P2838 - Disparities in the Incidence of Liver and Bile Duct Cancers in Hispanics at the U.S.-Mexico Border Region

Alejandro Robles, MD¹, Marc Zuckerman, MD², Sherif Elhanafi, MD², Abhizith Deoker, MD², Jorge Cervantes, MD, PhD^2
1Texas Tech University Health Sciences Center, El Paso, TX; ²Texas Tech Health Sciences Center, El Paso, TX

Introduction: Primary liver and bile duct cancers are the fifth most common cause of cancer-related death in men and the seventh most common in women. Both Hispanic men and women are twice as likely to be diagnosed and die from liver cancer as non-Hispanic Whites. Several risk factors may be contributing to this disparity, including higher rates of obesity, diabetes, NAFLD, and alcohol-related liver disease among Hispanics. We investigated the incidence rates of liver and bile duct cancers in persons living near the U.S.-Mexico border, a region where these risk factors appear to be more prevalent.

Methods: Average annual incidence rates (cases per 100,000 persons) from 2013 to 2017 of liver and bile duct cancers for counties along the U.S.-Mexico border were obtained from the NIH National Cancer Institute. Data was categorized by ethnicity (Hispanic and non-Hispanic White) and gender. The Wilcoxon matched-pairs signed rank test was used to compare rates among Hispanics versus non-Hispanic Whites. The Mann-Whitney test was used to compare incidence rates between border Hispanics and Hispanics at the national level. Counties/counts were excluded if fewer than 16 cases were reported in a specific area, sex, or ethnicity category (to ensure confidentiality).

Results: Incidence rates for border Hispanics were significantly higher than for border non-Hispanic Whites (p < 0.01). When comparing among genders, incidence rates for border Hispanic males were higher than for border non-Hispanic White males (p < 0.01). No statistically significant difference was observed among female groups (p = 0.25); likely attributed to the fact that incidence data for non-Hispanic White females was only available for 3 counties. In addition, the aggregated incidence rate for border Hispanics was significantly higher than the national Hispanic rate (p = 0.0019) (Table 1).

Discussion: To our knowledge, this is the first study comparing incidence rates of liver and bile duct cancers between ethnic groups in the U.S.-Mexico border region. Hispanics are disproportionately affected by liver and bile duct cancers. This disparity is even more evident in the U.S.-Mexico border region, where incidence rates for border Hispanics are higher than the national Hispanic rate. These findings may be related to the higher prevalence of modifiable risk factors in the border region.

BORDER COUNTY	HISPANIC (both genders)	NH WHITE (both genders)	HISPANIC (males)	NH WHITE (males)	HISPANIC (females)	NH WHITE (females)
Cameron	16.9 (14.9, 19.1)	6.4 (3.9, 10.4)	27.9 (24.0, 32.3)	8.8 (4.6, 16.2)	8.6 (6.8, 10.8)	*
Cochise	15.7 (10.7, 22.2)	8 (5.9, 10.7)	21.2 (13.0, 32.6)	12.2 (8.6, 17.1)	*	*
Dona Ana	13.7 (10.8, 17.0)	6.3 (4.3, 9.2)	19.3 (14.4, 25.3)	10.3 (6.6, 15.8)	8.9 (5.9, 12.8)	*
EL Paso	17.8 (16.3, 19.4)	7.5 (5.6, 9.9)	28.2 (25.4, 31.2)	10.5 (7.4, 14.7)	9.8 (8.4, 11.4)	4.8 (2.8, 8.0)
Hidalgo	14.2 (12.8, 15.7)	5.9 (3.8, 9.1	22.1 (19.5, 25.0)	8.8 (5.3, 14.5)	8 (6.6, 9.6)	*
Imperial	19.2 (16.0, 22.8)	8.6 (5.1, 14.6)	30 (24.1, 36.8)	*	10.3 (7.2, 14.3)	*
Maverick	19.2 (14.2, 25.3)	*	31.3 (21.9, 43.3)	*	*	*
Pima	13.8 (11.9, 15.9)	7.7 (6.8, 8.6)	22.5 (18.9, 26.6)	11.3 (9.8, 12.8)	6.6 (4.9, 8.8)	4.4 (3.6, 5.5)
San Diego	17.2 (15.8, 18.7)	7 (6.5, 7.5)	25.5 (23.0, 28.3)	10.8 (9.9, 11.7)	10.6 (9.1, 12.2)	3.4 (2.9, 3.9)
Starr	16.7 (12.1, 22.4)	*	21.7 (14.1, 31.8)	*	12.2 (7.2, 19.4)	*
Val Verde	29.8 (22.6, 38.6)	*	50.5 (36.5, 67.9)	*	*	*
Webb	17.9 (15.3, 20.8)	*	29.6 (24.4, 35.6)	*	9.1 (6.8, 12.1)	*
Yuma	14 (10.8, 17.8)	6.5 (4.2, 9.8)	22.2 (16.5, 29.3)	10 (6.0, 15.8)	6.6 (3.7, 10.8)	*
NATIONAL	13.5 (13.3, 13.6)	7.1 (7.0, 7.1)	20 (19.7, 20.3)	10.7 (10.6, 10.8)	7.9 (7.7, 8.1)	3.8 (3.8, 3.9)

Table: TABLE 1: Incidence rates of liver and bile duct cancers for counties along the U.S.-Mexico border region.

Average annual incidence rates per 100,000 persons from 2013 to 2017. 95% confidence intervals in parenthesis.
NH = Non-Hispanic
* Fewer than 16 cases reported - data suppressed to ensure confidentiality and stability of rate estimates.


Disclosures:
Alejandro Robles indicated no relevant financial relationships.
Marc Zuckerman indicated no relevant financial relationships.
Sherif Elhanafi indicated no relevant financial relationships.
Abhizith Deoker indicated no relevant financial relationships.
Jorge Cervantes indicated no relevant financial relationships.


Alejandro Robles, MD¹, Marc Zuckerman, MD², Sherif Elhanafi, MD², Abhizith Deoker, MD², Jorge Cervantes, MD, PhD². P2838 - Disparities in the Incidence of Liver and Bile Duct Cancers in Hispanics at the U.S.-Mexico Border Region, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.