Healthcare disparities in Asians and Pacific Islanders with hepatocellular cancer

Abstract

Background-Hawaii has the highest incidence of hepatocellular cancer (HCC) in the U.S. and the largest proportion of Asian/Pacific Islanders(PI). HCC studies generally combine these groups into one ethnicity and we sought to examine differences between Asian/PI subpopulations.

Late recurrence of hepatocellular carcinoma after liver transplantation

“…This study aims to identify and characterize cases of late recurrent HCC after transplantation in Hawaii, a state with a high burden of liver disease and cancer due to a large population of Asians and Pacific Islanders with viral hepatitis. [5–7]…”

Liver resection for early hepatocellular cancer: Comparison of centers in 3 different countries

“…Compared to the generally homogeneous Tokyo and Shanghai patients, the Honolulu cohort was comprised of racially and ethnic diverse individuals born within and outside the United States. Many Honolulu patients had comorbidities including those that may contribute to disease progression (obesity, type-2 diabetes, excess alcohol consumption and past intravenous drug use)[10]. We were unable to account for these differences in comorbidities and risk factors as this information was not available for the Tokyo and Shanghai cohorts.…”

“…Patients were primarily United States citizen of diverse racial/ethnic backgrounds including Whites, Asians, and Pacific Islanders but also included foreign nationals from Asian countries who sought medical care in the United States Race/ethnicity and birthplace were assessed as risk factors for HCC were previously shown to vary by these demographic characteristics in this study population[10]. This clinic and the transplant center were initially affiliated with Hawaii Medical Center-East (formerly St. Francis Medical Center) and after 2012, the Queens Medical Center.…”

Hepatitis B Virus Screening Patterns amongst Physicians in Hawaii: Changes in a Decade

“…Lastly, screening tests done by non-physician providers significantly increased, doubled in proportion (1.3% to 2.8%) and tripled in number (679 to 2053) between the two eras (see Figure 2). In terms of analysis by provider specialties and geographic locations, 13,975 of the 125,576 screening tests (11.1%) were excluded from the analysis because they were marked as unknown provider specialty (13,057) and/or unknown provider geographic location (11,975). The primary care group on Oahu ordered 4466 more screening tests in the second era than the first era, a 20% increase.…”

“…The incidence of HBV in these small Pacific Island nations is reportedly as high as 15% [9]. As a consequence, Hawaii has the highest incidence and second highest death rate of hepatocellular cancer in the U.S. and nearly 40% of this is HBV-related [10] [11]. Due to Hawaii's unique demographics with a growing population deemed as high risk for HBV, we seek to understand physicians' HBV screening practice patterns by querying a large administrative billing database over a 10-year period.…”