Diabetes -Identified as Risk Factor for Liver Cancer Across
Ethnic Groups
Diabetes Identified as Risk Factor
for Liver Cancer Across Ethnic Groups
Dec. 9, 2013 — Diabetes was associated with an increased
risk for developing a type of liver cancer called hepatocellular carcinoma, and this association was
highest for Latinos, followed by Hawaiians, African-Americans, and
Japanese-Americans, according to results presented here at the Sixth AACR
Conference on the Science of Cancer Health Disparities in Racial/Ethnic
Minorities and the Medically Underserved, held Dec. 6-9.
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"People
with diabetes have a two- to threefold higher risk for hepatocellular carcinoma
compared with those without diabetes," said V. Wendy Setiawan,
Ph.D., assistant professor in the Department of Preventive Medicine at Keck
School of Medicine of the University of Southern California. "We also
found that the interethnic differences in the prevalence of diabetes were
consistent with the pattern of hepatocellular carcinoma incidence observed
across ethnicities: Ethnic groups with a high prevalence of diabetes also have
high hepatocellular carcinoma rates, and those with a lower prevalence of
diabetes have lower hepatocellular carcinoma rates."
The number of new cases of hepatocellular carcinoma in the
United States tripled in the past three decades, with Latinos and
African-Americans experiencing the largest increase in incidence. Prior
research has suggested that diabetes may be a risk factor for hepatocellular
carcinoma, and its increasing incidence may be contributing to the rising rate
of hepatocellular carcinoma.
"People with diabetes should be aware that their
condition is associated with a higher risk of developing hepatocellular
carcinoma," Setiawan said. "Maintaining a healthy weight, managing
their diabetes, preventing and treating hepatitis infection, and limiting
alcohol and tobacco use should be in their priority to-do list."
In addition, Setiawan said that public health efforts
encouraging obesity/diabetes prevention and effective diabetes management
should be directed at high-risk populations.
Setiawan and colleagues examined if the association between
diabetes and hepatocellular carcinoma differed by race/ethnic group. They
analyzed data from more than 150,000 people enrolled in the Multiethnic Cohort
Study between 1993 and 1996. During the study follow-up period of about 15
years, 506 cases of hepatocellular carcinoma were reported: 59 cases in
non-Hispanic whites, 81 in African-Americans, 33 in Hawaiians, 158 in
Japanese-Americans, and 175 in Latinos.
Compared with non-Hispanic whites, Latinos had 2.77 times
the risk for being diagnosed with hepatocellular carcinoma, the highest risk
identified. Native Hawaiians had 2.48 times the risk; African-Americans, 2.16;
and Japanese-Americans, 2.07.
The prevalence of diabetes was consistent with that of
hepatocellular carcinoma. Sixteen percent of Hawaiians, 15 percent of Latinos
and African-Americans, 10 percent of Japanese-Americans, and 6 percent of
non-Hispanic whites had diabetes. Compared with those without diabetes, Latinos
with diabetes had 3.3-fold higher risk for hepatocellular carcinoma; Hawaiians,
2.33-fold higher risk; Japanese-Americans, 2.02-fold higher risk;
African-Americans, 2.02-fold higher risk; and non-Hispanic whites had 2.17-fold
higher risk.
Hepatocellular carcinoma was attributed to diabetes in 26
percent of cases in Latinos, 20 percent of Hawaiians, 13 percent of
African-Americans, 12 percent of Japanese-Americans, and 6 percent of
non-Hispanic whites, the researchers estimated. According to Setiawan,
eliminating diabetes could potentially reduce hepatocellular carcinoma
incidence in all racial/ethnic groups, with the largest potential reduction
possible in Latinos.
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