differ from larger US populations.
This study is aimed to determine frequency of gastrointestinal cancers in Mexican Americans.
We analyzed self-reported data from the Cameron County Hispanic Cohort where we find high rates of risk factors for cancer: obesity (48.5 %) and diabetes (30.7 %). Participants provided cancer histories about themselves and first- and second-degree relatives. Logistic regression models assessed risk factors. Frequencies of cancer sites were ranked and validated using concurrent age local cancer registry data.
Among 9,249 individuals (participants and their relatives), there were 1,184 individuals with reports of cancer. Among cohort participants under 70 years of age, the most significant risk factor for all-cause cancers was diabetes (OR 3.57, 95 % CI 1.32, 9.62). Participants with metabolic syndrome were significantly more likely to report cancer in relatives [1.73 (95 % CI 1.26, 2.37]. Among cancers in fathers, liver cancer was ranked third, stomach fourth, colorectal sixth, and pancreas tenth. In mothers, stomach was third, liver fourth, colorectal seventh, and pancreas eleventh. The unusual prominence of these cancers in Mexican Americans, including liver cancer, was supported by age-adjusted incidence in local registry data.
Gastrointestinal system cancers, particularly, liver cancer, in a Mexican American health disparity cohort and their relatives rank higher than in other ethnicities and are associated with high rates of diabetes and metabolic syndrome. Effective prevention of diabetes and low-tech, high-quality screening strategies for gastrointestinal cancers are needed in health disparity communities.
KeywordsGastrointestinal cancer Liver Diabetes Mexican Americans
We thank Dr. Brian Smith, Director of Region 11, Texas Department of State Health Services, for reviewing the manuscripts and helpful suggestions. We thank our cohort recruitment team, particularly, Rocio Uribe and Julie Ramirez-Gomez. We also thank Marcela Montemayor and other laboratory staff for their contribution, Gloria Sanchez and Pablo Sanchez for our database management, and Christina Villarreal for administrative support. We thank Valley Baptist Medical Center, Brownsville, for providing us space for our Center for Clinical and Translational Science Clinical Research Unit. We finally thank the community of Brownsville and the participants who so willingly participated in this study in their city.
Compliance with Ethical Standards
Ms. Garza and Ms. Vatcheva declare that they have no conflict of interest. Drs. Fisher-Hoch, Rahbar, Fallon, Pan, and McCormick declare they have no conflict of interest.
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 . Informed consent was obtained from all patients for being included in the study. No identifying information was used in this article. This study and all procedures including written informed consent forms were approved by the Committee for the Protection of Human Subjects at University of Texas Health (UTHealth), Houston (approval numbers HSC-SPH-03-007 A and B). The study was explained to all participants in their language of choice (Spanish or English) before obtaining written consent.
No animals were used in this study.
This work was supported by MD000170 P20 funded from the National Institute on Minority Health and Health Disparities (NIMHD), and the Centers for Clinical and Translational Science Award 1U54RR023417-01 from the National Center for Research Resources (NCRR).
This work was supported by MD000170 P20 funded from the National Center on Minority Health and Health disparities (NCMHD), and the Centers for Clinical and Translational Science Award UL1 TR000371 from the National Center for Research Resources (NCRR).
Conflict of Interest
None of the authors have any relationships that they believe could be construed as resulting in an actual, potential, or perceived conflict of interest with regard to this manuscript submitted for review.
- 1.World Health Organisation. Global status report on non-communicable diseases. Alwan A. Italy: World Health Organisation; 2011. p. 1–176.Google Scholar
- 2.International Agency for Research on Cancer. World cancer report 2014. Lyon: World Health Organisation; 2014.Google Scholar
- 5.United States Census Bureau: Hispanic America by the numbers. [article online]. 2011. Available from http://www.infoplease.com/spot/hhmcensus1.html.
- 6.Kanna B, Fersobe S, Soni A, Michelen W. Leading health risks, diseases and causes of mortality among Hispanics in the United States of America. Internet J Health. 2008;8. doi: 10.5580/273c.
- 9.Ennis SR, Rios-Vargas M, Albert NG. The Hispanic population: 2010. Census briefs. C201088 04. United States Census Bureau; 2010.Google Scholar
- 10.United States Census Bureau. USA quick facts. U.S. Department of Commerce; 2012.Google Scholar
- 11.Fisher-Hoch SP, Vatcheva KP, Laing ST, Hossain MM, Rahbar MH, Hanis CL, et al. Missed opportunities for diagnosis and treatment of diabetes, hypertension, and hypercholesterolemia in a Mexican American population, Cameron County Hispanic Cohort, 2003–2008. Prev Chronic Dis. 2012;9:E135.PubMedCentralGoogle Scholar
- 13.American Cancer Society. Cancer facts and figures for Hispanics/Latinos 2012–2014. Atlanta: American Cancer Society; 2014.Google Scholar
- 14.Arias E, Schauman WS, Eschbach K, Sorlie PD, Backlund E. The validity of race and Hispanic origin reporting on death certificates in the United States. Vital Health Stat. 2008;21–3:2008.Google Scholar
- 15.Murphy SL, Xu J, Kochanek KD. Deaths: preliminary data for 2010. Natl Vital Stat Rep. 2012;60(4):1–52. National Center for Vital Statistics.Google Scholar
- 16.Rosenberg HM, Maurer JD, Sorlie PD, Johnson NJ, MacDorman MF, Hoyert DL, et al. Quality of death rates by race and Hispanic origin: a summary of current research. Vital Health Stat. 1999;96(6):1–13Google Scholar
- 18.National Center for Health Statistics. Heath, United States, 2013: with special feature on prescription drugs. 2015.Google Scholar
- 19.Centers for Disease Control and Prevention. Heath, United States, 2013. 2015.Google Scholar
- 20.Pleis JR, Lucas JW, Ward BW. Summary health statistics for U.S. adults: National Health Interview Survey; 2008. Vital Health Stat. 2009;101–57.Google Scholar
- 26.National Cancer Institute and Centers for Disease Control and Prevention. State Cancer Profiles; 2012.Google Scholar
- 27.Texas Cancer Registry. Age-adjusted invasvive cancer incidence in Texas. 2012.Google Scholar
- 28.Centers for Disease Control and Prevention. United States cancer statistics. 2012. Public information data. CDC; 2012.Google Scholar
- 29.IARC. Globocan 2008 fast stats. Lyon: World Health Organization; 2012.Google Scholar
- 30.Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009;120:1640–5.CrossRefPubMedGoogle Scholar
- 40.Texas Department of State Health Services. Behavioral risk factor surveillance system. 2012.Google Scholar