Racial disparity in primary hepatocellular carcinoma : Tumor stage at presentation, surgical treatment and survival
The incidence and mortality rates from primary hepatocellular carcinoma (HCC) are higher in black Americans compared to whites. The goal of this study was to determine if there are racial disparities in HCC stage at diagnosis and treatment. We compared patient age, tumor stage, rates of surgical int...
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| Veröffentlicht in: | Journal of the National Medical Association 2006-12, Vol.98 (12), p.1934-1939 |
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| creator | SLOANE, Dana HEGANG CHEN HOWELL, Charles |
| description | The incidence and mortality rates from primary hepatocellular carcinoma (HCC) are higher in black Americans compared to whites. The goal of this study was to determine if there are racial disparities in HCC stage at diagnosis and treatment.
We compared patient age, tumor stage, rates of surgical intervention and survival in black (n=1718) and white (n=9752) HCC cases between 1992 and 2001 in the Surveillance, Epidemiology and End Results (SEER)-11 + Alaska database.
Black HCC cases were significantly younger at diagnosis (p < 0.0001). Black cases were more likely to have regional and distant metastasis at presentation (p < 0.0005) and were less likely to have surgery performed (p < 0.001). The racial difference in surgery treatment was significant among patients with localized (p = 0.001) and regional (p = 0.012) HCC, but not with distant HCC. Overall survival rates were lower in blacks (p = 0.0033). Survival was similar in blacks and whites with regional and distant disease. Yet, among patients with localized HCC, survival rates were lower in blacks (p = 0.0030).
Black HCC patients have more advanced tumor stage at diagnosis and lower rates of both surgical intervention and survival. The racial disparities in surgical treatment utilization and survival were most striking between black and white HCC patients with localized HCC. |
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We compared patient age, tumor stage, rates of surgical intervention and survival in black (n=1718) and white (n=9752) HCC cases between 1992 and 2001 in the Surveillance, Epidemiology and End Results (SEER)-11 + Alaska database.
Black HCC cases were significantly younger at diagnosis (p < 0.0001). Black cases were more likely to have regional and distant metastasis at presentation (p < 0.0005) and were less likely to have surgery performed (p < 0.001). The racial difference in surgery treatment was significant among patients with localized (p = 0.001) and regional (p = 0.012) HCC, but not with distant HCC. Overall survival rates were lower in blacks (p = 0.0033). Survival was similar in blacks and whites with regional and distant disease. Yet, among patients with localized HCC, survival rates were lower in blacks (p = 0.0030).
Black HCC patients have more advanced tumor stage at diagnosis and lower rates of both surgical intervention and survival. The racial disparities in surgical treatment utilization and survival were most striking between black and white HCC patients with localized HCC.</description><identifier>ISSN: 0027-9684</identifier><identifier>EISSN: 1943-4693</identifier><identifier>PMID: 17225837</identifier><identifier>CODEN: JNMAAE</identifier><language>eng</language><publisher>Thorofare, NJ: Slack</publisher><subject>Adolescent ; Adult ; African Americans - statistics & numerical data ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Carcinoma, Hepatocellular - ethnology ; Carcinoma, Hepatocellular - mortality ; Carcinoma, Hepatocellular - pathology ; Carcinoma, Hepatocellular - surgery ; Child ; Early Diagnosis ; European Continental Ancestry Group - statistics & numerical data ; Female ; Gastroenterology. Liver. Pancreas. Abdomen ; General aspects ; Hepatectomy - utilization ; Humans ; Incidence ; Liver Neoplasms - ethnology ; Liver Neoplasms - mortality ; Liver Neoplasms - pathology ; Liver Neoplasms - surgery ; Liver. Biliary tract. Portal circulation. Exocrine pancreas ; Male ; Medical sciences ; Middle Aged ; Survival Rate ; Tumors ; United States - epidemiology</subject><ispartof>Journal of the National Medical Association, 2006-12, Vol.98 (12), p.1934-1939</ispartof><rights>2007 INIST-CNRS</rights><rights>Copyright National Medical Association Dec 2006</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2569668/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2569668/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,53766,53768</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18458362$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17225837$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>SLOANE, Dana</creatorcontrib><creatorcontrib>HEGANG CHEN</creatorcontrib><creatorcontrib>HOWELL, Charles</creatorcontrib><title>Racial disparity in primary hepatocellular carcinoma : Tumor stage at presentation, surgical treatment and survival</title><title>Journal of the National Medical Association</title><addtitle>J Natl Med Assoc</addtitle><description>The incidence and mortality rates from primary hepatocellular carcinoma (HCC) are higher in black Americans compared to whites. The goal of this study was to determine if there are racial disparities in HCC stage at diagnosis and treatment.
