Cancer In Hispanics Research Articles

Modifiable Risk Factors in Hispanic Adults With Gastric Cancer in the United States.

Hispanics make up 19% of the U.S. population and are experiencing rising rates of cancer, primarily due to an increase in infection-related cancers (gastric, hepatic, cervical) and advanced cancers secondary to delayed screening (colorectal, cervical, breast). There is an increased incidence of gastric cancer (associated with infection, obesity, alcohol, and tobacco use) in Hispanics, especially at a young age, highlighting the need to consider ethnicity as a risk factor. This study utilized the 2016-2019 National Inpatient Sample database to examine all patients admitted with gastric cancer. Individuals were stratified by race, age, and comorbidities, including modifiable risk factors that are associated with gastric cancer. There were 5,785 (7.44%) patients aged 18-44, 28,370 (36.49%) aged 45-64, and 43,590 (56.07%) over 65 years of age. Notably, 34.3% of the youngest group were Hispanic, contrasted with 19.7% and 12.9% in the older groups, respectively. Younger Hispanic patients showed a higher prevalence of H. pylori infection (8.6%) compared with older Hispanics (3.6% in the middle age group and 2.1% in the oldest, p<0.01). There was a high prevalence of obesity, tobacco use, and gastric ulcers in this cohort. Other risk factors such as alcohol use and gastric polyps were present at a lesser prevalence. This study reveals that Hispanic patients tend to have a younger age of onset of gastric cancer, coupled with an increased incidence of H. pylori infection at a younger age. This finding underscores the potential benefit of H. pylori screening among asymptomatic young Hispanics with the aim of reducing gastric cancer morbidity and mortality in this population.

Esophageal cancer in Hispanics: a demographic analysis of the National Cancer Database

BackgroundHispanics are the fastest-growing minority and the second largest ethnic group in the United States, accounting for 18% of the national population. The American Cancer Society estimated 18,440 new cases of esophageal cancer (EC) in the United States in 2020. Hispanics are reported to be at high risk of EC. We sought to interrogate the demographic patterns of EC in Hispanics. Secondary objective was to examine evidence of socioeconomic disparities and differential therapy. MethodsWe identified Hispanic vs non-Hispanic patients with EC in the National Cancer Database between 2005 and 2015. Groups were statistically equated through propensity score-matched analysis. ResultsA total of 3205 Hispanics (3.8%) were identified among 85,004 patients with EC. We identified significant disparities between Hispanic and non-Hispanic groups. Disparities among Hispanics included higher prevalence of squamous EC, higher likelihood of stage IV cancer diagnosis, younger age, uninsured status, and income< $38,000. Hispanics were less likely to have surgical intervention or any type of treatment when compared to non-Hispanics. Multivariate analysis showed that age, ethnicity, treatment, histology, grade, stage, and Charlson–Deyo scores were independent predictors of survival. Treated Hispanics survived longer than non-Hispanics. ConclusionDespite the lower prevalence of EC, there is a disproportionately higher prevalence of metastatic and untreated cases among Hispanics. This disparity may be explained by Hispanics' limited access to medical care, exacerbated by their socioeconomic and insurance status. Further study is warranted to examine these health disparities among Hispanics.

Abstract 802: Molecular profile of gastric cancer in Hispanics living in Puerto Rico

Abstract Gastric cancer (GC) is the 4th leading cause of cancer death globally. The incidence and mortality rates of GC differ dramatically between racial/ethnic groupings. In the United States (U.S.), Hispanics, non-Hispanic Blacks, and Asian or Pacific Islanders are more likely to be diagnosed with GC and have a higher mortality rate than non-Hispanic Whites. Among the Hispanic population living in Puerto Rico (PRH), GC ranks among the top ten leading causes of cancer death, whereas this malignancy is not a major cause of cancer mortality in the mainland U.S. Tumor profiling approaches have resulted in the discovery of actionable gene alterations, which serve as a guide for treatment strategies and ultimately enhance the overall survival rates of individuals diagnosed with cancer. However, descriptive information regarding the genetic mutational landscape of GC tumors from PRH is limited. This study aims to describe the genomic profile of GC tumors in PRH and to identify the most prevalent genetic mutations. We retrospectively examined GC tumor mutational profiles from 106 PRH that underwent NGS testing from 2015 to 2022 (provided by CARIS Life Sciences and the Precision Oncology Alliance). We compared PRH GC tumor somatic mutation prevalence to TCGA and the AACR Project Genomics Evidence Neoplasia Information Exchange (GENIE), both available through the cBioPortal for Cancer Genomics. Descriptive statistics were performed to characterize the database. Among the top mutated genes for GC tumors in PRH were TP53 (54.1%, n=85), ARID1A (34.2%, n=73), KMT2D (30.5%, n=82), CDH1 (29.4%, n=85) and ZFHX3 (27.3%, n=55). The most frequent gene amplifications were ERBB2 (7.1%, n=84), KRAS (6.0%, n=84), and CCNE1 (4.9%, n=81). Compared to other datasets, PRH had significantly different mutational frequencies of GC driver genes like TP53, ARID1A, CDH1, and KMT2D. This study is the first to report PRH GC tumor mutational profiles and compare the mutational frequencies to other non-Hispanic and U.S. mainland Hispanic populations using TCGA and GENIE data sets. Furthermore, our study provides data on the specific mutational landscape for Hispanics with GC and the implications on therapeutic options and clinical outcomes. Developing new treatments for genomically diverse populations requires understanding the most common carcinogenic molecular pathways that affect Hispanics with GC. Citation Format: Ingrid Montes-Rodriguez, Hilmaris Centeno-Girona, Noridza Rivera, Marcia Cruz-Correa. Molecular profile of gastric cancer in Hispanics living in Puerto Rico [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 802.

