Hepatocellular carcinoma on the rise among Mexican Americans

Hepatocellular carcinoma (HCC), the primary cancer of the liver, is on the verge of becoming an epidemic among Mexican Americans, especially in Texas.

"Texas has one of the highest mortality rates for liver cancer in the United States," said Dr. Howard Monsour, a hepatologist with Houston Methodist Hospital. "We have one of the highest populations with a body mass index (BMI) greater than 30, and we are in the top three or four in cases of hepatitis C. It's hitting the Mexican American community very hard, especially in south Texas."

Hispanic males are twice more likely to develop this type of cancer than whites, while Hispanic women are three times more likely than whites. The number of cases in the Hispanic population in Texas increased 90 percent from 1993 to 2007. Liver cancer is the fastest growing cancer incidence in the U.S. with a growth rate of close to two percent a year.

Monsour believes the rise can be attributed to the maturation of the Hepatitis C epidemic where over 30 percent of patients presenting to the physician for the first time with the disease already have cirrhosis. Another factor is the rise in people being diagnosed with non-alcoholic fatty liver disease (NAFLD), a condition where fat lives inside the liver cells brought on by obesity, lipid disorders or diabetes.

"If you have fatty liver disease you are more than four times as likely to get this type of liver cancer," Monsour said. "We are also seeing hepatitis C starting to show up in people at an advanced stage of the disease that contracted the disease 25 to 30 years ago and this is a big concern."

Monsour is working with the Texas Medical Association to set up a task force that will look at ways of early detection of this problem. Eight objectives have been identified to help raise awareness of the pending hepatocellular cancer epidemic. Because of the disproportionate effect on the Texas Hispanic population an emphasis will also be directed towards this community before it becomes a full-blown epidemic.

"We are only seeing the tip of the iceberg," Monsour said. "Our goals are to raise the awareness of Texas physicians and the high risk groups to enhance early detection that we hope will lead to a cure or at least a liver transplant before it's too late."