Disparities in risk of advanced stage liver cancer and mortality by race and ethnicity
Menée à partir des données des registres américains des cancers portant sur 60 146 patients atteints d'un cancer du foie diagnostiqué entre 2004 et 2018, cette étude analyse les disparités ethniques dans le stade de la maladie au diagnostic et dans la mortalité spécifique
Background : In the United States liver cancer is the 5th and 7th most common cause of cancer related-death among men and women, respectively. Compared to other racial/ethnic groups in the U.S. Asian and Pacific Islander populations experience the highest incidence rates of liver cancer, but little is known about disparities in risk of advanced stage disease or risk of liver cancer mortality across these heterogenous populations. All statistical tests were 2-sided. Methods : In a population-based cohort of 60,146 patients 20–79 years of age diagnosed with liver cancer from 2004–2018 identified through the Surveillance, Epidemiology and End Results Program, we examined associations between race/ethnicity, including specific Asian and Pacific Islander subgroups, and risk of advanced stage liver cancer and liver cancer-specific mortality. Results : Compared to non-Hispanic White patients, non-Hispanic Black, Filipino, and Laotian patients had 30%–85% elevated odds of being diagnosed with stage IV liver cancer, while Hispanic, Vietnamese, and Chinese patients had 7–33% lower odds of being diagnosed with stage IV liver cancer (all p-values <0.05). Additionally, non-Hispanic Black, Kampuchean, and Laotian patients had 6–22% elevated hazards of liver cancer-specific mortality, and Hispanic, Vietnamese, Chinese, and Korean patients had 3–27% lower hazards of liver cancer-specific mortality (all p-values <0.05). Conclusions : Substantial variations in risk of advanced stage liver cancer and in risk of liver cancer mortality were observed by race and ethnicity including considerable heterogeneity across individuals broadly defined as Asians and Pacific Islanders. Further efforts to understand the contributors to these disparities are needed in order to inform potential targeted screening and treatment interventions.