Esophageal cancer in Hispanics: A propensity score matched analysis of the National Cancer Database.

258 Background: Hispanics are the fastest-growing minority and largest ethnic group accounting for 19.1% of the US population. The American Cancer Society estimated 21,560 new cases of esophageal cancer (EC) in the US in 2023. Hispanics are reported to be at high risks for EC. We sought to interrogate the demographic patterns of esophageal cancer in Hispanics. Additionally, we sought to examine evidence of socioeconomic disparities and differential therapy. Methods: We identified Hispanic vs Non-Hispanic (NH) patients in the National Cancer Database with esophageal cancer between 2005–2018. Variables compared were age, sex, tumor data, surgical intervention, type of treatment, insurance status, income, residence area, and Charlson/Deyo score. Pearson’s Chi-square test was used to compare categorical variables. Groups were statically equated with propensity score-matched analysis (PSM). Survival analysis was estimated by the Kaplan-Meier method and associated log-rank test. Significance was considered at p-value ≤0.05. Results: We identified 66,335 patients with a median age of 63 years (18-90). Hispanics represented 4.2% (2,786) of the entire patient cohort. In this US population we identified significant disparities between Hispanic and NH groups. Differences among Hispanics included higher prevalence of squamous EC (22% vs 19%) p&lt;0.001, higher likelihood of stage IV disease (40.7% vs. 34.8%) p&lt;0.001, younger age p&lt;0.001, higher uninsured status (10.3% vs 3.3%) with income &lt; $40,227 (27.5% vs 16.9%) p&lt;0.001 when compared to NH. However, Hispanics were less likely to have surgical intervention (20.5% vs 27.5%) p&lt;0.001, receive neoadjuvant therapy (61.8% vs 72%) and overall, less likely to receive any type of treatment (30.1% vs 26.1%) when compared to NH p&lt;0.001. Time to treatment was delayed in those Hispanics who were uninsured 37 weeks (22-55) compared to those with private insurance 31 weeks (20-47) p&lt;0.001. Multivariate analysis revealed that any treatment, insurance status, and lower income were all predictors of survival. Treated Hispanics demonstrated no difference in survival then their treated non-Hispanic counterparts (median survival 18.5 vs 18.7 months) with overall 5 year survival at 24% and 25% respectively (p=0.66). Conclusions: Despite lower prevalence, there is a disproportionately higher number of metastatic and untreated cases of esophageal cancer among Hispanics. This disparity may be explained by Hispanics' limited access to medical care exacerbated by their socioeconomic and insurance status. Our findings warrant further clinical and epidemiologic research to reveal other factors impacting these health and health care disparities.

Prevalence of modifiable risk factors of Hispanic adult patients admitted with gastric cancer in the US.

