RESUMO
BACKGROUND: Disease patterns in Mexican American health-disparity populations differ from larger US populations. AIMS: This study is aimed to determine frequency of gastrointestinal cancers in Mexican Americans. METHODS: We analyzed self-reported data from the Cameron County Hispanic Cohort where we find high rates of risk factors for cancer: obesity (48.5 %) and diabetes (30.7 %). Participants provided cancer histories about themselves and first- and second-degree relatives. Logistic regression models assessed risk factors. Frequencies of cancer sites were ranked and validated using concurrent age local cancer registry data. RESULTS: Among 9,249 individuals (participants and their relatives), there were 1,184 individuals with reports of cancer. Among cohort participants under 70 years of age, the most significant risk factor for all-cause cancers was diabetes (OR 3.57, 95 % CI 1.32, 9.62). Participants with metabolic syndrome were significantly more likely to report cancer in relatives [1.73 (95 % CI 1.26, 2.37]. Among cancers in fathers, liver cancer was ranked third, stomach fourth, colorectal sixth, and pancreas tenth. In mothers, stomach was third, liver fourth, colorectal seventh, and pancreas eleventh. The unusual prominence of these cancers in Mexican Americans, including liver cancer, was supported by age-adjusted incidence in local registry data. CONCLUSIONS: Gastrointestinal system cancers, particularly, liver cancer, in a Mexican American health disparity cohort and their relatives rank higher than in other ethnicities and are associated with high rates of diabetes and metabolic syndrome. Effective prevention of diabetes and low-tech, high-quality screening strategies for gastrointestinal cancers are needed in health disparity communities.
Assuntos
Neoplasias Gastrointestinais/etnologia , Disparidades nos Níveis de Saúde , Neoplasias Hepáticas/etnologia , Americanos Mexicanos/estatística & dados numéricos , Adulto , Idoso , Estudos de Coortes , Estudos Transversais , Diabetes Mellitus/etnologia , Feminino , Humanos , Incidência , Modelos Logísticos , Masculino , Síndrome Metabólica/etnologia , Pessoa de Meia-Idade , Sistema de Registros , Fatores de Risco , Autorrelato , Estados Unidos/epidemiologiaRESUMO
OBJECTIVE: A retrospective observational study was done to describe the clinical and pathological profile of gastrointestinal stromal tumors (GISTs) in Afro-Caribbean patients at a tertiary care referral center over a 5-year period. RESULTS: Eighteen cases of GIST were identified over the period under review. Male to female ratio was 1.25:1, the mean age was 54.7 years, and abdominal pain (44%) and gastrointestinal bleeding (50%) were the predominant presenting symptoms. The majority of tumors were of gastric location (83%) and spindle cell morphology (66%). C-kit (CD117) positivity was found in 13 of 14 (93%) cases tested. Using current guidelines for assigning risk of aggressive behavior, 44% of tumors were considered high risk. Of the 10 patients with high-risk or intermediate-risk tumors, 4 died, 1 of which had developed resistance to imatinib therapy. CONCLUSION: In this group of patients, GISTs demonstrated predominantly gastric location and spindle cell morphology and a guarded outlook for more aggressive tumors, which is moderated in the long-term by imatinib resistance.
Assuntos
Neoplasias Gastrointestinais/etnologia , Tumores do Estroma Gastrointestinal/etnologia , Adulto , Idoso , Idoso de 80 Anos ou mais , População Negra , Região do Caribe , Feminino , Neoplasias Gastrointestinais/diagnóstico , Neoplasias Gastrointestinais/patologia , Tumores do Estroma Gastrointestinal/patologia , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Cancer incidence rates among first-generation Japanese immigrants in the city of São Paulo, Brazil, were estimated from the data of the São Paulo Cancer Registry during the years 1969 to 1978. From all registered cases, 2,179 cancer cases of Japan-born residents (1,288 males, 891 females) were selected and age-specific and summary age-adjusted incidence rates (AAIR) were calculated for the selected sites of cancer. The AAIR for all sites except non-melanoma skin cancer was 195.2 per 100,000 population (95 percent confidence interval: 176.4-214.1) in males and 147.3 (134.6-160.0) in females. Stomach cancer had the highest incidence rate of all cancers in both sexes (males, 69.3; females, 32.0). This was followed by cancer of the lung (22.5), esophagus (10.2), colon (8.3), and prostate (7.1) in males; and by breast (24.0), cervix (18.0), colon (8.4), and lung (7.2) in females. When these rates were compared with those among Japanese in Japan, cancer of the stomach and rectum revealed significantly lower rates, while non-melanoma skin cancer, and prostate and breast cancer showed higher rates. No significant increase of colorectal cancer was recognized among Japanese immigrants in São Paulo, contrary to the remarkably high rates of colorectal cancer being observed among Japanese immigrants in the US.