Patterns and co-occurrence of risk factors for hepatocellular carcinoma in four Asian American communities: a cross-sectional study.

Autor:	Stewart SL; Public Health Sciences, University of California Davis School of Medicine, Sacramento, California, USA., Dang JH; UC Davis Comprehensive Cancer Center, University of California Davis School of Medicine, Sacramento, California, USA., Török NJ; Division of Gastroenterology & Hepatology, Department of Medicine, Stanford University, Stanford, California, USA., Chen MS Jr; UC Davis Comprehensive Cancer Center, University of California Davis School of Medicine, Sacramento, California, USA.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2019 Jun 28; Vol. 9 (6), pp. e026409. Date of Electronic Publication: 2019 Jun 28.
DOI:	10.1136/bmjopen-2018-026409
Abstrakt:	Objectives: To investigate risk factor patterns and the simultaneous occurrence of multiple risk factors in the viral, metabolic and lifestyle domains among Asian Americans, who have had the highest mortality rates from hepatocellular carcinoma (HCC). Setting: Sacramento County, California, USA. Participants: Eligible participants were county residents ages 18 and older who had not been screened for chronic hepatitis B virus (HBV) and were born in a CDC-defined endemic area or whose parent was born in that area. Of 1004 enrolled, 917 were foreign-born Chinese (130 women, 94 men), Hmong (133 women, 75 men), Korean (178 women, 90 men) or Vietnamese (136 women, 81 men) with complete risk factor data. Primary and Secondary Outcome Measures: We tested participants for HBV and chronic hepatitis C virus (HCV); measured haemoglobin A1c and waist circumference; and recorded self-reported history of diabetes, hypertension, alcohol use and smoking status. We identified risk factor patterns using cluster analysis and estimated gender-specific age-standardised prevalence rates. Results: We identified four patterns: (1) viral (chronic HBV or HCV); (2) lifestyle (current smoker or alcohol user, no viral); (3) metabolic (≥2 metabolic, no lifestyle or viral); and (4) lower risk (≤1 metabolic, no lifestyle or viral). Vietnamese men (16.3%, 95% CI 7.4% to 25.3%) and Hmong women (15.1%, 95% CI 7.8% to 22.5%) had the highest viral pattern prevalence. Hmong women had the highest metabolic (37.8%, 95% CI 29.8% to 45.9%), and Vietnamese men the highest lifestyle (70.4%, 95% CI 59.1% to 81.7%) pattern prevalence. In multiple domains, Hmong men and women were most likely to have viral+metabolic risk factors (men: 14.4%, 95% CI 6.0% to 22.7%; women: 11.9%, 95% CI 5.6% to 18.3%); Vietnamese men were most likely to have lifestyle+viral (10.7%, 95% CI 2.7% to 18.8%), and lifestyle+metabolic but not viral (46.4%, 95% CI 34.4% to 58.5%) risk factors. Conclusions: Efforts to reduce HCC must comprehensively address multiple risk factors. Trial Registration Number: NCT02596438. Competing Interests: Competing interests: MSC served as a consultant to Gilead Sciences in 2016-18. (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu