Abstract
•California has the highest hepatocellular carcinoma disease burden in the United States.•The impact of race/ethnicity on hepatocellular carcinoma treatment/survival is unknown.•In our analysis, Black patients were less likely to receive treatment; survival was longer for Asian patients.•Future studies are needed to identify factors that can improve outcomes.
Hepatocellular carcinoma is the third-leading cause of cancer-related death worldwide. In the United States, California has the highest hepatocellular carcinoma incidence burden and a high level of racial/ethnic diversity. The impact of race/ethnicity on hepatocellular carcinoma treatment and survival in California has not been investigated.
We performed a retrospective analysis of patients diagnosed with hepatocellular carcinoma from 2000 to 2012 using the California Cancer Registry. Patients were categorized by race/ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic, non-Hispanic Asian). Overall five-year survival was calculated using the Kaplan-Meier method. Cox proportional hazards univariable and multivariable analyses were performed to identify factors that influenced survival.
We analyzed data from 12,288 patients (4545 non-Hispanic White; 942 non-Hispanic Black; 3299 Hispanic; 3502 non-Hispanic Asian). Non-Hispanic Black patients were least likely to receive systemic treatment, chemoembolization, or surgery. Overall five-year survival was highest for non-Hispanic Asian patients (22.9 %), followed by Hispanics (16.8 %), non-Hispanic Whites (16.5 %), and non-Hispanic Blacks (11.9 %) (log-rank P < 0.001). Multivariable analyses identified factors that negatively influenced survival, including age (>70 years), race/ethnicity (non-Hispanic, non-Asian), low socioeconomic status, Deyo-Charlson comorbidity score ≥2, tumor size ≥5 cm, grade II/III/IV tumor differentiation, and AJCC stage of II, III, or IV at diagnosis.
Multiple factors influence patients’ hepatocellular carcinoma diagnosis, treatment, and survival. Future studies are needed to identify key factors that can impact treatment and survival among hepatocellular carcinoma patients of different racial/ethnic backgrounds.
Despite California’s diverse population, racial/ethnic backgrounds can still significantly impact treatment and survival among hepatocellular carcinoma patients.