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

ObjectivesTo 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).SettingSacramento County, California, USA.ParticipantsEligible 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 measuresWe 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.ResultsWe 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.ConclusionsEfforts to reduce HCC must comprehensively address multiple risk factors.Trial registration numberNCT02596438.

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High viral load is a risk factor for hepatocellular carcinoma in patients with chronic hepatitis B virus infection

Journal of Gastroenterology and Hepatology ◽

10.1111/j.1440-1746.2004.03360.x ◽

2004 ◽

Vol 19 (6) ◽

pp. 670-675 ◽

Cited By ~ 75

Author(s):

KAZUYUKI OHATA ◽

KEISUKE HAMASAKI ◽

KAN TORIYAMA ◽

HIROKI ISHIKAWA ◽

KAZUHIKO NAKAO ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Chronic Hepatitis ◽

Risk Factor ◽

Viral Load ◽

Hepatitis B Virus ◽

Virus Infection ◽

High Viral Load ◽

Hepatitis B Virus Infection ◽

Chronic Hepatitis B Virus ◽

B Virus

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Incidence and risk factors of hepatocellular carcinoma in untreated subjects with chronic hepatitis B virus infection: a systematic review and meta-analysis

Digestive and Liver Disease ◽

10.1016/j.dld.2015.01.057 ◽

2015 ◽

Vol 47 ◽

pp. e25

Author(s):

E. Raffetti ◽

G. Fattovich ◽

F. Donato

Keyword(s):

Risk Factors ◽

Hepatocellular Carcinoma ◽

Systematic Review ◽

Chronic Hepatitis ◽

Hepatitis B Virus ◽

Virus Infection ◽

Meta Analysis ◽

Hepatitis B Virus Infection ◽

Chronic Hepatitis B Virus ◽

B Virus

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Abstract B80: Multiple Risk Factors for Hepatocellular Carcinoma (HCC) among Asian Americans: Implications for Intervention

10.1158/1538-7755.disp16-b80 ◽

2017 ◽

Author(s):

Susan L. Stewart ◽

Julie HT Dang ◽

Moon S. Chen

Keyword(s):

Risk Factors ◽

Hepatocellular Carcinoma ◽

Asian Americans ◽

Multiple Risk Factors ◽

Multiple Risk

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Number of Risk Factors in Down Syndrome Pregnancies

American Journal of Perinatology ◽

10.1055/s-0038-1666974 ◽

2018 ◽

Vol 36 (01) ◽

pp. 079-085 ◽

Cited By ~ 1

Author(s):

Deana Hussamy ◽

Christina Herrera ◽

Diane Twickler ◽

Donald Mcintire ◽

Jodi Dashe

Keyword(s):

Risk Factors ◽

Down Syndrome ◽

Risk Factor ◽

Population Based ◽

Femur Length ◽

Multiple Risk Factors ◽

Calculated Risk ◽

Multiple Risk ◽

Stillborn Infant ◽

Singleton Pregnancies

Objective The objective of this study was to evaluate risk factor prevalence in pregnancies with fetal Down syndrome, in an effort to characterize efficacy of population-based screening. Study Design Retrospective review of singleton pregnancies with delivery of live born or stillborn infant with Down syndrome from 2009 through 2015. Risk factor categories included maternal age ≥35 years, abnormal serum screening, identification of ≥1 ultrasound marker at 16 to 22 weeks (nuchal thickness ≥6 mm, echogenic intracardiac focus, echogenic bowel, renal pelvis dilatation, femur length <third percentile), and detection of a major fetal anomaly. Statistical analyses included χ2 test and Mantel–Haenszel χ2 test. Results Down syndrome infants represented 1:428 singleton births. All risk categories were assessed in 125 pregnancies and included abnormal serum screen in 110 (88%), ≥1 ultrasound marker in 66 (53%), and ≥1 anomaly in 41 (34%). The calculated risk was at least 1:270 in 93% of Down syndrome pregnancies. More pregnancies had multiple risk factors than had a single risk factor, 90 (72%) versus 30 (24%), p < 0.001. An abnormal ultrasound marker or anomaly was identified in >50% of fetuses in women <35 years and in >75% of those 35 years and older. Conclusion In a population-based cohort, sensitivity of second-trimester Down syndrome screening was 93%, with multiple risk factors present in nearly three-fourths of cases.

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Abstract WP229: Young African Americans With Stroke Have a Greater Burden of Multiple Risk Factors Than Their White Counterparts

Stroke ◽

10.1161/str.51.suppl_1.wp229 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

Prachi Mehndiratta ◽

Kathleen Ryan ◽

John W Cole ◽

Marcella Wozniak ◽

Seemant Chaturvedi ◽

...

Keyword(s):

Risk Factors ◽

Young Adults ◽

Logistic Regression ◽

Risk Factor ◽

Vascular Risk Factors ◽

Factor Group ◽

Vascular Risk ◽

Multiple Risk Factors ◽

Multiple Risk ◽

Group D

Background: Stroke in young adults accounts for 15-18% of all ischemic stroke (IS) cases and disproportionately affects African Americans (AfrAm). While it is well known that a higher prevalence of vascular risk factors, particularly HTN and DM, contributes to this excess risk, few studies have examined the potential contribution of the synergistic risk from multiple vascular risk factors. Methods: A population-based case-control study with 582 cases and 727 controls ages 15-49 was used to investigate the relationship of multiple risk factors and IS in young adults and compare AfrAM and White cases for the prevalence of multiple risk factors. Logistic regression analysis with adjustment for age, sex, and race was used to evaluate the association between the following mutually exclusive risk factor groups and IS: (a) Smoking alone, (b) Smoking+ HTN only, (c) Smoking + HTN +Obesity only (d) Smoking + HTN + Obesity +DM. The reference group for these analyses was those with no risk factors. Logistic regression with adjustment for age only was also used to compare AfrAM vs White cases for their prevalence in each risk factor group. Results: There were a total 218 cases with no risk factors. The odds of having an IS increased exponentially as the number of risk factors increased (OR 2.3, 95% CI 1.8 - 3.0, p <0.0001 for group a versus OR 16.5, 95% CI 4.8-56.1, p<0.0001 for group d). Young AfrAM cases were approximately 6 times more likely (25.3% vs. 4.3% p<0.0001) than White cases to be in the multiple risk factor group d. Conclusion: The risk of IS increases in an exponential manner in young adults with an increasing number of traditional risk factors. Compared to their White counterparts, young AfrAm IS cases are approximately 6 times more likely to have all 4 risk factors: smoking, HTN, DM and obesity. Risk factor synergy could contribute to the excess risk of IS among young AfrAm and our study emphasizes early screening for vascular risk factors in this subgroup.

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