Molecular and Sociodemographic Colorectal Cancer Disparities in Latinos Living in Puerto Rico.

BACKGROUND: The incidence of sporadic colorectal cancer (CRC) among individuals <50 years (early-onset CRC) has been increasing in the United States (U.S.) and Puerto Rico. CRC is currently the leading cause of cancer death among Hispanic men and women living in Puerto Rico (PRH). The objective of this study was to characterize the molecular markers and clinicopathologic features of colorectal tumors from PRH to better understand the molecular pathways leading to CRC in this Hispanic subpopulation. METHODS: Microsatellite instability (MSI), CpG island methylator phenotype (CIMP), and KRAS and BRAF mutation status were analyzed. Sociodemographic and clinicopathological characteristics were evaluated using Chi-squared and Fisher's exact tests. RESULTS: Of the 718 tumors analyzed, 34.2% (n = 245) were early-onset CRC, and 51.7% were males. Among the tumors with molecular data available (n = 192), 3.2% had MSI, 9.7% had BRAF, and 31.9% had KRAS mutations. The most common KRAS mutations observed were G12D (26.6%) and G13D (20.0%); G12C was present in 4.4% of tumors. A higher percentage of Amerindian admixture was significantly associated with early-onset CRC. CONCLUSIONS: The differences observed in the prevalence of the molecular markers among PRH tumors compared to other racial/ethnic groups suggest a distinct molecular carcinogenic pathway among Hispanics. Additional studies are warranted.

Gastric Intestinal Metaplasia: Demographic and Epidemiological Characterization in Puerto Rican Hispanics (2012-2014).

BACKGROUND AND AIMS: Gastric cancer is the 5th leading cause of cancer mortality worldwide and the leading infection-associated cancer. Helicobacter pylori is the most common chronic bacterial infection in humans and the major predisposing factor for the development of gastric intestinal metaplasia (GIM), the principal preneoplastic lesion in the gastric carcinogenesis pathway. GIM surveillance is now recommended for individuals among high-risk subgroups by three major gastroenterology societies in Europe, England, and U.S. Our objective was to provide the initial epidemiologic data for GIM among Hispanics in Puerto Rico. METHODS: Using a cross-sectional study design, we analyzed an extensive pathology database (n = 43,993) that captured approximately 50% of all endoscopy biopsies taken during 2012-2014 at academic, public, and private sectors in Puerto Rico. Prevalence estimates of GIM, GIM subgroups, and H. pylori status were estimated using logistic regression models. RESULTS: A total of 4,707 GIM cases were identified during the study period for a prevalence rate of 10.7%. H. pylori was detected in 26.9% (95% CI: 25.7-28.2) of the GIM cases. The majority of the pathology reports lacked information regarding the high-risk subtypes (99.6%) and extension (71.2%). CONCLUSIONS: The prevalence of GIM among Hispanics living in Puerto Rico may be higher than in U.S. mainland non-Hispanic populations. The prevalence of H. pylori detected in our study population was comparable to the rates reported in the mainland U.S. Standardization of the endoscopy biopsy protocol and pathology reporting is needed to characterize and risk stratify GIM surveillance programs in Puerto Rico.

Factors associated with metabolic syndrome in a sample of women in Puerto Rico.

OBJECTIVE: The aim of this study was to determine the association between metabolic syndrome (MetS) and demographic, health, and lifestyle characteristics in a sample of women living in Puerto Rico. METHODS: The study group consisted of 214 women aged 36 to 82 years, residing in the metropolitan area of San Juan, Puerto Rico. Demographic, reproductive, lifestyle, and metabolic variables were assessed through an annual questionnaire and blood chemistries. MetS was defined according to the criteria set by the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults/Adult Treatment Panel III (NCEP/ATP III) and the International Diabetes Federation (IDF). RESULTS: The overall prevalence of MetS was 24% according to NCEP/ATP III criteria and 33% according to IDF criteria. When using the IDF criteria, 37% of participants older than 51 years have MetS, in contrast to 28% when using the NCEP/ATP III criteria. Obese women have an increased probability of MetS when adjusting for age, education level, menopause status, and/or alcohol use (IDF criteria: estimated odds ratio [OR], 2.68; 95% CI, 1.44-4.97; NCEP/ATP III criteria: estimated OR, 3.42; 95% CI, 1.71-6.84). A higher education level (estimated OR, 0.45; 95% CI, 0.23-0.92 [IDF criteria]) and alcohol consumption (estimated OR, 0.48; 95% CI, 0.23-0.99 [NCEP/ATP III criteria]) seem to provide a protective effect, when adjusting for confounders. CONCLUSIONS: Our study confirms obesity as an important risk factor associated with MetS in this sample of women in Puerto Rico. Alcohol consumption and a higher education level seem to decrease the prevalence of MetS. In view of this, patient counseling regarding weight reduction and lifestyle modification should be emphasized in the primary prevention and management of MetS. Additional studies are warranted to further characterize the effect of menopause status on MetS.