Risk Of Liver Cancer Research Articles

Anthropometric indicators of adiposity and risk of primary liver cancer: A systematic review and dose–response meta-analysis

Background and aimsAdiposity is associated with an increased risk of primary liver cancer (PLC). As the most commonly used indicator of adiposity, the body mass index (BMI) has been questioned for its limitations in reflecting visceral fat. This study aimed to investigate the role of different anthropometric indicators in identifying the risk of PLC by accounting for potential non-linear associations. MethodsSystematic searches were conducted in the PubMed, Embase, Cochrane Library, Sinomed, Web of Science, and CNKI databases. Hazard ratios (HRs) and the corresponding 95% confidence intervals (CIs) were used to assess the pooled risk. The dose-response relationship was assessed using a restricted cubic spline model. ResultsSixty-nine studies involving more than 30 million participants were included in the final analysis. Regardless of the indicator used, adiposity was strongly associated with an increased risk of PLC. When comparing the HRs per 1-standard deviation increment across indicators of adiposity, the association was strongest for waist-to-height ratio (WHtR) (HR = 1.39), followed by waist-to-hip ratio (WHR) (HR = 1.22), BMI (HR = 1.13), waist circumference (WC) (HR = 1.12), and hip circumference (HC) (HR = 1.12). A strong non-linear association was observed between each anthropometric parameter and the risk of PLC, regardless of whether the original or decentralised value was used. The positive association between WC and PLC risk remained substantial after adjusting for BMI. The incidence of PLC was higher with central adiposity (52.89 per 100,000 person-years, 95% CI = 50.33–55.44) than general adiposity (39.01 per 100,000 person-years, 95% CI = 37.26–40.75). ConclusionCentral adiposity seems to contribute more to the development of PLC than general adiposity. A larger WC, independent of BMI, was strongly associated with the risk of PLC and might be a more promising predictive indicator than BMI.

Habitually Skipping Breakfast Is Associated with the Risk of Gastrointestinal Cancers: Evidence from the Kailuan Cohort Study

BackgroundHabitually skipping breakfast may promote the initiation and progression of gastrointestinal (GI) cancers, which have never been systematically explored in large-scale prospective studies.MethodsWe prospectively examined the effects of breakfast frequency on the occurrence of GI cancers among 62,746 participants. The hazard ratios (HRs) and 95% confidence intervals (95% CIs) of GI cancers were calculated by Cox regression. The CAUSALMED procedure was used to perform the mediation analyses.ResultsDuring a median follow-up of 5.61 (5.18 ~ 6.08) years, 369 incident GI cancer cases were identified. Participants who consumed 1–2 times breakfasts per week exhibited an increased risk of stomach (HR = 3.45, 95% CI: 1.06–11.20) and liver cancer (HR = 3.42, 95% CI: 1.22–9.53). Participants who did not eat breakfast had an elevated risk of esophageal (HR = 2.72, 95% CI: 1.05–7.03), colorectal (HR = 2.32, 95% CI: 1.34–4.01), liver (HR = 2.41, 95% CI: 1.23–4.71), gallbladder, and extrahepatic bile duct cancer (HR = 5.43, 95% CI: 1.34–21.93). In the mediation effect analyses, BMI, CRP, and TyG (fasting triglyceride-glucose) index did not mediate the association between breakfast frequency and the risk of GI cancer incidence (all P for mediation effect > 0.05).ConclusionsHabitually skipping breakfast was associated with a greater risk of GI cancers including esophageal, gastric, colorectal, liver, gallbladder, and extrahepatic bile duct cancer.Trial RegistrationKailuan study, ChiCTR–TNRC–11001489. Registered 24 August, 2011-Retrospectively registered, http://www.chictr.org.cn/showprojen.aspx?proj=8050

Recall patterns and risk of primary liver cancer for subcentimeter ultrasound liver observations: a multicenter study

