Abstract B80: Multiple Risk Factors for Hepatocellular Carcinoma (HCC) among Asian Americans: Implications for Intervention

Multiple Risk Factors for Hepatocellular Carcinoma (HCC) among Asian Americans: Implications for Intervention Introduction: Asian Americans have the highest mortality rates from HCC compared to all other racial/ethnic populations. Historically, mitigating their HCC risks has been through screening for hepatitis B (HBV) and providing linkage to care to those who are chronically infected; however, HCC has multiple risk factors. Besides HBV, obesity-related metabolic factors, including diabetes, and chronic hepatitis C (HCV) are becoming important risk factors for HCC. Lifestyle factors, such as alcohol and tobacco use, also increase risk of HCC. Our study is among the first to measure seven literature-documented HCC risk factors to assess the prevalence of combined risk factors in this population. Objectives and hypothesis: We sought to measure the joint prevalence of 7 HCC risk factors in 3 domains (viral, metabolic, and lifestyle), and hypothesized that a substantial proportion of foreign-born Asian Americans are at risk in multiple domains. Methods: We focused on Asians born in HBV endemic areas (≥ 2%) and tested 967 adult foreign-born Chinese, Hmong, Korean, and Vietnamese American residents of Sacramento County, CA for HBV and HCV; measured hemoglobin A1c (HbA1c) and waist circumference; and recorded self-reported history of diabetes, hypertension, consumption of alcohol in the past 30 days, and smoking status. Metabolic risk factors included high glucose, defined as HbA1c ≥ 5.7% or self-reported diagnosis of diabetes; a large waist circumference, defined according to Asian cut-points (≥ 35 inches for men, ≥ 32 inches for women); and self-reported hypertension. We computed gender-specific age standardized prevalence rates with 95% confidence intervals (CI) for viral, metabolic, and lifestyle risk factors, alone and in combination. Results: Chronic HBV was much more common than HCV in Chinese, Hmong, and Vietnamese Americans; both HBV and HCV were very uncommon among Koreans. Vietnamese men (15.3%, 95% CI 6.9-23.7%) and Hmong women (15.0%, 95% CI 7.6%-22.3%) had the highest viral risk factor prevalence. High glucose was most common among Chinese men (56.3%, 95% CI 43.2-69.3%), followed by Korean men (49.3%, 95% CI 33.4-65.3%). A large waist circumference was most common among Hmong women (83.9%, 95% CI 75.0-92.8%) and Hmong men (66.9%, 95% CI 54.7-79.1%) and least common among Korean men (36.0% 95% CI 19.7-53.2%), Korean women (40.5%, 95% CI 31.3-49.8%),