254 Background: More than 19% of the US population is comprised of Hispanic individuals. For decades, cancer incidence has been increasing in this population, including cancers associated with infection (gastric, hepatic, cervical) and resulting from delayed screening (colorectal, cervical and breast). Risk factors associated with gastric cancer include H. pylori, obesity, alcohol, and tobacco use. However, ethnicity has not been a commonly reported risk factor despite the fact that studies have shown increasing incidence of gastric cancer in Hispanics at a younger age. Methods: We used the 2016-2019 National Inpatient Sample (NIS) database to stratify patients with gastric cancer by age, ethnicity, and comorbidities. Results: There were 77,745 adults with gastric cancer. Of these, 578 (7.45%) were ages 18-44 (group 1), 28,370 (36.47%) 45-64 years old (group 2), and 43,590 (55.08%) were over 65 (group 3). Group 1 was comprised of 29.4% White, 34.3% Hispanic, 14.5% Black, and 21.8% Asian or Pacific Islander patients. Group 2 consisted of 46.7% White, 19.7% Hispanic, 17.4% Black, and 16.2% Asian or Pacific Islander individuals. Group 3 had the highest percentage of White patients (56.0%) and lowest percentage of Hispanic individuals (12.9%). Group 3 also consisted of 15.1% Black and 16.0% Asian or Pacific Islander patients. In Hispanics with gastric cancer, there was a predominance of H. pylori among younger patients (8.6% in group 1 vs 3.6% and 2.1% in groups 2 and 3 respectively) (p = 0.00). Incidence of smoking increased with age (19.9% in group 1, 28.1% in group 2 and 31.1% in group 3) (p = 0.00) as did incidence of diabetes (8.1% in group 1, 26.4% in group 2 and 36.0% in group 3) (p = 0.00). Alcohol use was 3.0% in group 1, 4.3% in group 2 and 2.3% in group 3 (p = 0.035). The differences between all groups for gastric ulcer, gastric polyp and obesity were not statistically significant. Conclusions: Gastric cancer accounts for approximately 1.5% of all new cancers diagnosed in the US, with a high incidence in older White populations. However, this study demonstrates that there is a large proportion of young Hispanics with gastric cancer who have higher associated instances of H. pylori. This suggests the need for further research to determine if there is utility in screening for H. pylori in asymptomatic young Hispanics to decrease the burden of gastric cancer in this population. [Table: see text]

Do Hispanic individuals have similar overall survival of nodular lymphocyte-predominant Hodgkin’s lymphoma? A national analysis.

e19512 Background: Nodular lymphocyte-predominant Hodgkin’s Lymphoma (NLPHL) is a rare subtype of Hodgkin’s Lymphoma (HL) accounting for approximately 5% of all cases of HL in the United States (US). (PMID: 29763144 ) The prognosis overall for NLPHL is exceptionally good. (PMID: 34923571) Much of the clinical outcome data for NLPHL is from European countries or the US without racial sub-group analysis available. (PMID: 34923571, PMID: 33976110, PMID: 29222274 ) Few studies examine if there are disparities in outcomes nationally within each HL subtype when comparing Hispanics and non-Hispanics. (PMID: 22241896, PMID: 26198444) This study looks at the impact of ethnicity across several key variables and the survival outcomes of this cancer in Hispanics (HI) compared to Non-Hispanics (NH) within the US, using Surveillance, Epidemiology, and End Results (SEER) database. Methods: Data was analyzed on NLPHL patients in the US and reported to the SEER database between 2000 -2018. Patient demographics, survival, and clinical course were evaluated with Kaplan-Meier, Cox regression, multivariate analysis, and propensity score matching. Results: 2,532 of NLPHL patients, 11% were HI, and 89% were NH. &gt; 65% of those diagnosed were male in both groups. HI pts were younger, with a median age of 35 years old vs 45 years old (p &lt; 0.001); the majority of HI (55%) were diagnosed in the age bracket of &lt; 40 years old vs the majority of NH 42% were diagnosed in the age bracket of &lt; 40 years old (p = &lt; 0.001) Both groups had a majority of diagnosis during the years 2015-2018 (p = 9.18). Regarding race, most of HI and NH were whites 89% vs 68%, followed by blacks 6% vs 26%. Both groups were most commonly Stage at the time of diagnosis ~30% (0.584). In terms of radiation therapy rates were similar ~37% (p = 0.287) On survival analysis, the survival probability at 2, 5, and 10 years of HI vs NH was 93% vs 96%, 89% vs 92%, and 84% vs 80%, respectively. The median survival time was not reached years for HI and was also not reached for NH, and there was no overall survival difference favoring HI/NH (p = 0.43) On multivariate analysis, when adjusting for age, those who were &gt; 80 years old and between 60-80 years old had worse OS compared to those &lt; 60 years old with HR 33.5 (CI 95% 20.6 – 54.5) and 4.3 (CI 95% 2.7 – 6.9). Regarding stage, stage III/IV had worse OS than stage I/II with HR 1.9 (95% CI 1.1 – 3.4) vs HR 2.4 (95% CI 1.0 - 5.6). Conclusions: Overall HI were younger at the time of diagnosis without a significant difference in stage of diagnosis. Median survival was not reached in both NH and HI which reflects the good prognosis associated with NHLPL. Despite HI being having a younger median age of diagnosis than NH this did not correlate with improved OS in HI vs NH despite younger showing improved OS. Given there are little few other studies examining HI vs NH outcomes in NLPHL more research is needed to evaluate possible confounders skewing these results.

