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DDW 2016: Racial Disparities Found in Liver Cancer Survival Rates

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Key Points

  • The median survival after diagnosis was 301 days for black patients, compared to 534.5 days for non-Hispanic white patients and 437 days for Hispanics.
  • After adjusting for factors, such as alcohol use, tobacco use, insurance status, and age at diagnosis, non-Hispanic whites had a 25% reduced risk of death and Hispanics had a 21% reduced risk of death compared to black patients.
  • Liver transplants were associated with a 66% reduction in hepatocellular carcinoma deaths, but only 11.9% of black patients received a transplant, compared to 33.3% of non-Hispanic whites. 

Black patients diagnosed with hepatocellular carcinoma, the most common liver cancer, had a 33% increased risk of death compared to non-Hispanic whites. They also were far less likely to receive lifesaving liver transplants, according to a new study presented by Jones et al at Digestive Disease Week (DDW) 2016 (Abstract Mo1491).

“When we looked at a diverse sample of patients being diagnosed with hepatocellular carcinoma, race was the strongest predictor of survival,” said Patricia D. Jones, MD, MSCR, the study’s lead author, Assistant Professor of Medicine and member at Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine. “Black patients were more likely to present with tumors that were larger—indicating that they were at a later stage of hepatocellular carcinoma when diagnosed, potentially delaying their eligibility for a liver transplant, a curative option for hepatocellular carcinoma.”

Study Findings

When researchers analyzed patient records by race, they found the median survival after diagnosis was 301 days for black patients, compared to 534.5 days for non-Hispanic white patients and 437 days for Hispanics. After adjusting for factors, such as alcohol use, tobacco use, insurance status, and age at diagnosis, non-Hispanic whites had a 25% reduced risk of death and Hispanics had a 21% reduced risk of death compared to black patients. Researchers also found that black patients were more likely to have hepatitis B virus (HBV), which is an underlying cause of hepatocellular carcinoma. 

Dr. Jones and her team conducted a retrospective analysis of 999 patients diagnosed with hepatocellular carcinoma at the University of Miami Sylvester Comprehensive Cancer Center/Jackson Memorial Hospital between 2005 and 2014. These centers serve a diverse patient population, where 14.7% of patients are black, 34.9% are Hispanic, and approximately 50% are born outside North America. 

The team also found that, overall, liver transplants were associated with a 66% reduction in deaths, but only 11.9% of black patients received a transplant, compared to 33.3% of non-Hispanic whites. 

“We are conducting additional research to determine which factors contribute to the lower survival rate in black patients, such as access to care, birthplace, socioeconomic status, or increased prevalence of viral hepatitis,” added Dr. Jones. “Hepatitis B can be prevented by vaccination and management of this infection depends on access to care, which may be an underlying issue for this community.” 

According to the National Cancer Institute, hepatocellular carcinoma is the sixth most prevalent cancer and the third leading cause of cancer-related deaths worldwide. Its incidence in the U.S. is rising, specifically in relation to the spread of hepatitis C virus (HCV) infection. HBV and HCV infections appear to be the most significant causes of hepatocellular carcinoma globally.  

Researchers plan to conduct additional community-based research to explore the perceptions of HBV and HCV in at-risk populations and determine where the opportunities for further education and screening exist in order to ensure earlier cancer detection.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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