Patients with cirrhosis and subcentimeter lesions on liver ultrasound are recommended to undergo short-interval follow-up ultrasound because of the presumed low risk of primary liver cancer (PLC). The aim of this study is to characterize recall patterns and risk of PLC in patients with subcentimeter liver lesions on ultrasound. We conducted a multicenter retrospective cohort study among patients with cirrhosis or chronic hepatitis B infection who had subcentimeter ultrasound lesions between January 2017 and December 2019. We excluded patients with a history of PLC or concomitant lesions ≥1cm in diameter. We used Kaplan Meier and multivariable Cox regression analyses to characterize time-to-PLC and factors associated with PLC, respectively. Of 746 eligible patients, most (66.0%) had a single observation, and the median diameter was 0.7cm (interquartile range: 0.5-0.8cm). Recall strategies varied, with only 27.8% of patients undergoing guideline-concordant ultrasound within 3-6 months. Over a median follow-up of 26 months, 42 patients developed PLC (39 HCC and 3 cholangiocarcinoma), yielding an incidence of 25.7 cases (95% CI, 6.2-47.0) per 1000 person-years, with 3.9% and 6.7% developing PLC at 2 and 3 years, respectively. Factors associated with time-to-PLC were baseline alpha-fetoprotein >10ng/mL (HR: 4.01, 95% CI, 1.85-8.71), platelet count ≤150 (HR: 4.90, 95% CI, 1.95-12.28), and Child-Pugh B cirrhosis (vs. Child-Pugh A: HR: 2.54, 95% CI, 1.27-5.08). Recall patterns for patients with subcentimeter liver lesions on ultrasound varied widely. The low risk of PLC in these patients supports short-interval ultrasound in 3-6 months, although diagnostic CT/MRI may be warranted for high-risk subgroups such as those with elevated alpha-fetoprotein levels.

Comparison and Analysis of Liver Cancer Prediction Using ML

In diagnosis centers the importance of detecting a cancer on time is vital. With the help of tools like x-ray, MRI machine, medical professionals can detect somatic mutations easily (a somatic mutation is an acquired change in a genetic code of one or more cells). Here we chose a disease that is liver cancer. This deployed model is given data via google Collab, then analyzed in real-time with machine learning model which was pretrained and the result is shown in the google Collab. Models that are used in our project are Logistic regression, Naive Bayes classifier and Random Forest etc., is used to carry out computation for prediction. And we compare these machine learning models accuracies. But we got good accuracy for machine learning model (random forest classifier). Early detection can help in identifying the risk of liver cancer. Our model is helpful for doctors to give timely medications for treatment.

Prospective Cohort Study of Ginseng Consumption in Association with Cancer Risk: Shanghai Women’s Health Study

BackgroundGinseng has been commonly used in Asian countries to promote longevity and health for >2000 years. Recent in vitro and in vivo studies, coupled with limited epidemiologic studies, have suggested that regular ginseng consumption may be related to lower cancer risk. ObjectivesWe evaluated the association of ginseng consumption with risk of total and 15 site-specific cancers in a large cohort study conducted among Chinese women. Given the previous literature on ginseng consumption and cancer risk, we hypothesized that ginseng consumption might be associated with varying risks of cancer. MethodsThis study included 65,732 female participants (mean age: 52.2 years) of the Shanghai Women’s Health Study, an ongoing prospective cohort study. Baseline enrollment occurred between 1997 and 2000, and follow-up concluded on 31 December 2016. Ginseng use and covariates were assessed via an in-person interview conducted at the baseline recruitment. The cohort was followed for cancer incidence. Cox proportional hazard models were used to estimate HRs and 95% CIs for ginseng-cancer associations after adjusting for confounders. ResultsDuring a mean 14.7 years of follow-up, 5067 incident cancer cases were identified. Overall, regular ginseng use was mostly not associated with risk of any site-specific cancer, or all cancers combined. Short-term (<3 years) ginseng use was found to be significantly associated with increased risk of liver cancer (HR = 1.71; 95% CI: 1.04, 2.79; P = 0.035), whereas long-term (≥3 years) ginseng use was found to be associated with increased risk of thyroid cancer (HR = 1.40; 95% CI: 1.02, 1.91; P = 0.036). Long-term ginseng use was found to be significantly associated with decreased risk of lymphatic and hematopoietic tissue malignancy (HR = 0.67; 95% CI: 0.46, 0.98; P = 0.039) and non-Hodgkin’s lymphoma (HR = 0.57; 95% CI: 0.34, 0.97; P = 0.039). ConclusionsThis study provides suggestive evidence that ginseng consumption may be associated with risk of certain cancers.

