US Residents of Mexican Descent Show Higher Liver Cancer Risk in Successive Generations

The risk of hepatocellular carcinoma (HCC) in individuals of Mexican descent living in Los Angeles, California, amplified with each successive generation in the United States, according to study results presented at the15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved.

The results highlight that birthplace may influence cancer risk, and US-born Hispanics are at a greater risk of developing liver cancer compared with foreign-born Hispanics, because of acculturation.

“Hispanics/Latinos represent 1 of the largest and fastest-growing ethnic groups in the United States. Epidemiologic trends show rising incidence of liver and intrahepatic bile duct cancer in this population for both men and women, whereas we are seeing a decline for many other cancer sites,” lead study author Nicholas Acuna, MPH, a PhD student in epidemiology in the Department of Population & Public Health Sciences at the Keck School of Medicine of USC, said in a statement.

“It is important to understand the reasons behind these trends,” he said.

Investigators leveraged the Multiethnic Cohort, which is a large population-based prospective study of risk factors for cancer and other chronic diseases among more than 215,000 participants from 5 US ethnic and racial groups in Los Angeles and Hawaii, and they analyzed how generation status affected the risk of HCC among individuals of Mexican descent residing in the city.

Additionally, the analysis focused on self-identified Mexicans who had available information about their parental birthplaces. Generation status was categorized as first generation for those born in Mexico with both parents also born in Mexico; second generation for those born in the United States with at least 1 parent born in Mexico; and third generation for those born in the United States with both parents also born in the United States.

HCC risk was assessed after adjusting for age, alcohol and coffee intake body mass index (BMI), history of diabetes, sex, and smoking status.

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

Second- and third-generation individuals of Mexican descent had a significantly increased risk of HCC compared with their first-generation counterparts.

The successive generations also showed that individuals of Mexican descent were more likely to be smokers, consume more coffee, have elevated BMIs, and have a higher alcohol intake.

The study authors also applied a statistical interaction test to assess whether the association between generation status and risk of HCC differed by alcohol intake, BMI status, having diabetes, or smoking status but did not find significant differences, which is assumed to be because of the low number of HCC cases.

Third-generation individuals who did not have diabetes had a significantly higher risk of HCC compared with first-generation individuals who did not have diabetes, indicating that multiple risk factors are at play in determining the increased risk of HCC.

“Interventions targeting acculturation and adoption of negative lifestyle behaviors, such as increased alcohol intake, unhealthy diet, and cigarette smoking, among U.S.-born Mexicans are needed to mitigate the increased risk of HCC in this population,” Acuna said.

Study limitations included not considering the different etiologies of HCC, such as alcoholic and non-alcoholic fatty liver disease and viral hepatitis B and C. The investigators also only focused on individuals of Mexican descent, so the study results cannot be generalized to other Latin American subgroups, and future studies are needed.

Reference

US residents of Mexican descent may have a higher risk of liver cancer with each successive generation. News release. AACR. September 16, 2022. Accessed September 16, 2022. https://aacr.ent.box.com/s/8d84oe5wv64qt3d0i9e909qdf82pw6dh