A review of the Hispanic paradox: time to spill the beans?

Young, Robert P.; Hopkins, Robert E.

doi:10.1183/09059180.00000814

Cited by 28 publications

(18 citation statements)

References 74 publications

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“…Specific exposures that fit these criteria are challenging to identify, but may include diet, which is heavily patterned by race/ethnicity, 39 although it is also patterned by SES. 40 …”

Section: Discussionmentioning

confidence: 99%

Race/ethnicity, socioeconomic status, and ALS mortality in the United States

et al. 2016

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Objective:To determine whether race/ethnicity and socioeconomic status are associated with amyotrophic lateral sclerosis (ALS) mortality in the United States.Methods:The National Longitudinal Mortality Study (NLMS), a United States–representative, multistage sample, collected race/ethnicity and socioeconomic data prospectively. Mortality information was obtained by matching NLMS records to the National Death Index (1979–2011). More than 2 million persons (n = 1,145,368 women, n = 1,011,172 men) were included, with 33,024,881 person-years of follow-up (1,299 ALS deaths , response rate 96%). Race/ethnicity was by self-report in 4 categories. Hazard ratios (HRs) for ALS mortality were calculated for race/ethnicity and socioeconomic status separately and in mutually adjusted models.Results:Minority vs white race/ethnicity predicted lower ALS mortality in models adjusted for socioeconomic status, type of health insurance, and birthplace (non-Hispanic black, HR 0.61, 95% confidence interval [CI] 0.48–0.78; Hispanic, HR 0.64, 95% CI 0.46–0.88; other races, non-Hispanic, HR 0.52, 95% CI 0.31–0.86). Higher educational attainment compared with < high school was in general associated with higher rate of ALS (high school, HR 1.23, 95% CI 1.07–1.42; some college, HR 1.24, 95% CI 1.04–1.48; college, HR 1.10, 95% CI 0.90–1.36; postgraduate, HR 1.31, 95% CI 1.06–1.62). Income, household poverty, and home ownership were not associated with ALS after adjustment for race/ethnicity. Rates did not differ by sex.Conclusion:Higher rate of ALS among whites vs non-Hispanic blacks, Hispanics, and non-Hispanic other races was not accounted for by multiple measures of socioeconomic status, birthplace, or type of health insurance. Higher rate of ALS among whites likely reflects actual higher risk of ALS rather than ascertainment bias or effects of socioeconomic status on ALS risk.

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“…Specific exposures that fit these criteria are challenging to identify, but may include diet, which is heavily patterned by race/ethnicity, 39 although it is also patterned by SES. 40 …”

Section: Discussionmentioning

confidence: 99%

Race/ethnicity, socioeconomic status, and ALS mortality in the United States

et al. 2016

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“…Smoking causes lung cancer in part through its pro-oxidant properties31. It is believed that the protective effects of fruits and vegetables are due to their rich collection of various antioxidants323334, and this may explain why the protective effects were only seen in ever smokers. In addition, this is in line with our observation that the protective effects of the “fruits and vegetables” pattern were more evident for squamous cell carcinoma, which is most strongly associated with smoking among the main histological types of NSCLC35.…”

Section: Discussionmentioning

confidence: 99%

Different dietary patterns and reduction of lung cancer risk: A large case-control study in the U.S.

Heymach

Wen

et al. 2016

Sci Rep

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Reducing lung cancer risk by modifying diet is highly desirable. We investigated whether different U.S. dietary patterns were associated with lung cancer risk. Dietary patterns were derived using exploratory factor analysis for 2139 non-small cell lung cancer (NSCLC) cases and 2163 frequency-matched controls. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs). Highest adherence (highest vs. lowest quintile) to the “Tex-Mex”, “fruits and vegetables”, and “American/Western” patterns was associated with a 55% reduced (OR = 0.45; 95% CI = 0.37–0.56; P < 0.001), 32% reduced (OR = 0.68; 95% CI = 0.55–0.85; P = 0.001), and 45% increased (OR = 1.45; 95% CI = 1.18–1.78; P < 0.001) risk of lung cancer, respectively. The effects were stronger for squamous cell carcinoma and ever smokers for the “fruits and vegetables” pattern, and stronger for other non-small cell lung cancer and never smokers for the “American/Western” pattern. Among six genome-wide association (GWA) studies-identified lung cancer susceptibility loci assessed, a variant (rs2808630) of the C-reactive protein gene modified the associations for the “fruits and vegetables” (P for interaction = 0.03) and “American/Western” (P for interaction = 0.02) patterns. Our study first showed that the “Tex-Mex” dietary pattern was associated with a reduced lung cancer risk. Also, the “fruits and vegetables” and “American/Western” patterns affected lung cancer risk, and the effects were further modified by host genetic background.

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“…Besides genetic factors, differences in life styles, specifically diet, have been proposed as a possible explanation for this observation [9]. Asian Americans have also a generally lower cancer risk than all other racial groups [3] and even in this case there is an interplay between genetic differences and a variety of behavioral/environmental risk factors.…”

Section: Epidemiological Evidence For Racial Differences In Cancer Sumentioning

confidence: 99%

Racial Differences in Cancer Susceptibility and Survival: More Than the Color of the Skin?

2017

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Epidemiological studies point to race as a determining factor in cancer susceptibility. In US registries recording cancer incidence and survival by race (distinguishing “Black versus White”), individuals of African ancestry have a globally increased risk of malignancies compared to Caucasians and Asian Americans. Differences in socioeconomic status and health care access play a key role. However, the lesser disease susceptibility of Hispanic populations with comparable life-styles and socioeconomic status as African Americans, (“Hispanic paradox”) points to the concomitant importance of genetic determinants. Here, we overview the molecular basis of racial disparity in cancer susceptibility ranging from genetic polymorphisms and cancer-driver gene mutations to obesity, chronic inflammation and immune responses. We discuss implications for race-adapted cancer screening programs and clinical trials to reduce disparities in cancer burden.

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A review of the Hispanic paradox: time to spill the beans?

Abstract: Past epidemiological observations and recent molecular studies suggest that chronic obstructive pulmonary disease (COPD) and lung cancer are closely related diseases, resulting from overlapping genetic susceptibility and exposure to aero-pollutants, primarily cigarette smoke.

Cited by 28 publications

References 74 publications

Race/ethnicity, socioeconomic status, and ALS mortality in the United States

Race/ethnicity, socioeconomic status, and ALS mortality in the United States

Different dietary patterns and reduction of lung cancer risk: A large case-control study in the U.S.

Racial Differences in Cancer Susceptibility and Survival: More Than the Color of the Skin?

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