Rescue of infant progressive familial intrahepatic cholestasis type 3 mice by repeated dosing of AAV gene therapy

Background & AimsGene therapy using recombinant adeno-associated virus (rAAV) vector carrying multidrug resistance protein 3 (MDR3) coding sequence (AAV8-MDR3) represents a potential curative treatment for progressive familial intrahepatic cholestasis type 3 (PFIC3), which presents in early childhood. However, patients with the severest form of PFIC3 should receive treatment early after detection to prevent irreversible hepatic fibrosis leading ultimately to liver transplantation or death. This represents a challenge for rAAV-based gene therapy because therapeutic efficacy is expected to wane as rAAV genomes are lost owing to hepatocyte division, and the formation of AAV-specific neutralising antibodies precludes re-administration. Here, we tested a strategy of vector re-administration in infant PFIC3 mice with careful evaluation of its oncogenicity – a particular concern surrounding rAAV treatment. MethodsAAV8-MDR3 was re-administered to infant Abcb4-/- mice 2 weeks after a first dose co-administered with tolerogenic nanoparticles carrying rapamycin (ImmTOR) given at 2 weeks of age. Eight months later, long-term therapeutic efficacy and safety were assessed with special attention paid to the potential oncogenicity of rAAV treatment. ResultsCo-administration with ImmTOR mitigated the formation of rAAV-specific neutralising antibodies and enabled an efficacious second administration of AAV8-MDR3, resulting in stable correction of the disease phenotype, including a restoration of bile phospholipid content and healthy liver function, as well as the prevention of liver fibrosis, hepatosplenomegaly, and gallstones. Furthermore, efficacious repeat rAAV administration prevented the appearance of liver malignancies in an animal model highly prone to developing hepatocellular carcinoma. ConclusionsThese outcomes provide strong evidence for rAAV redosing through co-administration with ImmTOR, as it resulted in a long-term therapeutic effect in a paediatric liver metabolic disorder, including the prevention of oncogenesis. Impact and implicationsRedosing of gene therapy for inborn hepatobiliary disorders may be essential as effect wanes during hepatocyte division and renewal, particularly in paediatric patients, but the approach may carry long-term risks of liver cancer. Viral vectors carrying a therapeutic gene exerted a durable cure of progressive familial intrahepatic cholestasis type 3 in infant mice and reduced the risk of liver cancer only following a second administration.

Risk of death from liver cancer in relation to long-term exposure to fine particulate air pollution in Taiwan

ABSTRACT According to the International Agency for Research on Cancer (IARC), airborne fine particulate matter (PM2.5), which is categorized as a Group I carcinogen, was found to lead to predominantly lung as well as other cancer types in humans. Hepatocellular carcinoma (HCC) is endemic in Taiwan where it is the second and fourth foremost cause of cancer deaths in men and women, respectively. Taiwan’s mortality rates for liver cancer vary considerably from one region to another, suggesting that the environment may exert some influence on deaths attributed to liver cancer. The aim of this investigation was to perform an ecologic study to examine the possible link between ambient PM2.5 levels and risk of liver cancer in 66 in Taiwan municipalities. To undertake this investigation, annual PM2.5 levels and age-standardized liver cancer mortality rates were calculated for male and female residents of these areas from 2010 to 2019. Data were tested using weighted-multiple regression analyses to compute adjusted risk ratio (RR) controlling for urbanization level and physician density. Annual PM2.5 levels of each municipality were divided into tertiles. The adjusted RRs for males residing in those areas with intermediate tertile levels (21.85 to 28.21 ug/m3) and the highest tertiles levels (28.22–31.23 ug/m3) of PM2.5 were 1.29 (95% CI = 1.25–1.46) and 1.41 (95% CI = 1.36–1.46), respectively. Women in these locations shared a similar risk, 1.32 (1.25–1.4) and 1.41 (1.34–1.49), respectively. Evidence indicated that PM2.5 increased risk of mortality rates attributed to liver cancer in both men and women in Taiwan.

The impact of a hepatitis B diagnosis

Hepatitis B significantly impacts a person's quality of life, starting at diagnosis. This includes their physical health, such as an increased risk of liver cancer, as well as their mental and emotional wellbeing, contributing to depression, anxiety and self-isolation, exacerbated by stigma and discrimination. Goals have been set to eliminate hepatitis B. To reach these goals, it is essential that people living with hepatitis B are actively involved in their treatment and management through shared decision-making. This will require further research into its effects on individuals who are directly affected. Moving towards elimination means expanding testing to identify those infected, as well as ensuring that protections are in place to support people living with hepatitis B and minimise stigma and discrimination.