Abstract 1963: Characterization of thyroid cancer among Hispanics in California

Abstract Introduction: Thyroid cancer is the second most commonly diagnosed cancer among Hispanic women, but little research on thyroid cancer has focused on Hispanics in the U.S. As one in four Hispanics live in California (CA), our study used data from the population-based California Cancer Registry (CCR) to characterize thyroid cancer in Hispanics. Methods: We used CCR Research File of December 2020 to identify thyroid cancer cases diagnosed from 1988-2018 among CA residents in SEER*Stat readable format along with statewide mortality data with causes of death information. We examined the case distribution by sex (male, female), age of diagnosis (0-39, 40-64, and 65+ years old), race (Hispanic, Non-Hispanic (NH) White, NH Black, and Asian Pacific Islander (API)), histology (papillary, follicular, medullary, anaplastic), TNM stage (I-IV), tumor size (T0-T4) and lymph node involvement (N0, N1), lymphovascular invasion (LVI) (yes, no), and multifocality (solitary, multifocal). Age-adjusted incidence rate (AAIR) was calculated by sex, race, and selected tumor characteristics along with average annual percent change (AAPC). Age-adjusted morality rate (AAMR) for thyroid cancer-specific cause of death was also calculated by sex and race. Multivariate cox proportional hazards regression analysis was performed to evaluate the mortality risk from all causes of death by race. Results: 97,948 thyroid cancer cases were diagnosed, accounting for 25.5% of cases. Hispanics had the highest female predominance (80.9%) and highest percentage of patients diagnosed under 40 years of age (38.7%) among all races. Hispanic overall AAIR per 100,000 in 2018 ranked 3rd (12.8) following those of APIs (14.6) and NH whites (13.5) but had the highest AAPC from 1988-2018 at 3.8% (95% CI 2.8-4.7). Hispanics had a greater percentage of stage I at diagnosis (66.5%), but a greater percentage of large tumor sizes (T3-T4: 31.1%), nodal involvement (31.5%), LVI (16.1%), and multifocality (41.8%). Among women, Hispanics had the highest AAPC in incidence (3.7%, 95% CI 2.9-4.4), papillary thyroid cancer (3.8%, 95% CI 3-4.6), Stage IV diagnosis (3.4% 95% CI 1.2-5.7), N1 nodal stage (6.6%, 95% CI 4.5-8.7), and multifocality (4.7%, 95% CI 3.6-5.9). Hispanics had the highest AAMR (0.77 overall, 0.70 males, and 0.81 females per 100,000). Adjusting for the demographic and tumor covariates, compared to NH Whites, Hispanics had the highest mortality risk among all races (hazard ratio: 1.32, 95% CI: 1.29-1.34) and seen among both sexes. Conclusion: Hispanic thyroid cancer patients in CA had a greater proportion of larger tumor size, nodal involvement, LVI, and multifocal disease at diagnosis. Hispanics had the highest overall AAPC in incidence with Hispanic women having the highest AAPC in numerous disease characteristics. Hispanics also had the highest AAMR and mortality risk. These findings warrant further investigation of possible biological and socioeconomic factors involved. Citation Format: Robert C. Hsu, Kai-Ya Tsai, Krithika Chennapan, Katherine Y. Wojcik, Alice W. Lee, Jacob Thomas, Jorge J. Nieva, Lihua Liu. Characterization of thyroid cancer among Hispanics in California [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 1963.

Early onset of nasopharyngeal cancer in Asian/Pacific Islander Americans revealed by age-specific analysis.

Incidence of nasopharyngeal cancer is substantially higher in Asian/Pacific Islanders (APIs) than other racial groups. Examining age-specific incidence patterns by racial group and histology could inform disease etiology. We analyzed data from 2000 through 2019 from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) Program to compare age-specific incidence rates of nasopharyngeal cancer in non-Hispanic (NH) Blacks, NH APIs, and Hispanics to NH Whites using incidence rate ratios with 95% confidence intervals (CIs). NH APIs showed the highest incidence of nasopharyngeal cancer across all histologic subtypes and almost all age groups. The racial differences were most pronounced in the age 30-39 group; relative to NH Whites, NH APIs were 15.24 (95% CI: 11.69-20.05), 17.26 (95% CI: 12.56-24.07), and 8.91 (95% CI: 6.79-11.48) times as likely to have differentiated non-keratinizing, undifferentiated non-keratinizing, and keratinizing squamous cell tumors, respectively. These findings suggest an earlier onset of nasopharyngeal cancer among NH APIs, which highlight unique early life exposure to critical nasopharyngeal cancer risk factors as well as genetic predisposition in this high-risk population.

Caregivers with Cancer Patients: Focus on Hispanics.

Cancer is a public health concern and causes more than 8 million deaths annually. Cancer triggers include population growth, aging, and variations in the prevalence and distribution of the critical risk factors for cancer. Multiple hallmarks are involved in cancer, including cell proliferation, evading growth suppressors, activating invasion and metastasis, resisting cell death, enabling replicative immortality, reprogramming energy metabolism, and evading immune destruction. Both cancer and dementia are age-related and potentially lethal, impacting survival. With increasing aging populations, cancer and dementia cause a burden on patients, family members, the health care system, and informal/formal caregivers. In the current article, we highlight cancer prevalence with a focus on different ethnic groups, ages, and genders. Our article covers risk factors and genetic causes associated with cancer and types of cancers and comorbidities. We extensively cover the impact of cancer in Hispanics in comparison to that in other ethnic groups. We also discuss the status of caregivers with cancer patients and urgent needs from the state and federal support for caregivers.

