Black patients diagnosed with hepatocellular carcinoma (HCC), 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 life-saving liver transplants, and also were more likely to have hepatitis B virus (HBV), which is an underlying cause of HCC, according to data being presented at Digestive Disease Week (DDW) 2016, being held in San Diego this week. 

“When we looked at a diverse sample of patients being diagnosed with HCC, race was the strongest predictor of survival,” 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, FL said in a prepared statement about the study. “Black patients were more likely to present with tumors that were larger — indicating that they were at a later stage of HCC when diagnosed, potentially delaying their eligibility for a liver transplant, a curative option for HCC.”

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 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. 

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


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The team also noted 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, socio-economic 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, HCC is the sixth most prevalent cancer and the third leading cause of cancer-related deaths worldwide. Its incidence in the United States is rising, specifically in relation to the spread of hepatitis C virus (HCV) infection. 

The researchers explained that they 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 to ensure earlier cancer detection.

Reference

1. Jones PD, Martin P, KKobetz E, et al. Racial Disparities in Survival after Hepatocellular Carcinoma Diagnosis in a Diverse American Population. Abstract # Mo1491. Presented at: DDW2016. May 22-24, 2016. San Diego.