Protein Acetylation Increased Risk of Fibrosis-Related Liver Cancer.

The occurrence of liver fibrosis and fibrosis-related liver cancer is the reason for the increase in morbidity and mortality worldwide. Transforming growth factor-β2 (TGF-β2) is an important mediator of chronic liver fibrosis. This study aims to find the molecular mechanism that mediates HBV infection and induces TGF-β2 and verifies that CREB binding protein acetylation mediates HBV infection and induces TGF-β2 expression. The acetylated proteins were extracted from HepG2-NTCP cells and HBV-infectedHepG2-NTCP cells. The acetylated proteins were screened by modification enrichment technology and database search. Protein annotation, motif analysis of modification sites, and protein function enrichment analysis of these proteins were performed to roughly clarify the location and function of these acetylated modification proteins in cells. Acylated proteins enriched in the TGF-β pathway were obtained by KEGG pathway enrichment analysis. The effect of the selected acetylated modification protein on the TGF-β pathway was verified by experiments, that is, the target protein gene was knocked out by siRNA, and the expression level of the TGF-β2 was detected by qRT-PCR. Proteins were extracted from HepG2-NTCP cells and HepG2-NTCP cells infected with HBV, and differential acetylation modification proteins were screened. The target protein CREB binding protein was screened by modification enrichment technology and database search. The aggregation analysis of TGF-β pathway showed that CREB binding protein was acetylated at amino acid positions 434 and 439, and enriched in the TGF-β signaling pathway. siRNA targeting CREB binding protein was transfected, and the expression of TGF-β2 in cells was detected by qRT-PCR and western blot, respectively. It was verified that HBV infection-inducedCREB-binding protein acetylation regulated the high expression of TGF-β2. After HBV infection, CREBBP acetylation was up-regulated, which promoted the high expression of TGF-β2.

Malignant Neoplasms of the Gastrointestinal Tract After Blood or Marrow Transplant

Survivors of blood or marrow transplant (BMT) are at increased risk of subsequent malignant neoplasms (SMNs). Cancers of the gastrointestinal (GI) system are of special interest because their clinical behavior is often aggressive, necessitating early detection by increasing awareness of high-risk populations. To describe the risk of SMNs in the GI tract after BMT. A cohort study of 6710 individuals who lived at least 2 years after BMT performed between January 1, 1974, and December 31, 2014, at City of Hope, University of Minnesota, or University of Alabama at Birmingham. End of follow-up was March 23, 2020. Data analysis was performed between September 1, 2022, and September 30, 2022. Demographic and clinical factors; therapeutic exposures before or as part of BMT. Development of SMNs in the GI tract after BMT. Participants self-reported SMNs in the GI tract; these were confirmed with pathology reports, medical records, or both. For deceased patients, death records were used. Standardized incidence ratios determined excess risk of SMNs in the GI tract compared with that of the general population. Fine-Gray proportional subdistribution hazard models assessed the association between risk factors and SMNs in the GI tract. The cohort of 6710 individuals included 3444 (51.3%) autologous and 3266 (48.7%) allogeneic BMT recipients. A total of 3917 individuals (58.4%) were male, and the median age at BMT was 46 years (range, 0-78 years). After 62 479 person-years of follow-up, 148 patients developed SMNs in the GI tract. The standardized incidence ratios for developing specific SMNs ranged from 2.1 for colorectal cancer (95% CI, 1.6-2.8; P < .001) to 7.8 for esophageal cancer (95% CI, 5.0-11.6; P < .001). Exposure to cytarabine for conditioning (subdistribution hazard ratio [SHR], 3.1; 95% CI, 1.5-6.6) was associated with subsequent colorectal cancer. Compared with autologous BMT recipients, allogeneic BMT recipients with chronic graft-vs-host disease were at increased risk for esophageal cancer (SHR, 9.9; 95% CI, 3.2-30.5). Conditioning with etoposide (SHR, 2.0; 95% CI, 1.1-3.5) and pre-BMT anthracycline exposure (SHR, 5.4; 95% CI, 1.3-23.4) were associated with an increased risk of liver cancer compared with no exposure to the respective agents. The findings of this cohort study are relevant for oncologists and nononcologists who care for the growing number of survivors of transplant. Awareness of subgroups of survivors of BMT at high risk for specific types of SMNs in the GI tract may influence recommendations regarding modifiable risk factors, as well as individualized screening.