Abstract C060: Investigating the clinical relevance in prostate cancer of the serum biomarkers PVT1 exons 4A, 4B and 9 across risk levels and ethnicity/race

Abstract Chromosome 8q24 is of particular importance for cancer susceptibility. Located in this region is the Plasmacytoma Variant Translocation 1 (PVT1) gene, a long noncoding RNA that has been implicated in multiple cancers including prostate cancer. Amplification of the PVT1 gene locus is a common event in many malignant diseases and is associated with poor clinical outcomes. The pioneering role of PVT1, and its alternatively spliced transcripts, as a cancer biomarker is progressively becoming established. We have demonstrated that copy numbers of PVT1 exons 4A, 4B and 9 is quantifiable in cancer cells, tissue, and serum from cancer patients. In this study, we assessed clinically annotated serum samples from 40 prostate cancer patients to investigate the clinical relevance of PVT1 exons 4A, 4B, and 9 as a biomarker across cancer risk levels and ethnicity/race. Explorative data analysis for the development of composite score for prostate cancer was performed using Kruskal-Wallis Rank Sum Test. We observed significantly higher copy numbers of PVT1 exons 4B and 9 across all races (White, Black and Hispanic) and Blacks and Hispanics when compared to the control. Additionally, using a 3-level cancer risk rating assessment in which 0 = healthy, 1 = low risk and 2 = high risk, we observed that PVT1 exon 9 may distinguish between cancerous and noncancerous cases across all races, but may not help distinguish between indolent and aggressive cancer cases. Notably, PVT1 exon 4B may help distinguish between indolent and aggressive cancer cases for Blacks and Hispanics. The results of this study suggest that using PVT1 exon 4B or 9 may identify cancer regardless of ethnicity/race, and that utilization of serum PVT1 exon 4B copy number may help distinguish between indolent and aggressive prostate cancer in Blacks and Hispanics. Citation Format: Fayola Levine, Emmanuel Asante-Asamani, Gargi Pal, Michael Liss, Olorunseun Ogunwobi. Investigating the clinical relevance in prostate cancer of the serum biomarkers PVT1 exons 4A, 4B and 9 across risk levels and ethnicity/race [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr C060.

Abstract PO-175: National trends in younger onset obesity-related cancer incidence

Abstract Obesity is a risk factor for many cancers, and obesity-related cancer incidence in the United States (U.S.) has been rising over the years. In the recent decades, the younger population of the United States has experienced an increase in obesity. These increases have been the highest among ethnic minorities, and in the Southeast, while they have been less evident in the Northeast. The impact of rising rates of obesity among younger individuals on younger onset cancer incidence is less well understood. We estimated 15-year trends in incidence for 11 obesity-related cancers among adults under the age of 50 stratified by race/ethnicity and geographic region of the United States. Age adjusted incidence rates for cancers of the female breast, colorectal, endometrial, esophageal, hepatocellular carcinoma, kidney, multiple myeloma, non-cardia gastric, ovarian, pancreatic, and thyroid cancers were calculated from 2001-2016 using data obtained from Surveillance, epidemiology, and End Results (SEER-18). Data were stratified by age +/- 50 years old, four racial/ethnic groups: non-Hispanic white (NHW), non-Hispanic black (NHB), Asian American or Pacific Islander (AAPI), and Hispanic, and four geographical regions: West, Midwest, Northeast, and Southeast, and by sex. We used SEER*Stat and JoinPoint software for analysis. We observed statistically significant increasing 15-year trends among younger adults for colorectal cancer in NHWs, NHBs, and Hispanics, kidney cancer in all race groups, multiple myeloma among NHBs, non-cardia gastric cancer in Hispanic males and thyroid cancer in NHW and AAPI males. Stratification by geography revealed increasing trends of younger onset female breast cancer in the Midwest and that increasing trends for younger onset myeloma, non-cardia gastric, and thyroid cancers are steepest in the Northeastern U.S. and steepest for younger onset colorectal cancer in the Southeast U.S. We observed increasing trends in younger onset cancers of the kidney, colorectal, multiple myeloma, non-cardia gastric, thyroid, and female breast. Preventing obesity in ways such as education, better food produce availability and programs, and lower healthcare costs may reduce the impact of these cancers. Reduced age for screening for colorectal cancer may improve opportunity for earlier detection and improved prognoses in younger adults. Citation Format: Talia Begi, Osika Tripathi, Paris Offor, Caroline A. Thompson. National trends in younger onset obesity-related cancer incidence [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-175.

