Abstract
Hepatocellular carcinoma (HCC) is highly prevalent in Asians and Pacific Islanders (API) but this heterogenous group is often aggregated into a single category, despite vast differences in culture, socioeconomic status, education, and access to care among subgroups. There remains a significant knowledge gap in HCC outcomes among different subgroups of API. The Surveillance, Epidemiology, and End Results (SEER) database was accessed, and site/ICD codes were used to identify HCC patients during 2010–2019 who were API ethnicity. Data collected: demographics, socioeconomic status, tumor characteristics, treatment, and survival. Subgroup analyses were performed among different Asian ethnicities in a secondary analysis. 8,249 patients were identified/subdivided into subgroups of Asian ethnicities and Other Pacific Islanders (NHOPI) groups. The median age was 65 years for Asians and 62 years for NHOPI (p < 0.01), and significant differences were found in income (p < 0.01). A higher proportion of NHOPI lived in rural areas compared to Asians (8.1 vs. 1.1%, p < 0.01). There were no statistically significant differences in tumor size, stage, pre-treatment AFP level, or surgical treatments between the two groups. However, Asians had higher overall median survival than NHOPI (20 months v 12 months, p < 0.01). Secondary analyses among different subgroups of Asian ethnicities revealed significant differences in tumor size and staging, surgical resection, transplant rates, and median survival. While API had similar tumor characteristics and treatment, Asians had much higher survival than NHOPI. Socioeconomic differences and access to care may contribute to these differences. This study also found significant survival disparities within API ethnicities.
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Availability of Data and Materials
This study utilized a publicly available SEER database.
Abbreviations
- AFP:
-
Alpha-fetoprotein
- AJCC:
-
American Joint Committee on Cancer
- API:
-
Asians and Pacific Islanders
- BCLC:
-
Barcelona Clinic Liver Cancer
- CI:
-
Confidence interval
- HBV:
-
Hepatitis B virus
- HCC:
-
Hepatocellular carcinoma
- HCV:
-
Hepatitis C virus
- ICD:
-
International Classification of Diseases
- ICD-O-3:
-
International Classification of Disease for Oncology, 3rd edition
- LRT:
-
Locoregional therapy
- NAFLD:
-
Nonalcoholic fatty liver disease
- NHOPI:
-
Native Hawaiians and Other Pacific Islanders
- NOS:
-
Not otherwise specified
- SEER database:
-
The Surveillance, Epidemiology, and End Results database
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This study was not supported by funding or grants. All authors report no financial disclosures (none declared).
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ST, PCW, PRJ, CC, NA contributed to the literature review, manuscript drafting, and editing; WL contributed to study supervision, manuscript drafting, and editing; all of the authors have approved the final version of the manuscript.
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Linda L Wong is a speaker bureau of Eisai.
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This study utilized a publicly available database; therefore, institutional review board approval was not needed to conduct this study. This study followed the SEER Research Data Use Agreement.
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Sempokuya, T., Pan, CW., Pattison, R.J. et al. Disparities in Hepatocellular Carcinoma Outcomes Among Subgroups of Asians and Pacific Islanders: A SEER Database Study. J Immigrant Minority Health 25, 824–834 (2023). https://doi.org/10.1007/s10903-023-01478-1
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DOI: https://doi.org/10.1007/s10903-023-01478-1