Estimates and trends of the global burden of NASH-related liver cancer attributable to high fasting plasma glucose in 1990–2019: analysis of data from the 2019 Global Burden of Disease Study

BackgroundExperimental and epidemiological studies have indicated an association between diabetes exposure and an increased risk of liver cancer due to nonalcoholic steatohepatitis (NASH). However, to date, no systematic study has specifically investigated the burden of NASH-related liver cancer due to exposure to high fasting plasma glucose (HFPG) levels worldwide.MethodsThe number and rate of deaths and disability-adjusted life years (DALYs) from HFPG-induced NASH-related liver cancer were estimated based on the results of the 2019 Global Burden of Disease Study. The estimated annual percentage changes (EAPCs) for age-standardized death or DALYs rates were calculated using a generalized linear model with a Gaussian distribution to quantify the temporal trends in the global burden of NASH-related liver cancer attributable to HFPG. The strength and direction of the association between the sociodemographic index (SDI) and death or DALY rate were measured using Spearman’s rank-order correlation.ResultsGlobally, approximately 7.59% of all DALY and 8.76% of all mortalities of NASH-related liver cancer in 2019 were due to HFPG. The age-standardized death and DALY rates of NASH-related liver cancer attributable to HFPG increased from 1990 to 2019. The corresponding EAPCs were 0.69 (95% UI 0.48–0.89), and 0.30 (95% UI 0.05–0.56), respectively. This increasing pattern was most obvious in the high- and low-SDI regions. The age-standardized mortality and DALYs rate of NASH-related liver cancer attributable to HFPG varies considerably worldwide, with the middle SDI region having the highest death and DALY rates in 2019 (DALY 0.96 [95% UI 0.23–2.18]; death 0.05 [95% UI 0.01–0.11]).ConclusionThe burden of NASH-related liver cancer attributable to HFPG has increased over the past three decades, particularly in regions with high and low SDI.

Aflatoxin Occurrence, Food Regulations, Dietary Exposure, and Risk Assessment: A Mini Review from the Malaysian Perspective

Aflatoxins are ubiquitous and occur in food. Exposure to aflatoxins seriously impact the health of human and animal. It is concerning especially when aflatoxins are odourless, colourless, and tasteless that hardly be detected through naked eyes. Ingestion of aflatoxin-contaminated food contributes the major route of exposure. The present review is an update on the aflatoxin occurrence in food, aflatoxin regulations in food, and recent risk assessment of aflatoxin exposure in Malaysia. Peanuts and chili were more prone to aflatoxin contamination in Malaysia. The extreme weather experienced in Malaysia and global climatic change may worsen the aflatoxin contamination in food. The regulatory standards for aflatoxins imposed by Malaysia are less stringent than developed countries. The dietary exposure of aflatoxins among Malaysian was relatively high as compared with other Asia countries, ranging from 0.002 to 34.00 ng/kg body weight/day. Nonetheless, Malaysian population had low risk of aflatoxin-related liver cancer, with an estimated liver cancer risk of &lt;1 cancer case/100,000 population/year.

Circulating Copper and Liver Cancer.

The association between circulating copper and the risk of liver cancer has been investigated by previous studies, while the findings were inconsistent. Thus, we aimed to evaluate the association between circulating copper and liver cancer by using meta-analysis and Mendelian randomization (MR). For meta-analysis, PubMed and Web of Science were searched to identify eligible studies published before April 4, 2022. Standardized mean difference (SMD) with 95% confidence interval (CI) in circulating copper level between liver cancer patients and controls were pooled. Furthermore, we selected genetic instruments for circulating copper from a genome-wide association study (GWAS) to conduct MR analysis. The summary statistics related to liver cancer were obtained from two large independent cohorts, UKBB and FinnGen, respectively. MR analysis was performed mainly by inverse-variance weighted (IVW) approach, followed by maximum-likelihood method as sensitivity analysis. In meta-analysis of eight studies, circulating copper was found to be higher in liver cancer patients (SMD: 1.65; 95% CI: 0.65 to 2.65) with high heterogeneity (I2 = 96.40%, P = 0.001). However, inconsistent findings were observed among subgroups with high evidence. In MR analysis, genetically predicted circulating copper was not significantly associated with the risk of liver cancer by IVW in UKBB (OR: 1.38; 95% CI: 0.72 to 2.65) and FinnGen (OR: 1.10; 95% CI: 0.69 to 1.73) separately, and the pooled results produced similar results (OR: 1.18, 95% CI: 0.81 to 1.72). Moreover, non-significant finding was confirmed by using maximum-likelihood method. There is no sufficient evidence to demonstrate that high levels of circulating copper increase the risks of liver cancer.

