PO.PS01.02 · 人群科学
美国拉丁裔人群跨世代的胃癌差异：来自多族裔队列研究的见解
Gastric cancer disparities across generations of Latino populations in the United States: Insights from the Multiethnic Cohort study
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摘要 Abstract
中文摘要
背景：美国拉丁美洲裔个体的胃癌（GC）发病率高于普通人群。移民史对这一差异的贡献仍未得到充分表征。本研究评估了拉丁裔人群中世代移民状态与GC风险之间的关联。
方法：我们分析了基于人群的多族裔队列研究（MEC）的数据，该研究于1993-1996年间招募了夏威夷和加利福尼亚的居民。纳入自我认定为墨西哥、中美洲或南美洲裔的拉丁裔参与者，以非西班牙裔白人（NHW）作为参照组。采用Cox比例风险模型估计GC总体及按解剖学亚型的风险比（HR）和95%置信区间（CI）。
结果：在79,963名参与者中（中位年龄59岁；48%为男性），识别出377例新发GC病例。拉丁裔参与者的GC风险约为NHW的两倍。该风险在各世代间保持稳定：第一代（出生于墨西哥、中美洲/南美洲）的HR为2.17（95%CI, 1.61-2.92）；第二代（在美国出生、父母一方或双方出生于墨西哥、中美洲/南美洲），HR 2.09（95%CI, 1.56-2.80）；第三代，HR 2.67（95%CI, 1.87-3.82）。墨西哥与中美洲/南美洲亚组之间未观察到显著差异。非贲门GC的关联更强（第一、第二和第三代的HR分别为2.78、2.62和3.42），但对贲门GC不显著。
结论：拉丁裔后代的GC风险较NHW高出两倍以上，且升高的风险在各世代间持续存在。在美国出生的个体中未出现衰减，提示存在超越移民相关暴露的持久的祖源或生物学易感性。这些发现强调了识别高风险人群并指导针对性预防策略的必要性。
表1. 拉丁裔后代按世代状态划分的胃癌HR。后代：NHW、第一代、第二代、第三代。拉丁裔参与者：39779、18720、14614、6850；病例：103、123、104、47；HR（95%CI）：1.00、2.17（1.61-2.92）、2.09（1.56-2.80）、2.67（1.87-3.82）。墨西哥参与者：39779、13703、14156、6850；病例：103、78、102、47；HR（95%CI）：1.00、1.77（1.27-2.48）、2.03（1.51-2.73）、2.63（1.84-3.77）。中美洲/南美洲参与者：39779、5005、139、6850；病例：103、45、1、47；HR（95%CI）：1.00、2.78（1.90-4.06）、1.92（0.27-13.76）、2.52（1.75-3.63）。
查看英文原文 English abstract
Background: Individuals of Latin American origin in the United States (US) have higher incidence of gastric cancer (GC) than the general population. The contribution of immigration history to this disparity remains inadequately characterized. This study assessed the association between generational immigration status and GC risk among Latino populations.
Methods: We analyzed data from the population-based Multiethnic Cohort Study (MEC), which enrolled residents of Hawaii and California between 1993-1996. Participants who self-identified as Latino of Mexican, Central or South American descent were included, with non-Hispanic Whites (NHWs) as reference group. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for GC overall and by anatomical subtype.
Results: Among 79,963 participants (median age 59 yr; 48% male), 377 incident GC cases were identified. Latino participants had around twice the risk of GC compared with NHWs. The risk remained stable across generations: first-generation (born in Mexico, Central/South America) had an HR of 2.17 (95%CI, 1.61-2.92); second-generation (US-born with one or both parents born in Mexico, Central/South America), HR 2.09 (95%CI, 1.56-2.80); and third-generation, HR 2.67 (95%CI, 1.87-3.82). No notable differences were observed across Mexican and Central/South American subgroups. Associations were stronger for non-cardia GC (HRs, 2.78, 2.62, and 3.42 for first-, second-, and third-generation, respectively) but were not significant for cardia GC.
Conclusions: Latino descendants showed more than twofold higher GC risk compared to NHWs, with elevated risk persisting across generations. No attenuation among US-born individuals suggests lasting ancestral or biological susceptibilities beyond immigration-related exposures. These findings underscore the need to identify at-risk populations and guide targeted prevention strategies.
Table 1. HRs of gastric cancer by generation status among Latino descendants Descendants NHW First Generation Second Generation Third Generation Latino Participants 39779 18720 14614 6850 Cases 103 123 104 47 HR (95%CI) 1.00 2.17(1.61-2.92) 2.09(1.56-2.80) 2.67(1.87-3.82) Mexico Participants 39779 13703 14156 6850 Cases 103 78 102 47 HR (95%CI) 1.00 1.77(1.27-2.48) 2.03(1.51-2.73) 2.63(1.84-3.77 Central/South America Participants 39779 5005 139 6850 Cases 103 45 1 47 HR (95%CI) 1.00 2.78(1.90-4.06) 1.92(0.27-13.76) 2.52(1.75-3.63)
利益披露 Disclosure
K. De la Torre-Cisneros, None.
H. In,
AstraZeneca Other, Educational Advisor.
A. Adams, None..
C. Chen, None..
B. Rana, None..
L. R. Wilkens, None.