Mo1447 – Agalactosylation of Serum Immunoglobulin G As a Potential Biomarker for Hepatocellular Carcinoma

Background Texas is the second largest state by area and population in the United States, and is reported to have the highest age adjusted incidence rate of hepatocellular carcinoma (HCC) in the nation.We explored temporal trends as well as demographic and regional variations in incidence and mortality to better understand the reasons for the high burden of HCC in Texas.Methods We analyzed Texas Cancer Registry (TCR) incidence and mortality data from 2001 to 2015, and compared results to national data using the US National Program of Cancer Registries (NPCR) and SEER Incidence public use dataset, and the National Center for Health Statistics (NCHS) Mortality data.We calculated age-adjusted rates for HCC per 100,000 people per year using SEER*Stat, and the average annual percent change (AAPC) using Joinpoint.Analyses were restricted to ages ≥25 years.Results In 2015, Texas had the highest HCC incidence rate of all states with 13.2 new cases per 100,000 (compared with 9.1 per 100,000 for the entire US).Between 2001 and 2015, HCC incidence increased annually by 4.4% (95% confidence interval 3.5-5.3).Incidence rates were more than three times higher in males (20.7 per 100,000) than females (6.4 per 100,000), but increased significantly in both.HCC incidence rates were highest for Hispanics (21.2 per 100,000) and lowest for non-Hispanic (NH) whites (9.3 per 100,000).There were statistically significant increases in HCC incidence during 2001-2015 for Hispanics (AAPC: 2.8%; 95% CI 2.1-3.4),NH African-Americans (AAPC: 4.6%; 95% CI 2.5-6.8), and NH whites (AAPC: 4.8%; 95% CI 4.2-5.5)but rates remained stable in NH Asian/Pacific Islanders (AAPC: 1.1%; 95% CI -2.4-0.3).Rates in Texas were 26-37% greater than national rates for Hispanics, NH African-Americans, and NH whites.In 2015, Texas Hispanics had a significantly higher incidence rate of HCC (21.2 per 100,000) than Hispanics in Florida (9.7 per 100,000) and California (15.7 per 100,000).Incidence rates were high in South Texas and US/Mexico border regions with the highest incidence rates in Health Service Regions 10 (e.g., 21.0 per 100,000 in El Paso County), and 11 (e.g., 21.7 per 100,000 in Nueces County).Increases occurred in all age groups over 55 years with the largest increase for ages 55-64y (AAPC: 8.6%; 95% CI 6.7-10.5).HCC mortality rates showed similar trends.Conclusions Texas has the highest overall incidence rate of HCC in the US.The high and increasing rate in Hispanics combined with the large number of Hispanics in Texas may be driving this trend.However, incidence rates were also higher in Texas for middle-aged NH whites and NH African-Americans.Further studies are warranted to determine the underlying etiological risk factors.