The Association between Physical Activity and Cancer Prevention, Recovery, and Recurrence: A Narrative Review

Cancer is a leading cause of death globally, accounting for around one in six deaths worldwide. This highlights the need to find effective prevention and recovery strategies. Physical activity, encompassing all bodily movements that consume energy, is significantly linked to cancer risk and survival. 28% of adults are insufficiently active, making physical inactivity the fourth leading risk factor for global mortality. Approximately one-third of cancer deaths are due to low physical activity and a poor diet. This narrative review explores the relationship between physical activity and cancer prevention, recovery, and recurrence. The findings indicate that adhering to recommended physical activity levels can significantly reduce the risk of various cancers, including breast, endometrial, kidney/renal, colon, rectal, liver, lung, bladder, head and neck cancer, gastric cardia, esophageal adenocarcinoma, myeloma, myeloid leukemia, and non-Hodgkin lymphoma. Physical activity aids in cancer recovery by reducing treatment side effects, enhancing physical fitness, mental health, and quality of life, and reducing recurrence risk. It influences cancer progression by controlling genomic instability, metabolic regulation, hormonal balance, and mitochondrial and immune function enhancement. Despite the known benefits, integrating physical activity into cancer care is not widespread due to barriers like pain, fatigue, a lack of motivation, and insufficient information. In conclusion, increasing physical activity across all life domains can markedly reduce cancer's burden and improve well-being. Personalized physical activity goals are recommended for individuals of all ages, including children with cancer. The study also recommends further research into different types of physical activities and their impact on various cancer types This is crucial for developing targeted interventions and comprehensive care strategies to harness the full potential of physical activity in cancer control.

Abstract C077: Understanding the epidemiology of NAFLD in Asian Americans: A literature review and survey development

Abstract Background: Non-alcoholic fatty liver disease (NAFLD) affects about 25% of the general population in the US. Although epidemiology of NAFLD is well studied in the US, the scientific understanding of how this disease affect Asian Americans is very limited. Given that NAFLD is strongly increases the risks of liver cancer, a condition that disproportionally affect Asian Americans, it is critical that we better understand the burden of NAFLD in this population and identify protective/risk factors. The goals of this study are to (1) review the existing body of literature on the epidemiology of NAFLD in Asian Americans and (2) develop a survey based to better understand the burden of the disease. Methods: In this study we conducted a review of previous studies on NAFLD in Asian Americans and in Asia/Pacific regions. We focused on three aspects: (1) the prevalence and incidence rates of NALFD in the target populations; (2) the risk factors and protective factors of NAFLD; (3) the knowledge of and attitude towards NAFLD and its prevention, diagnosis, and treatment. We also identified limitations in previous studies with regards to study design and methodology. Findings: We have found that so far there has been there is paucity of data for NAFLD burdens in Asian Americans. The few existing studies estimated the prevalence of NAFLD to be between 18% to 43% in Asian Americans, with higher rates in men than women. Comparative studies have inconsistent findings on the prevalence of NAFLD between Asian and non-Asian American populations, likely due to differences in target population and sampling methods. However, one consistent finding so far was that Asian Americans with NAFLD have lower BMI and waist circumference, and aminotransferases and triglycerides, and similar risk factors for advanced fibrosis and atherosclerotic cardiovascular disease, than non-Asian Americans with NAFLD. Though limited, these studies suggested that Asian Americans are potentially at high risks for NAFLD and liver cancer, but the specific mechanisms remained unclear. Survey Development: Recognizing the gaps in previous literature, we designed a survey to better understand the burden of NAFLD in Asian Americans and provide foundation for behavioral and clinical interventions. We developed a survey to examine the knowledge, attitude, and behaviors related to NAFLD prevention, diagnosis, and treatment among Asian Americans. Conclusion: Despite inconsistent findings on how prevalence rates compare between Asian Americans and non-Hispanic white, increased evidence points to an elevated risks for advanced NAFLD and worsen outcomes in Asian Americans. We will discuss the implications for the prevention in Asian Americans, as well as linkage to care for early diagnosis and treatment for Asian Americans with NAFLD. We will also discuss the participant recruitment and data collection process of conducting the survey. Citation Format: Lin Zhu, Dasam Jeong, Yassah N. Lavelah, Yin Tan, Grace X. Ma. Understanding the epidemiology of NAFLD in Asian Americans: A literature review and survey development [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 C077.

