Liver cancer in Hidalgo State, Mexico: analysis of the status, risk factors and regional public health policy requirements: a cross-sectional correlational study

BACKGROUND:  In Latin America, liver cancer is one of the top causes of cancer mortality. It is the fifth most common cause of death among malignant tumors in Mexico and is the leading cause in Hidalgo State (43.8% of the population living in poverty).

OBJECTIVE:  To conduct a correlational analysis on the main risk factors for liver cancer in Hidalgo State, Mexico, including municipal disaggregation and comparison with the national level.

DESIGN AND SETTING:  Cross-sectional, correlational, descriptive and comparative epidemiological study using Mexican governmental databases covering 1990-2019.

METHODS:  A comprehensive review of the databases of the General Directorate of Health Information (DGIS) was performed to analyze official death figures, hospital discharges and national and municipal population projections, using specific search criteria defined in the Global Burden of Disease classification, based on the risk factors for liver cancer.

RESULTS:  Liver cancer rates showed an evident rise in Hidalgo (183%), moving from 21^st place in Mexico in 1990 to 9^th place in 2019. This increase was correlated with alcoholism. An increasing trend for liver cancer deaths, of 133.89%, is projected for 2030. Females and the population over 60 years of age are more affected. There are some critical regions with liver cancer death rates twice the national rate or more.

CONCLUSION:  Targeted effective public health strategies should be structured by identifying, characterizing and regionalizing critical marginalized municipalities that are vulnerable to alcoholism and other risk factors for liver cancer. This approach may be helpful for other states in Mexico or similar countries.

KEY WORDS (MeSH terms):
Alcoholism; Health policy; Liver neoplasms; Regional medical programs; Risk factors; Public health

AUTHORS’ KEY WORDS:
Cirrhosis; Hepatocellular carcinoma; Marginalization; Non-alcoholic steatohepatitis; Regional strategies