Low survival in liver cancer Laos / Hmong-Americans

The study is funded by the National Cancer Institute / National Center on Minority Health and health inequalities and the U. S. Centers for Disease Control and Prevention.The study, the largest population based on the rates of liver cancer among Asian Americans, highlights a gap that asks deeper awareness-raising campaigns to detect and treat disease in Laos / Hmong Americans, said Moon Chen Jr., professor of hematology and oncology at the School of Medicine, UC Davis.

The Hmong are an ethnic group in Asia, in the mountainous regions of China, Vietnam, Laos and Thailand. During the Vietnam War, thousands of Hmong were recruited by the United States in Laos to fight communist rebels. Many Hmong war refugees were resettled in the United States after the war.

The study found significant differences in survival rates for Asian-Americans diagnosed with liver cancer. The average survival rate for Americans in Laos / Hmong involved in the study was just one month. He had three months to Cambodia-American, and four months in Thailand and the Philippines the Americans. The survival rate was six months for Chinese Americans, Japanese and Vietnamese. The survival rate of Korea and Southeast Asian American had seven months

For 16 people, symptoms improved by an average of one point on the scale after transplantation, and improvements in average life span of two years. The participants also had a reduction in the number and size of lesions in the brain. Two people died from complications of the transplant two months and 2-1/2 years post-transplant.

Chen also pointed out that the results underline the importance of developing liver cancer screening and other materials to increase awareness of the language spoken by different groups, in order to understand the importance of early diagnosis.

Now a liver specialist at the Queens Medical Center in Honolulu, Aoki said physicians must first identify patients at risk of exposure to hepatitis B virus, and those who test positive should be screened for liver cancer.

Liver cancer among Asian Americans is primarily related to infection with hepatitis B, which is endemic in many parts of Asia. The virus can be transmitted from mother to fetus developing cancer for many years.

Chen pointed out that, for all Americans, the mortality rate of liver cancer is less than 10 % after five years.

Other authors of the study Kwong Sand and Cancer Surveillance Research Branch of the California Department of Public Health and Susan L. Stewart, biostatistician and associate adjunct professor in the department of medicine at the University of California, San Francisco.

‘If we do surgery, we face not only the characteristics of a particular disease. We must find a way to reach the specific population that is affected.’

Chen is also principal investigator of the American Asian Cancer Awareness, Research and Training , the National Cancer Institute-funded program to reduce cancer disparities in Asian American populations. It also conducts a research program at UC Davis-based interventions for Hmong, Vietnamese and Korean Americans at risk of liver cancer.

‘We believe that cancer of the liver caused by hepatitis B can be controlled,’ he said. ‘We have an effective vaccine, and the combination of two screening and treatment can eventually eliminate liver cancer.’

‘That’s why public opinion among the doctors who deal with these patients is very important,’ said Aoki.

The study used data from the California Cancer Registry from more than 6,000 Asian-American patients diagnosed with hepatocellular carcinoma between 1988 and 2007. He found significant differences in survival rates among the nine largest Asian-American groups in California, including Chinese, Filipino, Vietnamese, South Asian, Korean, Japanese, Laotian / Hmong, Cambodian and Thai.

The researchers also found that the Laos / Hmong were far more likely to be diagnosed with cancer at later stages of the disease, which led to the findings of the poorest survival. The group was also less likely to receive any type of treatment, such as a liver transplant. Only 3 % of Laos / Hmong-Americans with cancer of the liver surgery or liver transplantation, compared with 22 % of other Asian Americans studied.

The study, ‘Disparities in survival of hepatocellular carcinoma among Asian Californians, 1988-2007’ was published online in the journal Cancer Epidemiology, Biomarkers & Prevention.

The research was conducted by UC Davis and his colleagues at the California Department of Public Health and UC San Francisco.