Much More Is Needed From Hepatitis B Core-Related Antigen to Predict Risk of Liver Cancer.

Singh, Satender Pal DM1; Jindal, Ankur DM1; Sharma, Manoj Kumar DM1; Sarin, Shiv Kumar MD, DM1 Author Information

Investigation of Novel Urinary Biomarkers in Hepatocellular Carcinoma Risk in a Predominantly African American Population: A Case-Control Study

Introduction: African Americans are at increased risk of hepatocellular carcinoma (HCC) compared to other racial and ethnic groups. We investigated the associations of four urinary biomarkers of prostaglandin E2 (PGE-M), prostacyclin (PGI-M), and thromboxane (11dTxB2) synthesis and the ratio of PGI-M to 11dTXB2 with HCC risk in a cohort of predominantly African American populations. Methods: We conducted a nested case-control study (50 cases; 43 with HCC, 151 controls) in the Southern Community Cohort Study (SCCS), a large prospective cohort study including over 80,000 study participants, of whom two-thirds are African Americans. Urine samples were collected at enrollment and subsequently analyzed to assess biomarker levels. Multivariable regression models adjusted for age, race, sex, BMI, smoking status, NSAID use, education level, income, and alcohol consumption were used to assess the relationship between the biomarker and HCC risk. Results: Only 11dTxB2 (OR = 11.50; 95% CI [2.34–56.47] for highest tertile vs. lowest tertile, p = 0.004) and the PGI-M/11dTXB2 ratio of the second quartile (0.25–0.49) (OR = 5.16; 95% CI [1.44–18.47]; p = 0.01) were significantly associated with increased risk of liver cancer. Conclusion: 11dTXB2 and PGI-M/11dTXB2 ratio may be urinary markers of HCC risk, particularly among African Americans, and future prospective studies are needed to evaluate this finding further and to develop accessible methods.

Abstract C069: Reducing liver cancer risk through dietary change: Positive results from a community-based educational initiative in three racial/ethnic groups

Abstract Background: The existing body of literature suggests that modifiable lifestyle behaviors such as alcohol consumption and dietary behaviors were linked to viral hepatitis B/C and liver cancer. So far, most of the liver cancer awareness campaigns and behavioral interventions have focused on preventive behaviors such as screening, vaccination, and early diagnosis. Not enough efforts have been made to raise awareness of behavioral mechanism of liver cancer prevention, especially in the medically underserved populations. Methods: We used the community-based participatory research (CBPR) approach to implement an education initiative regarding the promotion of liver cancer among the African, Asian, and Hispanic populations within the Philadelphia metropolitan area and New York City. In this study, we used data from the pre-education surveys and follow-up assessments at 6 months post-education to assess the changes in dietary behaviors and alcohol consumption among participants. Results: The study sample includes 344 participants recruited through community-based organizations. The sample consists of 31 African Americans, 174 Asian Americans, and 139 Hispanic Americans. Among the African Americans participants, the consumption of scores such as fruits (2.710 to 3.581) and poultry (2.613 to 3.677) increased significantly, while vegetables and red meats decreased. In Asian Americans, the consumption of non-refined cereals (3.362 to 4.282), red meats (2.655 to 3.195), and dairy (2.851 to 3.701) products decreased. Lastly, among the Hispanic American participants poultry (2.173 to 3.554), dairy products (2.101 to 3.863), and olive oil (3.022 to 3.849) increased, as well as the consumption of alcohol. Conclusion: This community-based educational imitative generated different impacts in the three populations, further highlighting the needs for more targeted, culturally tailored efforts in health promotion among these underprivileged communities. Citation Format: Tamar Tertulien, Ellen J. Kim, Wenyue Lu, Steven Zhu, Nathaly Rubio-Torio, Evelyn González, Marilyn A. Fraser, Ming-Chin Yeh, Lin Zhu, Grace X. Ma, Olorunseun O. Ogunwobi, Yin Tan. Reducing liver cancer risk through dietary change: Positive results from a community-based educational initiative in three racial/ethnic groups [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 C069.

