Investigating the cause of racial/ethnic disparity in hepatocellular cancer risk

调查肝细胞癌风险中种族/民族差异的原因

基本信息

批准号：
8704088
负责人：
VERONICA WENDY SETIAWAN
金额：
$ 8.22万
依托单位：
UNIVERSITY OF SOUTHERN CALIFORNIA
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-04-01 至 2016-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8704088
关键词：
Accounting Adult Africa African American Alcohol abuse Alcohol consumption Alcohols Asians Blood specimen Body mass index Caucasians Caucasoid Race Chronic Clinical Data Cohort Studies Coupled Data Diagnosis Diagnostic Dyslipidemias Early Diagnosis Elements Ethnic Origin Ethnic group Etiology Hawaiian population Hepatitis B Hepatitis B Virus Hepatitis C Hepatitis C virus Hispanics Hypertension Incidence Infection Japanese American Latino Malignant Neoplasms Malignant neoplasm of pancreas Metabolic syndrome Minority Groups Non-Insulin-Dependent Diabetes Mellitus Obesity Pacific Island Americans Persons Play Population Prevalence Primary Prevention Primary carcinoma of the liver cells Prospective Studies Public Health Questionnaires Race Risk Risk Factors Role Survival Rate Viral hepatitis Waist-Hip Ratio Weight Gain burden of illness cancer risk cohort emerging adult ethnic difference experience follow-up health disparity high risk mortality population based prospective public health relevance racial and ethnic racial and ethnic disparities racial/ethnic difference screening

项目摘要

DESCRIPTION (provided by applicant): Hepatocellular carcinoma (HCC) is the second most deadly cancer with a <12% five-year survival rate and 8 month median survival. HCC incidence has tripled in the US over the past three decades. Of all major cancers in the US, HCC has shown the second and single greatest annual percent increase in incidence and mortality, respectively. Racial/ethnic differences in HCC incidence have been consistently observed with excess rates seen among Asians/Pacific Islanders, Hispanics and African Americans. Inter-ethnic differences in the prevalence of known HCC risk factors (i.e. viral hepatitis infection and alcohol abuse) may explain the observed racial/ethnic differences in HCC incidence. However, taken together, these factors only account for half of disease burden in the US. Given that a large proportion of HCC remains unexplained, a study, especially in high-risk minority groups, to identify the etiologic factors for this fatal cancer is warranted. Obesity and type II diabetes, maor elements of metabolic syndrome, are highly prevalent in Hispanics and African Americans and suspected emerging risk factors for HCC. Their contribution to the rising HCC incidence in these populations is unknown. We propose a comprehensive analysis in a large, prospective and well- characterized Multiethnic Cohort Study (MEC) to identify factor(s) that explains racial/ethnic disparity in HCC risk, particularly the excess risk observed in Latinos and African Americans. The MEC is uniquely comprised of five racial/ethnic populations (>215,000 African Americans, Latinos, Japanese Americans, Native Hawaiians, and Caucasians) with varying HCC incidence rates. More than 800 incident cases of HCC have been diagnosed over a 19-year period (1993-2012) and comprehensive baseline and follow-up questionnaire data, clinical data, and pre-diagnostic blood samples have been collected in this cohort. The specific aims are: 1) to determine whether racial/ethnic differences in HCC incidence can be explained by inter-ethnic differences in the distribution of known and putative HCC risk factors; 2) to examine whether the association between obesity and other key elements of metabolic syndrome and HCC risk differs across racial/ethnic groups, and whether the association(s) is modified by known HCC risk factors. The increasing incidence coupled with HCC's high fatality rate among minority groups constitutes an emerging major public health problem. The proposed study will be the first population-based prospective study of HCC that includes a substantial number of Latinos, African Americans, Asians and Caucasians. Identifying etiologic factors that explain racial/ethnic differences in HCC risk could greatly enhance the current understanding of the HCC etiology in the US, help explain why the incidence has been rising significantly in US Hispanics and African Americans and have a significant impact on the primary prevention of this fatal cancer. In addition, more effective screening could be developed leading to earlier diagnosis and better survival.

描述（由申请人提供）：肝细胞癌（HCC）是第二大致命癌症，五年生存率<12％和8个月的中位生存期。在过去的三十年中，HCC的发病率在美国增加了两倍。在美国的所有主要癌症中，HCC分别显示出第二和最大的发病率和死亡率百分比。在亚洲/太平洋岛民，西班牙裔和非洲裔美国人中，HCC发病率的种族/族裔差异一直在观察到过多。族裔间疾病风险因素（即病毒肝炎感染和酗酒）的流行率差异可能解释了观察到的HCC发病率的种族/种族差异。但是，综上所述，这些因素仅占美国疾病负担的一半。鉴于大部分HCC仍然无法解释，因此有必要确定该致命癌症的病因学因素，尤其是在高危少数群体中的研究。肥胖和II型糖尿病，代谢综合征的MAOR元素，在西班牙裔和非洲裔美国人中非常普遍，并且怀疑HCC的新兴危险因素。它们对这些人群中HCC发病率上升的贡献尚不清楚。我们提出了一项大型，潜在且特征良好的多种族队列研究（MEC）的全面分析，以识别解释HCC风险中种族/种族差异的因素，尤其是在拉丁美洲人和非裔美国人中观察到的多余风险。 MEC由五个种族/族裔人口（> 215,000名非裔美国人，拉丁美洲人，日裔美国人，夏威夷人和高加索人）组成，HCC发病率不同。在19年（1993-2012）中已诊断出了800多例HCC事件病例，并在该队列中收集了全面的基线和随访问卷数据，临床数据和诊断前血液样本。具体目的是：1）确定HCC发病率的种族/种族差异是否可以通过族裔间差异来解释已知和推定的HCC风险因素的分布； 2）检查肥胖与代谢综合征和HCC风险的其他关键要素之间的关联是否在种族/族裔群体之间有所不同，以及该关联是否通过已知的HCC风险因素来改变。越来越多的发病率加上HCC在少数群体中的高死亡率构成了一个新兴的主要公共卫生问题。拟议的研究将是对HCC的首次基于人群的前瞻性研究，其中包括大量拉丁裔，非裔美国人，亚洲人和高加索人。确定解释HCC风险种族/族裔差异的病因学因素可以极大地增强对美国HCC病因的当前理解，这有助于解释为什么在美国西班牙裔和非洲裔美国人中发生的发病率显着升高，并对这种致命癌症的主要预防产生重大影响。此外，可以开发更有效的筛查，从而导致较早的诊断和更好的生存。