Ha John, Chaudhri Aysha, Avirineni Abhishek, Pan Jen-Jung
Department of Internal Medicine, The University of Texas Health Science Center at Houston, 6431 Fanin St, MSB 1.150, Houston, TX 77030 USA.
Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, The University of Texas Health Science Center at Houston, 6431 Fanin St, MSB 4.234, Houston, TX 77030 USA.
Biomark Res. 2017 Apr 21;5:15. doi: 10.1186/s40364-017-0096-5. eCollection 2017.
Hepatocellular carcinoma (HCC) is one of the fastest rising causes of cancer-related mortality in the United States (U.S.). Despite improved HCC screening and surveillance guidelines, significant race/ethnicity-specific disparities in hepatocellular carcinoma remain, disproportionately affecting at risk racial minorities in the U.S. The current review aims to provide an updated analysis on race/ethnicity-specific disparities in HCC epidemiology with a focus on predisposing risk factors.
Among different race/ethnicities in the U.S., Hispanics experienced the greatest burden of HCC, particularly those residing in South Texas. It is important to understand that the underlying etiologies for these disparities are complex and multi-factorial. Some of these risk factors for developing chronic liver disease include non-alcoholic fatty liver disease/non-alcoholic steatohepatitis and alcohol use. In addition, population genetics, acculturation of ethnic minorities, and access to healthcare may be further contributing to the observed disparities in HCC. By increasing awareness, improved modalities for screening and surveillance for HCC are important in guiding future research for targeted preventive and therapeutic interventions.
肝细胞癌(HCC)是美国癌症相关死亡率上升最快的原因之一。尽管肝细胞癌的筛查和监测指南有所改进,但肝细胞癌在种族/族裔方面仍存在显著差异,对美国有风险的少数族裔产生了不成比例的影响。本综述旨在对肝细胞癌流行病学中种族/族裔特异性差异进行更新分析,重点关注易感风险因素。
在美国不同种族/族裔中,西班牙裔承受的肝细胞癌负担最重,尤其是居住在得克萨斯州南部的西班牙裔。必须认识到,这些差异的潜在病因复杂且多因素。一些导致慢性肝病的风险因素包括非酒精性脂肪性肝病/非酒精性脂肪性肝炎和饮酒。此外,群体遗传学、少数族裔的文化适应以及医疗保健的可及性可能进一步导致了观察到的肝细胞癌差异。通过提高认识,改进肝细胞癌的筛查和监测方式对于指导未来针对性预防和治疗干预的研究很重要。