IARC 60th Anniversary - 19-21 May 2026
Session : 21/05/26 - Posters
Risk factors for hepatocellular carcinoma in a representative survey of men and women in southern and eastern Mexico: a descriptive study
REMES TROCHE J. 2, LAJOUS M. 3,8, FARIAS P. 8, ROMERO M. 1, SANTIAGO RUIZ L. 8, GROOPMAN J. 4, MANNAN R. 4, BURKE S. 4, MCGLYNN K. 5, HERNANDEZ FLORES K. 2, VILLALPANDO HERNANDEZ S. 9, RIOJAS H. 8, FLORES RIVERA A. 6, HERRERA CHI B. 7, MONGE A. 8
1 Center for Evaluation Research and Surveys, National Institute of Public Health, Mexico, Cuernavaca, Morelos, Mexico; 2 Medical Biological Research Institute, Universidad Veracruzana, Veracruz, Veracruz, Mexico; 3 Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, United States; 4 Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States; 5 Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, United States; 6 Hospital Regional de Alta Especialidad de la Península de Yucatán, Merida, Yucatan, Mexico; 7 Hospital General Regional 1, Instituto Mexicano del Seguro Social, Merida, Yucatan, Mexico; 8 Center for Research on Population Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico; 9 Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
Background
Mexico and Central America have emerged as areas with a significant hepatocellular cancer (HCC) burden with a potentially different distribution of risk factors. Also, an uncharacteristic HCC mortality pattern has been observed in this region, where men and women are equally affected and a rural-urban gradient is present.
Objectives
We aimed to describe the distribution of HCC risk factors in a representative sample of Mexican adults from high HCC risk regions in Southern and Eastern Mexico according to sex and location of residence.
Methods
Participants were drawn from a national household survey that follows a probabilistic, multistage, stratified, and cluster sampling design, Mexico's 2018 National Health and Nutrition Survey. The sample consisted of 952 adults (weighted n= 7,491,354) from five states in Southern and Eastern Mexico. Risk factor information was obtained from survey questionnaires. Hepatitis C (HCV) and B virus (HBV) seropositivity were assessed using Architect Anti-HCV and Architect or Monolisa HBsAg, respectively. Aflatoxin B1 in serum was quantified using liquid chromatography-mass spectrometry. We estimated prevalence (95% Confidence Intervals; 95%CI) and means (± standard deviation; SD) or medians (interquartile ranges; IQR) of HCC risk factors stratified by sex and location of residence.
Results
Mean age was 56.4(±SD 11.8) years. In women, the prevalence of metabolic syndrome [70.0% (64.8, 74.8) vs. 42.9% (36.2, 49.9)] and HCV seropositivity [0.7% (0.2, 2.7) vs. 0.1% (0.0, 0.4)], were higher relative to men. In contrast, women had a lower prevalence of excessive alcohol consumption [7.9% (5.3, 11.6) vs. 27.8% (22.4, 33.8)] and smoking [3.3% (2.0, 5.5) vs. 15.3% (11.6, 20.0)], and had lower levels of aflatoxin B1 (median, 0.142 pg/µL; IQR 0.047, 0.367), relative to men (median, 0.195 pg/µL; IQR 0.070, 0.802). Persons living in rural areas had higher levels of aflatoxin B1 (median, 0.316 pg/µL; IQR, 0.094, 0.962) relative to those in urban areas (0.123 pg/µL; IQR, 0.052, 0.351). The distribution of other HCC risk factors appeared to be similar in persons living in rural areas and those living in urban areas.
Conclusions
Higher frequency of metabolic syndrome and HCV infection in women could explain the equal burden of HCC in women and men in Mexico. Aflatoxin exposure could explain the increased burden of HCC in rural relative to urban areas. Understanding the distribution of risk factors across subpopulations may be useful for tailoring HCC prevention strategies in Mexico and Central America and beyond.