Racial Disparity in Gastrointestinal Cancer Risk

Abstract

Cancer from the gastrointestinal tract and its associated excretory organs will occur in over 300,000 Americans in 2017, with colorectal cancer responsible for over forty percent of that burden; there will be over 150,000 deaths from this group of cancers in the same time period. Disparities among subgroups related to these cancers’ incidence and mortality exist. The epidemiology and risk factors associated with each cancer bear out differences for racial groups in the United States. Esophageal adenocarcinoma is more frequent in Non-Hispanic Whites, whereas esophageal squamous cell carcinoma with risk factors of tobacco and alcohol is more frequent among Blacks. Liver cancer has been most frequent among Asian/Pacific Islanders chiefly due to hepatitis B vertical transmission, but other racial groups show increasing rates due to hepatitis C and emergence of cirrhosis from non-alcoholic fatty liver disease. Gastric cancer incidence remains highest among Asian/Pacific Islanders likely due to gene-environment interaction. In addition to esophageal squamous cell carcinoma, cancers of the small bowel, pancreas and colorectum show the highest rates among Blacks, where the explanations for the disparity are not as obvious and are likely multifactorial, including socio-economic and health care access, treatment and prevention (vaccination and screening) differences, dietary and composition of the gut microbiome, as well as biological and genetic influences. Cognizance of these disparities in gastrointestinal cancer risk, as well as approaches that apply precision medicine methods to populations with the increased risk, may reduce the observed disparities for digestive cancers.

PVT1 Long Non-coding RNA in Gastrointestinal Cancer

“…These subtypes follow very different oncogenic programs and thus display different molecular profiles (7). The etiology of gastric cancer is multifactorial but dietary factors, such as high salt and nitrate intake, and Helicobacter pylori infection increase the risk of gastric cancer development and progression (8)(9)(10). And finally, colorectal cancer occurs when tumor cells grow in the colon or rectum inner lining.…”

Effects of high‑intensity focused ultrasound treatment on peripancreatic arterial and venous blood vessels in pancreatic cancer

“…Pancreatic carcinoma is a highly malignant gastrointestinal cancer with a poor prognosis and a low 5-year survival rate (1). Recently, the incidence and mortality rates of pancreatic cancer have steadily increased in the United States, within Europe and in China (1)(2)(3)(4). According to the American Cancer Society, there were ~55,440 novel pancreatic cancer diagnoses and ~44,330 pancreatic cancer-associated mortalities in 2018 in the USA (4,5).…”

The disparities in gastrointestinal cancer incidence among Chinese populations in Shanghai compared to Chinese immigrants and indigenous non‐Hispanic white populations in Los Angeles, USA

“…NHWs have the highest risk of oesophageal adenocarcinoma and adenocarcinoma accounts for nearly 68% of oesophageal cancer cases; however, SCC remains the predominant type in Chinese populations, regardless of immigrant status. [39][40][41] This phenomenon indicates that the difference in oesophageal cancer subtype might be partly determined at the genetic level. A number of genome-wide association studies of oesophageal SCC have been performed for Asian populations; certain unique variants in alcoholmetabolizing genes have been identified, which were not observed in non-Asian populations.…”

“…Regarding the histology of oesophageal cancer, there are two primary subtypes: adenocarcinoma and squamous cell cancer (SCC). NHWs have the highest risk of oesophageal adenocarcinoma and adenocarcinoma accounts for nearly 68% of oesophageal cancer cases; however, SCC remains the predominant type in Chinese populations, regardless of immigrant status . This phenomenon indicates that the difference in oesophageal cancer subtype might be partly determined at the genetic level.…”