Racial disparities in treatment and survival of hepatocellular carcinoma in native Americans and Hispanics

Alkhalili, Eyas; Greenbaum, Alissa; Luo, Li; Rodriguez, Rodrigo; Munoz, Oscar Estrada; O'Neill, Jacqueline; Nir, Itzhak; Morris, Katherine T.

doi:10.1016/j.amjsurg.2016.09.033

Cited by 10 publications

(6 citation statements)

References 17 publications

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“…The robust improved survival may be due to higher rates of noncirrhotic HBV HCC; however, the results of the current analysis, which accounted for etiology, cirrhosis, and hepatic function, suggested that there may be other factors, such as genetic differences, that have significantly contributed to the improved survival noted among Asian individuals. The improved survival noted among Hispanic individuals in the current study was unexpected, given the studies suggesting that Hispanic patients have at best approximately equal and often worse survival compared with white patients in the United States . Although the results of the current study concurrently demonstrated that Hispanic individuals do have higher rates of nonviral HCC (particularly that of NASH etiology) compared with patients of other ethnicities, this did not appear to impact their survival.…”

Section: Discussioncontrasting

confidence: 51%

“…The improved survival noted among Hispanic individuals in the current study was unexpected, given the studies suggesting that Hispanic patients have at best approximately equal and often worse survival compared with white patients in the United States. 36,37 Although the results of the current study concurrently demonstrated that Hispanic individuals do have higher rates of nonviral HCC (particularly that of NASH etiology) compared with patients of other ethnicities, this did not appear to impact their survival. There are several limitations to the current study.…”

Section: Discussionmentioning

confidence: 54%

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Temporal trends in disease presentation and survival of patients with hepatocellular carcinoma: A real‐world experience from 1998 to 2015

Kim

Nguyen

Dang

et al. 2018

Cancer

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Over the last 18 years, the percentage of cases of nonalcoholic steatohepatitis HCC has increased but not overall survival. It is interesting to note that only 31% of patients with HCC identified via screening/surveillance received any curative treatment. Further research is needed to better understand the barriers to curative care for patients with HCC and the causes of the lack of improvement in survival in the more recent patient cohort. Cancer 2018;124:2588-98. © 2018 American Cancer Society.

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Section: Discussioncontrasting

confidence: 51%

Section: Discussionmentioning

confidence: 54%

Temporal trends in disease presentation and survival of patients with hepatocellular carcinoma: A real‐world experience from 1998 to 2015

Kim

Nguyen

Dang

et al. 2018

Cancer

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“…The age‐adjusted HCC incidence in the United States has increased in both men from 6.9 per 100 000 in 2000 to 10.8 in 2012 and women from 2.3 per 100 000 in 2000 to 3.2 in 2012, suggesting the majority (73%) of cases occur in men according to an average annual percentage change (APC) rate . Hispanics and non‐Hispanic whites have a severity of liver disease than Native Americans in the New Mexico region . Blacks have a high occurrence of HCC than Hispanics and whites based on tumor stage and liver function .…”

Section: Gender Race and Ethnicitymentioning

confidence: 99%

“…Cirrhosis is a major risk factor for the development of HCC and about 80% of patients with HCC have liver cirrhosis . A diverse safety‐net hospital population study in United States reported that cirrhosis patients were associated with 29.9% HCV, 13.4% HBV, 44.6% alcoholic cirrhosis and 8.9% nonalcoholic steatohepatitis (NASH) . Another study noted that cirrhosis‐caused deaths among native Americans were associated with 52.6% of alcoholic liver disease (ALD), 10.7% of HCV infection and 1% of HBV infection .…”

Section: Cirrhosismentioning

confidence: 99%

Assessment of risk factors, and racial and ethnic differences in hepatocellular carcinoma

et al. 2020

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Despite improved screening and surveillance guidelines, significant race/ethnicity‐specific disparities in hepatocellular carcinoma (HCC) continue to exist and disproportionately affect minority and disadvantaged populations. This trend indicates that social determinants, genetic, and environmental factors are driving the epidemic at the population level. Race and geography had independent associations with risk of mortality among patients with HCC. The present review discusses the risk factors and issues related to disparities in HCC. The underlying etiologies for these disparities are complex and multifactorial. Some of the risk factors for developing HCC include hepatitis B (HBV) and hepatitis C (HCV) viral infection, nonalcoholic fatty liver disease, nonalcoholic steatohepatitis, smoking and alcohol consumption. In addition, population genetics; socioeconomic and health care access; treatment and prevention differences; and genetic, behavioral, and biological influences can contribute to HCC. Acculturation of ethnic minorities, insurance status, and access to health care may further contribute to the observed disparities in HCC. By increasing awareness, better modalities for screening and surveillance, improving access to health care, and adapting targeted preventive and therapeutic interventions, disparities in HCC outcomes can be reduced or eliminated.

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“…Racial disparities in the utilization of TACE was not noted in this study, though previous studies have determined a discrepancy in Native-American patients and Hispanic patients compared to Caucasian patients[ 17 ]. This intervention may be considered more frequently in African-American patients because of increased frequency of the disease burden outside of Milan criteria.…”

Section: Discussionmentioning

confidence: 80%

African Americans are less likely to receive curative treatment for hepatocellular carcinoma

Sobotka

Hinton

Conteh

2018

WJH

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AIMTo determine if racial disparities continue to exist in the treatment of hepatocellular carcinoma (HCC).METHODSA retrospective database analysis using the Nationwide Inpatient Sample was performed including patients with a primary diagnosis of HCC. Univariate and multivariate analyses were utilized to determine racial disparities in liver decompensation, treatment, inpatient mortality, and metastatic disease.RESULTSA total of 62604 patients with HCC were included consisting of 32428 Caucasian, 9726 African-American, 8988 Hispanic, and 11462 patients of other races. Caucasian patients were more likely to undergo curative therapies of liver transplant (OR: 2.66, 95%CI: 1.92-3.68), resection (OR: 1.82, 95%CI: 1.48-2.23), and ablation (OR: 1.77, 95%CI: 1.36-2.30) than African-American patients. Hispanic patients were more likely to undergo transplant (OR: 2.18, 95%CI: 1.40-3.39) and ablation (OR: 1.46, 95%CI: 1.05-2.03) than African-American patients. Patients of other races were more likely to receive a liver transplant (OR: 2.41, 95%CI: 1.62-3.61), resection (OR: 1.79 95%CI: 1.39-2.32), and ablation (OR: 2.03, 95%CI: 1.47-2.80) than African-American patients. There are no differences in the rates of transarterial chemoembolization between races.CONCLUSIONRacial disparities in HCC treatment exist despite emphasis to support equality in healthcare. African-American patients are less likely to undergo curative treatments for HCC.

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Racial disparities in treatment and survival of hepatocellular carcinoma in native Americans and Hispanics

Cited by 10 publications

References 17 publications

Temporal trends in disease presentation and survival of patients with hepatocellular carcinoma: A real‐world experience from 1998 to 2015

Temporal trends in disease presentation and survival of patients with hepatocellular carcinoma: A real‐world experience from 1998 to 2015

Assessment of risk factors, and racial and ethnic differences in hepatocellular carcinoma

African Americans are less likely to receive curative treatment for hepatocellular carcinoma

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