We compared patient age, tumor stage, rates of surgical intervention and survival in black (n=1718) and white (n=9752) HCC cases between 1992 and 2001 in the Surveillance, Epidemiology and End Results (SEER)-11 + Alaska database.
Black HCC cases were significantly younger at diagnosis (p < 0.0001). Black cases were more likely to have regional and distant metastasis at presentation (p < 0.0005) and were less likely to have surgery performed (p < 0.001). The racial difference in surgery treatment was significant among patients with localized (p = 0.001) and regional (p = 0.012) HCC, but not with distant HCC. Overall survival rates were lower in blacks (p = 0.0033). Survival was similar in blacks and whites with regional and distant disease. Yet, among patients with localized HCC, survival rates were lower in blacks (p = 0.0030).
Black HCC patients have more advanced tumor stage at diagnosis and lower rates of both surgical intervention and survival. The racial disparities in surgical treatment utilization and survival were most striking between black and white HCC patients with localized HCC.</description><subject>Adolescent</subject><subject>Adult</subject><subject>African Americans - statistics & numerical data</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Carcinoma, Hepatocellular - ethnology</subject><subject>Carcinoma, Hepatocellular - mortality</subject><subject>Carcinoma, Hepatocellular - pathology</subject><subject>Carcinoma, Hepatocellular - surgery</subject><subject>Child</subject><subject>Early Diagnosis</subject><subject>European Continental Ancestry Group - statistics & numerical data</subject><subject>Female</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>General aspects</subject><subject>Hepatectomy - utilization</subject><subject>Humans</subject><subject>Incidence</subject><subject>Liver Neoplasms - ethnology</subject><subject>Liver Neoplasms - mortality</subject><subject>Liver Neoplasms - pathology</subject><subject>Liver Neoplasms - surgery</subject><subject>Liver. Biliary tract. Portal circulation. Exocrine pancreas</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Survival Rate</subject><subject>Tumors</subject><subject>United States - epidemiology</subject><issn>0027-9684</issn><issn>1943-4693</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BEC</sourceid><sourceid>BENPR</sourceid><recordid>eNpdkVtLxDAQhYsoul7-ggRBnyykSZomPgiyeANBkPW5TNN0jbRJTdIF_71ZXK9PAzPfHM6Z2cpmhWQ0Z1zS7WyGMalyyQXby_ZDeMUYC1mWu9leURFSClrNsvAEykCPWhNG8Ca-I2PR6M0A_h296BGiU7rvpx48UuCVsW4AdIEW0-A8ChGWGkFMGzpoGyEaZ89RmPzSqKQavYY4pAEC267bK7OC_jDb6aAP-mhTD7Lnm-vF_C5_eLy9n1895CMlRcw17xoBGCtcUcZazHDBO9k2smnKTmipG0GBAWVl1UIlKqJI1-JS0RILRhpGD7LLT91xagbdquTDQ19v0tUOTP13Ys1LvXSrmpRcci6SwNlGwLu3SYdYDyaszwFWuynUXBBZSIITePIPfHWTtylcTQqGWUEKkqDj33a-fXw9IwGnGwBCul7nwSoTfjjBEsYJ_QDqsZax</recordid><startdate>20061201</startdate><enddate>20061201</enddate><creator>SLOANE, Dana</creator><creator>HEGANG CHEN</creator><creator>HOWELL, Charles</creator><general>Slack</general><general>Elsevier Limited</general><general>National Medical Association</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>3V.</scope><scope>4T-</scope><scope>4U-</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>88G</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2M</scope><scope>M2P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>S0X</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20061201</creationdate><title>Racial disparity in primary hepatocellular carcinoma : Tumor stage at presentation, surgical treatment and survival</title><author>SLOANE, Dana ; HEGANG CHEN ; HOWELL, Charles</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p321t-e6fb8a00c07344d04016f9db9bb5f8e9eb83a4a3457da7872c2fd05c350842b43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>African Americans - statistics & numerical data</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Carcinoma, Hepatocellular - ethnology</topic><topic>Carcinoma, Hepatocellular - mortality</topic><topic>Carcinoma, Hepatocellular - pathology</topic><topic>Carcinoma, Hepatocellular - surgery</topic><topic>Child</topic><topic>Early Diagnosis</topic><topic>European