S0273 Worsening 3-Year Survival Disparity in Early Onset Colorectal Cancer in Hispanics Compared to Non-Hispanic Whites From 1990-2009

S0273 Worsening 3-Year Survival Disparity in Early Onset Colorectal Cancer in Hispanics Compared to Non-Hispanic Whites From 1990-2009

Abstract C053: Testicular cancer in Hispanics: Incidence of subtypes over time according to neighborhood sociodemographic factors in California

Abstract Background: Hispanic men in the U.S. experience the second-highest incidence rate of testicular cancer, behind non-Hispanic (NH) White men. Incidence of testicular cancer is increasing in the U.S., despite reports of a plateau during the 1990’s, and increases are especially steep in the Hispanic population. To date, the literature does not address whether the incidence of testicular cancer or the observed increases in incidence differ according to neighborhood factors. Purpose: We examined incidence rates and changes in incidence over time for testicular cancer histologic subtypes (i.e., seminoma and nonseminoma) according to neighborhood socioeconomic status (nSES) among Hispanic and, for comparison, NH White men, and according to neighborhood ethnic enclave among Hispanic men, using California Cancer Registry Data. Methods: We conducted a population-based study of 12,228 Hispanic and NH White men diagnosed with testicular cancer in California during three pericensal periods 1988-1992, 1998-2002, and 2008-2012. We calculated incidence rates according to nSES and, among Hispanics, according to ethnic enclave. Incidence rate ratios were calculated to compare incidence rates across nSES and ethnic enclave and to examine changes in incidence rates over time. Results: Hispanic men residing in high SES neighborhoods, compared to low SES neighborhoods, had greater incidence of both seminoma and nonseminoma testicular cancer across pericensal periods (2008-2012, high to low nSES, seminoma IRR, 1.67; 95% CI, 1.38-2.02 and nonseminoma IRR, 1.22; 95% CI, 1.00-1.48). Hispanic men residing in low ethnic enclave neighborhoods also had higher incidence of both seminoma and nonseminoma across pericensal periods. Between the periods 1998-2002 and 2008-2012, Hispanic men residing in low SES neighborhoods experienced increased incidence of seminoma (IRR, 2008-2012 compared to 1998-2002, 1.39; 95% CI, 1.17-1.65) while those residing in both low and middle SES neighborhood experienced increased incidence of nonseminoma (IRR, 2008-2012 compared to 1998-2002 for low nSES, 1.87; 95% CI, 1.57-2.20 and for middle nSES, 1.48; 95% CI, 1.21-1.79). Conclusions: While Hispanic men residing in neighborhoods with higher SES and lower enclave status have greater incidence of both seminoma and nonseminoma testicular cancer, recent increases in incidence are driven by Hispanic men residing in lower SES neighborhoods, particularly for the nonseminoma histologic subtype. Citation Format: Mindy C DeRouen, Meg McKinley, Sumit A Shah, Hala T Borno, Rhonda Aoki, Daphne Y Lichtensztajn, John T Leppert, James D Brooks, Benjamin Chung, Scarlett L Gomez, Iona Cheng. Testicular cancer in Hispanics: Incidence of subtypes over time according to neighborhood sociodemographic factors in California [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr C053.

Testicular cancer in Hispanics: incidence of subtypes over time according to neighborhood sociodemographic factors in California.

Hispanic men in the USA experience the second-highest incidence rate of testicular germ cell tumors (TGCTs), behind non-Hispanic (NH) White men, and have experienced steep increases in TGCT in recent decades. It is unknown whether increases in incidence differ according to neighborhood sociodemographic factors. We conducted a population-based study of n = 3759 Hispanic and n = 8469 NH White men (n = 12,228 total) diagnosed with TGCT in California during the three most recent pericensal periods. We calculated incidence rates according to neighborhood socioeconomic status (nSES) and among Hispanics, according to ethnic enclave. We calculated incidence rate ratios to compare rates across nSES and ethnic enclave and to examine changes in rates over pericensal time periods according to these neighborhood factors for major histologic types (i.e., seminoma and nonseminoma). Hispanic men residing in high SES, compared to low SES, neighborhoods had greater incidence of seminoma and nonseminoma testicular cancer across pericensal periods, as did Hispanic men in low enclave (less ethnic), compared to high enclave, neighborhoods. Between the periods 1998-2002 and 2008-2012, Hispanic men residing in low SES neighborhoods experienced a 39% increased incidence of seminoma, while those residing in low and middle SES neighborhoods experienced 87% and 48% increased incidence of nonseminoma, respectively. While TGCT incidence has increased among all Hispanic men, incidence increases appear to be driven disproportionately by those residing in lower SES and lower enclave neighborhoods, particularly for nonseminoma.

