Abstract SY02-04: Risk factors associated with cancer, type 2 diabetes, and cardiovascular disease in the multiethnic cohort: Comparisons across ethnic groups
Authors: Wilkens Lynne 
Published: August 2015

Many chronic diseases common in the United States, such as cancer, type II diabetes and cardiovascular disease, share many lifestyle risk factors, such as tobacco use, obesity, diet, and lack of physical activity. These factors likely act upon disease through common pathways, such as inflammation and immune suppression. Examining the association of these risk factors with chronic conditions within a cohort could provide insights into their roles in the etiology of cancer and disease in general.

The Multiethnic Cohort (MEC) is a prospective study that enrolled over 215,000 individuals in Hawaii and California from 1993 to 1996. The cohort is largely comprised of five major ethnic groups: African American, Native Hawaiian, Japanese American, Latino and white. The cohort is followed for disease endpoints via passive and active means. Cancer cases are identified through linkage to SEER registries in the two states, and deaths are identified through linkage to state and national death registries. Other conditions, such as type II diabetes and cardiac events are identified through self-reported and linkage to health care systems, such as Medicare and hospital discharge data.

Within the MEC, the risk of cancer varies by ethnic group and a focus has been on finding genetic and lifestyle risk factors that explain these differences. The influence of pre-existing chronic conditions is examined in terms of whether they explain some of the ethnic differences in cancer risk and whether they modify the associations for lifestyle factors. The chronic conditions considered was prior cancer, diabetes, hypertension, coronary heart disease and stroke. As tobacco use is such a strong predictor of smoking related cancers, such as oral and lung cancer, they will not be included. The focus is on cancer more related to hormonal and metabolic factors, such as cancers of the breast, colon, prostate, and endometrium.

For breast cancer, the Native Hawaiian women are at 50% higher risk and Latinas are at 27% lower risk, compared to white women, after adjustment for known risk factors. The presence of condition conditions at baseline was associated with a 14% higher risk of breast cancer, which was consistent across racial/ethnic groups. This did not differ by type of chronic condition. Adjustment for chronic condition did attenuate the associations for lifestyle factors, such as obesity, and there were modest differences in this attenuation by ethnic group.

The presentation will be expanded to additional cancer sites and risk factors. In addition, also explored will be whether risk factors are similar in individuals with only a cancer diagnosis compared to those with the diagnosis of multiple chronic conditions within a short time window. Any differential findings will be interpreted in light of possible pathways affected.

Citation Format: Lynne Wilkens. Risk factors associated with cancer, type 2 diabetes, and cardiovascular disease in the multiethnic cohort: Comparisons across ethnic groups. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr SY02-04. doi:10.1158/1538-7445.AM2015-SY02-04