Addressing population factors contributing to liver, colon cancers

MONIQUE VASQUEZ AND EBONY IRICK HADNOT / COURTESY

The UC Davis Department of Internal Medicine dedicates day to liver, colon cancer awareness

The Fourth Annual Liver Research Day opened with thoughtful liver and colon cancer surveillance discussions between undergraduates, graduate students, medical professionals and researchers. Attention to the liver signaled the arrival of the final organ-focused research day hosted by the UC Davis Department of Internal Medicine.

Before the Liver Research Day were Heart, Lung and Kidney Research Days. This year’s Liver Research Day was organized by Dr. Valentina Medici, an associate professor in the UC Davis Division of Gastroenterology and Hepatology and Dr. Christopher Bowlus, a professor and the chief of the Division of Gastroenterology and Hepatology.

The morning sessions focused on liver cancer, offering population perspectives and strategies to improve patient outcomes with hepatitis. Lunch was accompanied by a competitive poster session, in which researchers displayed the progress of their projects. The afternoon sessions highlighted colon cancer prevalence and clinical perspectives to improve colon cancer screenings.

The knowledge gained from Liver Research Day could be beneficial for members across all generations.

“At the event, we discussed that Hepatitis C incidence is high in 50-70-year old’s,” Medici said. “Now, it is also increasing in incidence in people from 20-30 years of age because of the opioid crisis.”

Hepatitis C exposure presents a major risk for developing liver cancer. Additionally, fatty liver disease and chronic illnesses, such as diabetes, hypertension and obesity, are becoming associated with a higher risk for liver cancer. This is a shift from assumptions that liver cancer is always associated with Hepatitis C exposure and alcohol use.

“Liver cancer incidence and prevalence are also increasing in the general population,” Medici said. “This calls for a multi-disciplinary approach to care coordination and how patients can navigate healthcare.”

UC Davis researchers and invited speakers shared the progress of their work to understand liver and colon cancers within specific populations.

Bradley Pollock, professor and chair of UC Davis Public Health Sciences, shared his research highlighting the likelihood of developing hepatocellular carcinoma, a common form of liver cancer, in the presence of risk factors such as socioeconomic status and social and medical histories. Another risk factor that was identified was exposure to aflatoxin, a potent carcinogen appearing in drought stressed crops like corn in south Texas counties.

“Hepatocellular carcinoma rates vary across ethnic groups, but Asian/ Pacific Islanders and Hispanics are disproportionately affected by the chronic condition,” Pollock said.

Pollock’s review found an association between lower socioeconomic status, including lower education and income levels, and an increased likelihood of developing hepatocellular carcinoma, in addition to Hepatitis C exposure, alcohol use and smoking. Traces of aflatoxin in the body were found to have increased odds of hepatocellular carcinoma.

“Surprisingly, aspirin and omega-3 consumption seemed to offer some protection against the effects of aflatoxin exposure,” Pollock said.

Sooraj Tejaswi, associate clinical professor at the UC Davis Division of Gastroenterology and Hepatology and program director of the gastroenterology and hepatology fellowship, shared his work investigating colon cancer rates in South Asians.

“South Asians have not been historically studied,” Tejaswi said. “Our people think rates of colon cancer are low. It reported to be very low, but not every case is tracked in South Asia like it is in California due to resources. Californians with South Asian origin tend to have higher rates of colon cancer than reported.”

According to Tejaswi, South Asians face 13.7 cases of colon cancer per 100,000 individuals in California, while non-hispanic whites encounter 26.1 cases of colon cancer per 100,000 individuals in California. In California, South Asians over the age of 50 experience 66.2 cases of colon cancer per 100,000 individuals. Non-Hispanic whites over the age of 50 face 114 cases of colon cancer per 100,000 individuals.

After looking at colonoscopy patients from the UC Davis Medical Center, Tejaswi found that South Asians have a similar number of tubular adenomas, polyps or growths that may become cancerous, in their colons as other ethnic groups. From 2006 to 2015, South Asian colonoscopy patients were found to have 22.7 tubular adenomas per 100 colonoscopy screenings, while non-hispanic whites were found to have 28.1 tubular adenomas per 100 colonoscopy screenings.

“This is alarming as South Asians take up the same lifestyle as Americans, they may catch up to the colon cancer rates of other ethnicities,” Tejaswi said. “This is an alarm call for people living in the United States and countries in South Asia.”

South Asians represent a fast-growing population in California and the United States. Effective cancer prevention strategies must account for their needs as a population instead of as isolated individuals to reduce the growing risks of colon cancer.

As colon and liver cancer rates escalate, ethnic populations cannot be treated the same. Preventative healthcare calls for a specialized approach to research and to understanding cancer.

 

Written by: Foxy Robinson — science@theaggie.org