Vidal Adriana C, Moylan Cynthia A, Wilder Julius, Grant Delores J, Murphy Susan K, Hoyo Cathrine
Department of Biological Sciences, Center for Human Health and the Environment, North Carolina State University, Raleigh, NC, United States.
Department of Medicine, Division of Gastroenterology and Hepatology, School of Medicine, Duke University, Durham, NC, United States.
Front Oncol. 2022 Aug 22;12:959852. doi: 10.3389/fonc.2022.959852. eCollection 2022.
Liver cancer incidence has tripled since the early 1980s, making this disease one of the fastest rising types of cancer and the third leading cause of cancer-related deaths worldwide. In the US, incidence varies by geographic location and race, with the highest incidence in the southwestern and southeastern states and among racial minorities such as Hispanic and Black individuals. Prognosis is also poorer among these populations. The observed ethnic disparities do not fully reflect differences in the prevalence of risk factors, e.g., for cirrhosis that may progress to liver cancer or from genetic predisposition. Likely substantial contributors to risk are environmental factors, including chemical and non-chemical stressors; yet, the paucity of mechanistic insights impedes prevention efforts. Here, we review the current literature and evaluate challenges to reducing liver cancer disparities. We also discuss the hypothesis that epigenetic mediators may provide biomarkers for early detection to support interventions that reduce disparities.
自20世纪80年代初以来，肝癌发病率增长了两倍，这使得该疾病成为增长最快的癌症类型之一，也是全球癌症相关死亡的第三大主要原因。在美国，发病率因地理位置和种族而异，西南部和东南部各州以及西班牙裔和黑人等少数族裔的发病率最高。这些人群的预后也较差。观察到的种族差异并不能完全反映风险因素流行率的差异，例如可能发展为肝癌的肝硬化或遗传易感性方面的差异。风险的可能主要促成因素是环境因素，包括化学和非化学应激源；然而，缺乏机制方面的见解阻碍了预防工作。在这里，我们回顾当前的文献并评估减少肝癌差异所面临的挑战。我们还讨论了表观遗传介质可能提供早期检测生物标志物以支持减少差异的干预措施这一假设。