Mutation profile of colon cancer in hispanic population of central California.

e16067 Background: The clinical and mutational profile of Hispanic patients with metastatic colon cancer is not well documented. In this retrospective study, we aim to describe the clinical and mutational profile of Hispanic patients with metastatic colon cancer in central California. Methods: We retrospectively evaluated the clinical and mutational profile of colon cancer at a single institution in Fresno, California from 2010-2019. We selected 136 patients out of which 70 patients self-identified as Hispanic and 66 self-identified as non-Hispanic. We studied clinical parameters and next-generation sequencing via Foundation one testing for these patients. Results: Among Hispanics, there were 43(61%) males and 27(38%) females. The median age at diagnosis was similar in both groups at 57. Right sided colon cancer accounted for 52% of Hispanic patients versus 40% in non-Hispanics. Fifty two percent of Hispanic patients presented with metastatic disease versus 45% in non-Hispanics. The frequency of commonly mutated genes in colon cancer in Hispanics versus non-Hispanics are as follows. KRAS (35.7% vs 37%), NRAS (11% vs 4%) BRAF (8% vs 7%), Her2/neu 0% in both groups. The frequency of other mutations such as TP53, APC, ATM, PTEN, CDKN2A, Myc amplification were also noted to be similar in both groups. PIK3CA mutation was seen in 18.6% of Hispanic patients versus 34% in non-Hispanic population which was statistically significant with a p value = 0.032. Microsatellite instability (MSI) was seen at 3.3% in Hispanics versus 10.6% in non-Hispanics. Tumor mutational burden was similar in both groups. Conclusions: The frequency of actionable mutations was similar in both Hispanic and non-Hispanic patients. Hispanics were noted to have lower PIK3CA and microsatellite instability. Metastatic disease and right sided colon cancer were seen at higher frequency in Hispanic population. Our results were similar to another population-based study which analyzed KRAS mutation with colon cancer patients in Puerto Rico[1]. Larger population based studies would be needed to further assess the differences in this patient population. Ruiz-Candelaria, Y., C. Miranda-Diaz, and R.F. Hunter-Mellado, K-RAS mutation profile in Puerto Rican patients with colorectal cancer: trends from April 2009 to January 2011. Int J Biol Markers, 2013. 28(4): p. e393-7.

Testicular cancer in Hispanics: Are we approaching ethnic parity?

e17059 Background: Hispanics (HI) are the fastest growing ethnic group in the US, representing 52% of US population growth from 2010-2018. In the past decade, they have also experienced a rise in incidence of testicular cancer. Studies have shown that HI have a higher incidence of Non-Seminomatous Germ Cell Tumors (NSGCT), present at an earlier age, have advanced stage at diagnosis, and worse outcomes (including increased mortality) when compared to Non-Hispanics (NH). However, there is a paucity of data and a growing need to better characterize this patient population. To our knowledge, this is the largest cohort of testicular cancer patients from a single academic institution that serves primarily HI. Methods: We retrospectively reviewed 243 patients with Testicular Cancer, both Seminoma and NSGCT; all diagnosed between 2010-2018. Key variables included age, race/ethnicity, comorbidities, insurance status, diagnosis, stage, treatment received/response and vitality status in 2018. Continuously distributed outcomes were summarized with mean/standard deviation; categorical outcomes with frequencies/percentages. Significance of associations between categorical outcomes was assessed with Chi Square test of association. Results: We identified 243 patients with testicular cancer, 168 (69%) HI and 75 (31%) NH. See Table. Median duration of follow up was 18.7 months (SD 27.3). When comparing HI vs NH: 65% vs 64% achieved complete response after primary treatment (p value 0.982); 16% vs 23% had a disease relapse (p value 0.184); and 82 vs 90% were alive at end of 2018 (p value 0.257). Conclusions: Our study supports available data that HI present at an earlier age. However, we found no significant difference in insurance status, histology, stage at diagnosis and outcomes in HI compared to NH. HI predominance in our population could explain the lack of difference observed but further studies are needed. Research Sponsor: None.[Table: see text]

Initial Presentation and Outcomes of Testicular Cancer among Different Racial and Ethnic Groups at a Tertiary Care Facility in New Mexico.

