MIAMI — Native Americans are among the racial/ethnic groups who are more likely to be diagnosed with more-severe hepatocellular carcinoma (HCC), according to a new study.
The report in Cancer Epidemiology noted that HCC is one of the leading causes of cancer-related deaths in the United States. Substantial disparities have been observed in cancer incidence and survival among racial groups., however, according to the study.1
Researchers from the Miami Cancer Institute at Baptist Health South Florida conducted a cross-sectional analysis of data from the National Inpatient Sample (NIS) between 2011 and 2016, utilizing the STROBE guidelines. The focus was on 83,876 weighted HCC hospitalizations which were reported during the study period.
Researchers used demographics to divide the patients according to NIS racial/ethnic categorization, which included Caucasian (57.3%), African American (16.9%), Hispanic (15.7%), Asian or Pacific Islanders (9.3%) and Native American (0.8%).
The study found that the association between greater odds of hospitalization and Elixhauser Comorbidity Index > 4 was significantly higher among Native Americans (aOR=1.79; 95% CI: 1.23-2.73), African Americans (aOR=1.24; 95% CI: 1.12-1.38), and Hispanics (aOR=1.11; 95% CI, 1.01-1.24).
“Risk-adjusted association between race and receipt of surgical procedures demonstrated that the odds of having surgery was significantly lower for African Americans (aOR=0.64; 95% CI: 0.55-0.73) and Hispanics (aOR=0.70; 95% CI: 0.59-0.82), while significantly higher for Asians/Pacific Islanders (aOR=1.36; 95% CI: 1.28-1.63),” according to the authors. “Post-operative complications were significantly lower for African Americans (aOR=0.68; 95% CI: 0.55-0.86) while the odds of in-hospital mortality were significantly higher for African Americans (aOR=1.28; 95% CI: 1.11-1.49) and Asians/Pacific Islanders (aOR=1.26; 95% CI: 1.13-1.62).”
The study team concluded that “there were significant racial disparities in pre-treatment presentations, surgical procedure allocations, and post-treatment outcomes among patients with HCC. Further studies are needed to determine the underlying factors for these disparities to develop targeted interventions to reduce these disparities of care.”
- Chikovsky L, Kutuk T, Rubens M, Balda AN, et. al. Racial disparities in clinical presentation, surgical procedures, and hospital outcomes among patients with hepatocellular carcinoma in the United States. Cancer Epidemiol. 2023 Feb;82:102317. doi: 10.1016/j.canep.2022.102317. Epub 2022 Dec 23. PMID: 36566577.