Racial disparities in hepatocellular carcinoma

Hoehn, Richard S.

doi:10.1002/cncr.33376

Cited by 3 publications

(4 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Third, our analysis of 1557 patients with most major types of chronic liver disease and our sub-analysis of 362 patients with no history of HCV exposure confirm and extend previous evidence [18][19][20][21] that Black patients have less advanced liver disease at the time of HCC diagnosis than patients of other racial/ethnic groups. Multivariable logistic regression showed that lack of private insurance, a FIB-4 score below 3.25 (indicating the absence of cirrhosis), male sex, and Black race increased the odds that a patient would present with HCC outside Milan criteria, limiting treatment options.…”

Section: Hcc In Patients With Liver Diseases Of All Major Etiologies:...supporting

confidence: 84%

“…16,17 Black patients with newly diagnosed HCC have larger and more advanced tumors and are more likely to have poorly differentiated tumors. 18 Despite more advanced HCC, liver disease is less advanced in Black patients with HCV infection [18][19][20][21] and Black patients with HBV exposure are more likely to develop HCC in the absence of cirrhosis than White patients. 22,23 These findings are consistent with evidence that non-Hispanic Black patients have slower fibrosis progression than White or Hispanic patients.…”

Section: Introductionmentioning

confidence: 99%

“…Black patients with HCC have worse survival than White, Hispanic, or Asian patients. 16,[18][19][20][21] In the United States, Black patients are less likely to be diagnosed with early-stage HCC than White patients. 17 The factors leading to worse outcomes are complex and multifactorial.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The adverse characteristics of hepatocellular carcinoma in the non‐cirrhotic liver disproportionately disadvantage Black patients

Shaltiel,

Sarpel,

Branch

2024

Cancer Medicine

View full text Add to dashboard Cite

BackgroundBlack patients have higher hepatocellular carcinoma (HCC)‐related mortality than White patients and more often develop HCC in non‐cirrhotic liver. HCC surveillance is primarily directed toward cirrhotic patients. We aimed to characterize HCC in non‐cirrhotic patients and to identify factors associated with HCC beyond Milan criteria.MethodsDemographic, imaging, laboratory, and pathology data of HCC patients at our institution, 2003–2018, were reviewed, retrospectively. Race/ethnicity were self‐reported. Cirrhosis was defined as a Fibrosis‐4 score ≥3.25.ResultsCompared to 1146 cirrhotic patients, 411 non‐cirrhotic patients had larger tumors (median 4.7 cm vs. 3.1 cm, p < 0.01) and were less likely to be within Milan criteria (42.6% vs. 57.7%, p < 0.01). Among non‐cirrhotic patients, Black patients had larger tumors (4.9 cm vs. 4.3 cm, p < 0.01) and a higher percentage of poorly differentiated tumors (39.4% vs. 23.1%, p = 0.02). Among cirrhotic patients, Black patients had larger tumors (3.3 cm vs. 3.0 cm, p = 0.03) and were less likely to be within Milan criteria (52.3% vs. 83.2%, p < 0.01). In multivariable analysis, lack of commercial insurance (OR 1.45 [CI 95% 1.19–1.83], p < 0.01), male sex (OR 1.34 [CI 95% 1.05–1.70], p < 0.01), absence of cirrhosis (OR 1.58 [CI 95% 1.27–1.98], p < 0.01) and Black race/ethnicity (OR 1.34 [CI 95% 1.09–1.66], p = 0.01) were associated with HCC beyond Milan criteria. Black patients had lower survival rates than other patients (p < 0.01).ConclusionsNon‐cirrhotic patients had more advanced HCC than cirrhotic patients. Black patients (with or without cirrhosis) had more advanced HCC than comparable non‐Black patients and higher mortality rates. Improved access to healthcare (commercial insurance) may increase early diagnosis (within Milan criteria) and reduce disparities.

show abstract

Section: Hcc In Patients With Liver Diseases Of All Major Etiologies:...supporting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The adverse characteristics of hepatocellular carcinoma in the non‐cirrhotic liver disproportionately disadvantage Black patients

Shaltiel,

Sarpel,

Branch

2024

Cancer Medicine

View full text Add to dashboard Cite

show abstract

“…HCC outcomes are not immune to racial disparities in America. Indeed, research shows that African-Americans have higher incidence of HCC in America but are less likely to receive surgery, more likely to wait longer for surgery if they have it, and have worse outcomes overall [ 75 , 76 , 77 , 78 , 79 ]. These disparities are undoubtedly a source of stress on an individual.…”

Section: Racial Disparities As a Subset Of Chronic Stress And Hbv-ass...mentioning

confidence: 99%

Hepatitis B Virus-Associated Hepatocellular Carcinoma and Chronic Stress

Noverati

Bashir-Hamidu

Halegoua-DeMarzio

et al. 2022

IJMS

View full text Add to dashboard Cite

The Hepatitis B virus is one of the most significant hepatocarcinogens globally. The carcinogenic mechanisms of this virus are complex, and may include interactions with the host’s immune system. Certain factors, such as stress on the body, can also potentiate these mechanisms. Stress, although adaptive in an acute form, is deleterious to health when chronic and can both suppress and activate the host’s defense system. In hepatocellular carcinoma, this can lead to tumor initiation and progression. Those that are more prone to stress, or exposed to situations that incite stress, may be at higher risk of developing cancer. Racial disparities, for example, are a source of chronic psychosocial stress in America and predispose minorities to poorer outcomes. As it remains perplexing why some individuals with chronic hepatitis B develop feared complications while others do not, it is important to recognize as many risk factors as possible, including those often overlooked such as chronic stress.

show abstract