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Published on: October 24, 2015
Hepatocellular carcinoma in Micronesians, a growing Pacific Islander population in the U.S
Eric M Wu1, Brenda Y Hernandez2, Linda L Wong1
1Department of Surgery, University of Hawaii, John A. Burns School of Medicine, Honolulu, HI 96813, USA.
Aim:
Micronesians are a rapidly growing population in Hawaii and the continental U.S. Hepatitis B is prevalent in Micronesia, but the consequences in those migrating to the U.S. are unclear. This study characterizes hepatocellular carcinoma in Micronesians with comparisons to other Pacific Islanders.
Methods:
A retrospective evaluation was undertaken of 40 Micronesian and 142 Non-Micronesian Pacific hepatocellular carcinoma patients diagnosed in a large clinical practice in Hawaii from 1993-2017.
Results:
All Micronesians were born outside of the U.S. Micronesians were younger at diagnosis (52.0 vs 60.2 years, had higher rates of hepatitis B (80% vs 31.2%), a family history of hepatocellular carcinoma (17.5% vs 4.4%) and more tumors <5 cm (64.1% vs 45.2%). Non Micronesian Pacific Islanders had higher rates of Hepatitis C (48.6% vs 22.5%) and hypertension (61.7% vs 32.4%). There was no difference in the proportions of screen-detected tumors, those meeting Milan criteria, tumor stage, or liver function. Micronesians had better 5-year survival rates (48% vs 16.7%).
Conclusion:
Hepatocellular carcinoma in Micronesians is primarily Hepatitis B-related. Micronesians were equally likely to have hepatocellular carcinoma found with screening, undergo transplant and had better survival. Our study emphasizes the need for hepatitis B screening and hepatocellular carcinoma surveillance in Micronesians.
Insights
Hepatocellular carcinoma (HCC) in Micronesians is mainly linked to Hepatitis B. This study highlights the need for Hepatitis B screening and HCC surveillance in this growing population, showing better survival rates for Micronesians.
Area of Science:
- Hepatology
- Oncology
- Public Health
Background:
- Micronesians are a growing population in the U.S. with high rates of Hepatitis B.
- The impact of Hepatitis B on hepatocellular carcinoma (HCC) in Micronesian migrants is not well understood.
Purpose of the Study:
- To characterize hepatocellular carcinoma (HCC) in Micronesians.
- Compare HCC in Micronesians to other Pacific Islanders.
Main Methods:
- Retrospective evaluation of 40 Micronesian and 142 non-Micronesian Pacific Islander HCC patients.
- Data collected from a large clinical practice in Hawaii between 1993 and 2017.
Main Results:
- Micronesians were younger at diagnosis and had higher rates of Hepatitis B and family history of HCC.
- Non-Micronesian Pacific Islanders had higher rates of Hepatitis C and hypertension.
- Micronesians demonstrated significantly better 5-year survival rates (48% vs 16.7%).
Conclusions:
- Hepatocellular carcinoma (HCC) in Micronesians is predominantly Hepatitis B-related.
- Micronesians had similar screening detection and transplant rates but improved survival.
- Emphasizes the critical need for Hepatitis B screening and HCC surveillance in Micronesian populations.
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