Continental Ancestry Group - statistics & numerical data</topic><topic>Female</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>General aspects</topic><topic>Hepatectomy - utilization</topic><topic>Humans</topic><topic>Incidence</topic><topic>Liver Neoplasms - ethnology</topic><topic>Liver Neoplasms - mortality</topic><topic>Liver Neoplasms - pathology</topic><topic>Liver Neoplasms - surgery</topic><topic>Liver. Biliary tract. Portal circulation. Exocrine pancreas</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Survival Rate</topic><topic>Tumors</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>SLOANE, Dana</creatorcontrib><creatorcontrib>HEGANG CHEN</creatorcontrib><creatorcontrib>HOWELL, Charles</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>ProQuest Central (Corporate)</collection><collection>Docstoc</collection><collection>University Readers</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>eLibrary</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>ProQuest Psychology</collection><collection>Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of the National Medical Association</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>SLOANE, Dana</au><au>HEGANG CHEN</au><au>HOWELL, Charles</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Racial disparity in primary hepatocellular carcinoma : Tumor stage at presentation, surgical treatment and survival</atitle><jtitle>Journal of the National Medical Association</jtitle><addtitle>J Natl Med Assoc</addtitle><date>2006-12-01</date><risdate>2006</risdate><volume>98</volume><issue>12</issue><spage>1934</spage><epage>1939</epage><pages>1934-1939</pages><issn>0027-9684</issn><eissn>1943-4693</eissn><coden>JNMAAE</coden><abstract>The incidence and mortality rates from primary hepatocellular carcinoma (HCC) are higher in black Americans compared to whites. The goal of this study was to determine if there are racial disparities in HCC stage at diagnosis and treatment.
We compared patient age, tumor stage, rates of surgical intervention and survival in black (n=1718) and white (n=9752) HCC cases between 1992 and 2001 in the Surveillance, Epidemiology and End Results (SEER)-11 + Alaska database.
Black HCC cases were significantly younger at diagnosis (p < 0.0001). Black cases were more likely to have regional and distant metastasis at presentation (p < 0.0005) and were less likely to have surgery performed (p < 0.001). The racial difference in surgery treatment was significant among patients with localized (p = 0.001) and regional (p = 0.012) HCC, but not with distant HCC. Overall survival rates were lower in blacks (p = 0.0033). Survival was similar in blacks and whites with regional and distant disease. Yet, among patients with localized HCC, survival rates were lower in blacks (p = 0.0030).
Black HCC patients have more advanced tumor stage at diagnosis and lower rates of both surgical intervention and survival. The racial disparities in surgical treatment utilization and survival were most striking between black and white HCC patients with localized HCC.</abstract><cop>Thorofare, NJ</cop><pub>Slack</pub><pmid>17225837</pmid><tpages>6</tpages></addata></record> |
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| subjects | Adolescent Adult African Americans - statistics & numerical data Aged Aged, 80 and over Biological and medical sciences Carcinoma, Hepatocellular - ethnology Carcinoma, Hepatocellular - mortality Carcinoma, Hepatocellular - pathology Carcinoma, Hepatocellular - surgery Child Early Diagnosis European Continental Ancestry Group - statistics & numerical data Female Gastroenterology. Liver. Pancreas. Abdomen General aspects Hepatectomy - utilization Humans Incidence Liver Neoplasms - ethnology Liver Neoplasms - mortality Liver Neoplasms - pathology Liver Neoplasms - surgery Liver. Biliary tract. Portal circulation. Exocrine pancreas Male Medical sciences Middle Aged Survival Rate Tumors United States - epidemiology |
| title | Racial disparity in primary hepatocellular carcinoma : Tumor stage at presentation, surgical treatment and survival |
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