This study explored differences in testicular cancer presentation, treatment, compliance and outcomes among ethnicities in New Mexico. A retrospective review of patients with testicular cancer treated between 2002 and 2015 was performed. Data included demographics, stage, delays in care, treatments, insurance status and nonadherence rates. Of 186 patients Hispanics and Native Americans presented at higher stage (p <0.01) and delayed treatment (p=0.02). Retroperitoneal lymph node dissection for stage I disease was 28% while stage II was 30%, compared to 18% and 58% nationally, respectively. Of stage II in Hispanic patients 24.5% received retroperitoneal lymph node dissection compared to 41.3% of Caucasians (p <0.05). Regarding chemotherapy Caucasian patients at stage I were more likely than Hispanics to receive chemotherapy (p <0.05). Hispanics had higher rates of nonadherence (p <0.01). Insurance rates did not differ among groups. However, insurance increased the likelihood for receiving chemotherapy/retroperitoneal lymph node dissection only for Caucasians. Lack of insurance increased active surveillance rates for stage I in Hispanics. The incidence of testicular cancer in Hispanics rose by 58% after 2009 (p <0.05). Minority groups presented at higher stages and delayed treatment. Retroperitoneal lymph node dissection rates differed nationally compared to this cohort with Hispanic patients at higher stage being less likely to receive retroperitoneal lymph node dissection. Meanwhile, Hispanics with stage I are less likely to obtain chemotherapy. Insurance rates did not differ among ethnicities but having insurance did not increase rates of chemotherapy/retroperitoneal lymph node dissection for Hispanics unlike for Caucasians. Meanwhile, lack of insurance increased stage I rates of active surveillance suggesting cultural/financial factors contribute to treatment decisions. Increased health literacy, outreach and access may aid in alleviating these disparities.

COLORECTAL CANCER IN HISPANICS LIVING NEAR THE U.S.-MEXICO BORDER.

The incidence of colorectal cancer (CRC) in the US has declined. The decreasing trend is observed in non-Hispanic Whites, Blacks, and Hispanics. However, close analysis of the trends demonstrates that the decline among Hispanics is less than other races/ethnicities. We investigate the burden of CRC in Hispanics living near the U.S.-Mexico border, a subpopulation of Hispanics composed primarily of individuals of Mexican origin. The objective of this study was to investigate and compare incidence rates of CRC in non-Hispanic Whites and Hispanics living in counties along the U.S.-Mexico border. Data from the National Institutes of Health National Cancer Institute and State Cancer Profiles were analyzed to obtain CRC incidence rates (per 100,000 population) for persons ≥ 50 years of age residing in counties along the U.S.-Mexico border by race (non-Hispanic White and Hispanic) and gender from 2011 to 2015. Incidence rates of CRC in Hispanic men ≥ 50 years of age, living in counties along the U.S.-Mexico border, were higher than the national average for Hispanic men of similar age. In contrast, the incidence of CRC declined or remained stable in non-Hispanic Whites and women. Our study unveils a significant disparity in CRC incidence among Hispanics living near the U.S.-Mexico border, disproportionally affecting men ≥ 50 years of age. Socioeconomic and cultural/lifestyle factors are likely contributing to these disparities.

Risk factors for keratinocyte carcinoma skin cancer in nonwhite individuals: A retrospective analysis

Because most of the US population will consist of nonwhite individuals by the year 2043, it is essential that both physicians and patients are educated about skin cancer in nonwhite persons. To update the epidemiology, investigate specific risk factors, and facilitate earlier diagnosis and intervention of keratinocyte carcinoma in nonwhite individuals. Institutional review board-approved retrospective chart review of all nonwhite patients who had received a biopsy-proven diagnosis of skin cancer at Drexel Dermatology during June 2008-June 2015. Squamous cell carcinoma (SCC) was the most commonly diagnosed skin cancer in black and Asian populations, and basal cell carcinoma was the most common skin cancer in Hispanics. Black persons exhibited the majority of their SCC lesions in sun-protected areas, particularly the anogenital area. On average, current smokers received skin cancer diagnoses 12.27years earlier than former smokers and 9.36years earlier than nonsmokers. Single-center design and interpractitioner variability of skin examination. The importance of lesions in photoprotected areas in nonwhite individuals should not go overlooked. However, emphasis should also be placed on active examination of sun-protected areas in nonwhite persons and recognition of the relationship between human papillomavirus and genitalSCClesions. Smoking cessation should be integrated in dermatologic counseling of all patients.Interventions tailored to each of these ethnic groups are needed.

Review of Nonmelanoma Skin Cancer in African Americans, Hispanics, and Asians.

Skin cancer has traditionally been studied in Caucasian skin. Although it does occur with increased relative frequency in Caucasians, patients with skin of color suffer from elevated morbidity and mortality when diagnosed with skin cancer. To detail the unique demographic and clinical features of nonmelanoma skin cancer (NMSC) in patients with skin of color, including Hispanic, African American, and Asian patients. A complete PubMed search was conducted spanning dates from 1947 to June 2017 yielding a total of 185 manuscripts, from which 45 were included in this review. Relative to Caucasians, NMSC, comprised squamous cell carcinoma and basal cell carcinoma, has unique demographic and clinical features in African Americans, Hispanics, and Asians. Familiarization with these unique presentations of skin cancer in skin of color is imperative to accurate identification and treatment of cutaneous malignancies in these populations and ultimately to improved disease-related outcomes.