Specific botanical groups of fruit and vegetable consumption and liver cancer and chronic liver disease mortality: a prospective cohort study

BackgroundBeyond alcohol and coffee, the relationship between other dietary factors, including specific vegetables and fruits, and liver outcomes remains poorly understood. ObjectiveTo evaluate the associations between fruit and vegetable intake with the risk of liver cancer and chronic liver disease (CLD) mortality. MethodsThis study was based on the National Institutes of Health-American Association of Retired Persons Diet and Health Study, including 485,403 participants aged 50–71 y from 1995 to 1996. Fruit and vegetable intake was estimated using a validated food frequency questionnaire. Cox proportional hazards regression was used to estimate the multivariable hazard ratios (HR) and 95% confidence intervals (CI) for liver cancer incidence and CLD mortality. ResultsDuring a median follow-up of 15.5 y, 947 incident liver cancers and 986 CLD deaths (other than liver cancer) were confirmed. A higher intake of total vegetables was associated with a lower risk of liver cancer (HRQuintile 5 vs. Quintile 1 = 0.72, 95% CI: 0.59, 0.89; Ptrend < 0.001). When further subclassified into botanical groups, the observed inverse association was mainly driven by lettuce and the cruciferous family (broccoli, cauliflower, cabbage, etc.) (Ptrend < 0.005). Additionally, higher total vegetable intake was associated with a lower risk of CLD mortality (HRQuintile5 vs. Quintile1 = 0.61, 95% CI: 0.50, 0.76; Ptrend < 0.001). Inverse associations were observed for lettuce, sweet potatoes, cruciferous vegetables, legumes, and carrots with CLD mortality (all Ptrend < 0.005). In contrast, total fruit intake was not associated with liver cancer or CLD mortality. ConclusionsHigher intakes of total vegetables, especially lettuce and cruciferous vegetables, were associated with lower liver cancer risk. Higher intakes of lettuce, sweet potatoes, cruciferous vegetables, legumes, and carrots were associated with a lower risk of CLD mortality.

Butane-2-one oxime as a potential carcinogen for humans - evidence and effects on businesses resulting from reclassification

Evidence of a change in the carcinogenicity category of butan-2-one oxime (MEKO) and the results of this change for manufacturing and using companies was presented and assessed. The online databases of scientific journals were reviewed, taking into account the reports on the harmonization of MEKO classification and labeling at EU level available on the ECHA website. Commission Regulation (EU) 2020/1182 introduced harmonized classification and labeling of MEKO for carcinogenicity to category 1B. The induction of tumors, the nature and importance of tumors for humans, and the sensitivity of the 2 species tested, both sexes - all of these factors support the classification of MEKO into the carcinogenicity category 1B. On the other hand, MEKO is negative in genotoxicity studies, including in mammalian cells and in vivo in animals. This is the argument that the classification of MEKO as carcinogen category 2 remains appropriate. The change in the MEKO carcinogenicity category results in legal consequences for companies, such as compliance with the conditions of REACH restriction, which includes restrictions on placing MEKO on the market for sale to the general public, keeping a register of works that require contact with MEKO or its mixtures containing MEKO in a concentration ≥0.1%. According to the opinion of MEKO suppliers, there is currently no practical MEKO substitute that has been so well researched, despite attempts to find it in recent years. The risk of additional liver cancer in the case of 40-year occupational exposure to MEKO is 4:100 000 at a concentration of approx. 0.7 mg/m3, and it is an acceptable risk in accordance with the arrangements adopted in Poland. Compliance with the permissible concentrations of MEKO in the air of the working environment at this level should protect employees against the carcinogenic effect of MEKO. Med Pr. 2022;73(6):457-70.