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Understanding the Determinants of Racial/Ethnic Disparities in Liver Cancer and Chronic Liver Disease in Understudied and High-Risk Populations

了解未充分研究和高危人群中肝癌和慢性肝病的种族/民族差异的决定因素

基本信息

批准号：
10112841
负责人：
VERONICA WENDY SETIAWAN
金额：
$ 35.03万
依托单位：
UNIVERSITY OF SOUTHERN CALIFORNIA
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-03-06 至 2023-08-31
项目状态：
已结题

项目摘要

ABSTRACT Hepatocellular carcinoma (HCC) and chronic liver diseases (CLD) and are significant health problems in the United States affecting racial/ethnic minorities disproportionately. In the Multiethnic Cohort (MEC) Study, a long- standing ethnically diverse prospective cohort (>200,000 participants), we observed striking ethnic differences in HCC incidence with Latinos having the highest incidence followed by Native Hawaiians, African Americans, Japanese Americans, and whites. US-born Latinos, particularly men, experience the highest rates of HCC incidence in the cohort. We also found nonalcoholic fatty liver disease (NAFLD) to be the most common cause of CLD and an unexpectedly high NALFD prevalence in Japanese Americans and Native Hawaiians. These findings provide the groundwork for studies to elucidate the factors that account for health disparities across these populations. To date, no liver disease studies have included Japanese Americans and Native Hawaiians; thus, a large knowledge gap remains in understanding the factors underlying disparities in HCC and NALFD in these understudied high-risk populations. The MEC with its comprehensive lifestyle, environmental, and genetic data offers a unique opportunity to elucidate the determinants that account for these health disparities. In this study we will examine the association of lifestyle, genetic, social, and contextual factors with HCC and NAFLD among MEC participants to better understand disease etiology in high-risk minorities and the factors underlying ethnic disparities. We will use existing resources of the MEC with detailed demographic, lifestyle, neighborhood- level data, health condition data, and cancer incidence and mortality information from SEER Cancer registries and state and national mortality databases, as well as a large biorepository of blood samples. These data have been collected in a consistent fashion amongst all MEC participants to permit valid ethnic comparisons. Our specific aims are 1) To quantify the contribution of known risk factors (chronic hepatitis C and B, adiposity, metabolic syndrome, alcohol intake and tobacco smoking) to ethnic differences in HCC incidence and identify additional risk factors (lifestyle and social/contextual factors) explaining the remaining ethnic variation in HCC incidence which would suggest novel or ethnic-specific mechanisms; 2) To evaluate ethnic-specific lifestyle, social and contextual factors and genetic factors that are associated with NAFLD across five ethnic groups and quantify their contributions to racial/ethnic differences in NALFD risk. Upon completion of this study, we will improve understanding of risk factors most important in certain ethnic groups and factors underlying disparities in HCC and NAFLD. The identification and defining the contribution of risk factors to racial/ethnic differences in HCC and NAFLD will be paramount for improving strategies for primary prevention of these diseases.

摘要肝细胞癌（HCC）和慢性肝病（CLD）是美国人的重要健康问题。美国对种族/族裔少数群体的影响不成比例。在多种族队列（MEC）研究中，站在种族多样的前瞻性队列（> 20万参与者）中，我们观察到了惊人的种族差异在HCC发病率中，拉丁美洲人的发病率最高，其次是夏威夷土著人，非洲裔美国人，日裔美国人和白人。美国出生的拉丁美洲人，特别是男性，患肝癌的几率最高。队列中的发病率。我们还发现非酒精性脂肪肝（NAFLD）是最常见的原因在日裔美国人和夏威夷原住民中，CLD和NALFD的患病率出乎意料地高。这些这些发现为研究阐明造成健康差异的因素提供了基础。这些人口。到目前为止，没有肝病研究包括日裔美国人和夏威夷土著人; 因此，在理解HCC和NALFD之间差异的潜在因素方面，仍然存在很大的知识差距，这些未被充分研究的高危人群。MEC以其全面的生活方式、环境和遗传数据为阐明造成这些健康差距的决定因素提供了独特的机会。在这我们将研究生活方式、遗传、社会和环境因素与HCC和NAFLD的关系在MEC参与者中，更好地了解高危少数民族的疾病病因和相关因素，种族差异。我们将利用MEC的现有资源，详细的人口统计，生活方式，邻里- 水平数据、健康状况数据以及来自SEER癌症登记处的癌症发病率和死亡率信息以及州和国家死亡率数据库，以及一个大型血液样本生物储存库。这些数据在所有MEC参与者中以一致的方式收集，以进行有效的种族比较。我们具体目的是1）量化已知风险因素（慢性丙型肝炎和B型肝炎，肥胖，代谢综合征、酒精摄入和吸烟）与HCC发病率的种族差异以及其他风险因素（生活方式和社会/背景因素）解释了HCC中剩余的种族差异提示新的或种族特异性机制的发病率; 2）评价种族特异性生活方式，在五个种族群体中与NAFLD相关的社会和背景因素以及遗传因素，量化他们对NALFD风险的种族/民族差异的贡献。研究完成后，我们会提高对某些族裔群体中最重要的风险因素和造成差异的因素的认识 HCC和NAFLD。识别和定义风险因素对种族/民族差异的贡献， HCC和NAFLD对于改善这些疾病的一级预防策略至关重要。