Etiology and Outcomes of Hepatocellular Carcinoma in an Ethnically Diverse Population: The Multiethnic Cohort.
Etiology and Outcomes of Hepatocellular Carcinoma in an Ethnically Diverse Population: The Multiethnic Cohort.
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DOI：
10.3390/cancers13143476
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发表时间：
2021-07-12
期刊：
影响因子：
5.2
通讯作者：
Setiawan VW
中科院分区：
文献类型：
--
作者：
Barzi A;Zhou K;Wang S;Dodge JL;El-Khoueiry A;Setiawan VW
肝细胞癌（HCC）发生率和结局的种族/民族差异先前已有描述。然而，由于确定潜在病因的挑战（例如，B型肝炎和C型肝炎），基本病因对种族差异的影响描述不多。利用多种族队列研究中关于肿瘤特征、生活方式和结局的综合数据，我们探讨了HCC的种族差异。我们发现在潜在病因、死亡率和治疗模式方面存在显著的种族差异。我们进一步表明，潜在的病因是一个显着的贡献者种族差异的死亡率按种族，并应在未来的研究中加以考虑。背景：HCC发病率因种族/民族而异。我们在多种族队列研究与SEER和医疗保险索赔的联系中描述了潜在病因、表现和生存率的种族差异。方法：获得参与者的HCC特征、治疗和潜在病因。死亡是通过国家死亡证明和国家死亡指数确定的。通过问卷调查收集风险因素。使用考克斯模型计算死亡的风险比（HR）和95%置信区间（CI）。结果：359例中，平均诊断年龄为75.1岁。最常见的病因是丙型肝炎（HCV）（33%），其次是非酒精性脂肪性肝病（NAFLD）（31%），并因种族而异（p < 0.0001）。非裔美国人（AA）（59.5%）和拉丁美洲人（40.6%）更有可能被诊断为HCV相关的HCC。在日裔美国人（33.1%）、夏威夷原住民（39.1%）和白人（34.8%）中，NAFLD是最常见的病因。接受治疗的情况因种族而异（p = 0.0005）; AA未接受治疗的比例最高（50.0%），其次是拉丁美洲人（45.3%）和白人（15.2%）。肝癌（72.2%）是最常见的死亡原因。在多变量分析中，AA（HR = 1.87; 95% CI：1.06-3.28）的死亡率显著高于白人。结论：我们发现在肝细胞癌的病因、治疗和预后方面存在明显的种族差异。这些发现对减少差距很重要。
Racial/ethnic disparities in the incidence and outcomes of hepatocellular carcinoma (HCC) is previously described. Yet, due to the challenges for ascertainment of the underlying etiology (e.g., hepatitis B and hepatitis C) in registry-based studies, the contribution of the underlying etiology to the racial disparities is poorly described. Utilizing comprehensive data on tumor characteristics, lifestyle, and outcomes in the Multiethnic Cohort Study, we explored racial disparities in HCC. We show significant racial disparities in the underlying etiology, mortality, and treatment patterns. We further show that underlying etiology is a significant contributor to racial disparities in mortality by race and should be considered in future research. Backgrounds: HCC incidence varies by race/ethnicity. We characterized racial differences in underlying etiology, presentation, and survival in the linkage of Multiethnic Cohort Study with SEER and Medicare claims. Methods: HCC characteristics, treatment, and underlying etiology in participants were obtained. Deaths were ascertained using state death certificates and the National Death Index. Risk factors were collected via questionnaires. Cox models were used to calculate hazard ratios (HR) and 95% confidence intervals (CI) for death. Results: Among 359 cases, the average age at diagnosis was 75.1. The most common etiology was hepatitis C (HCV) (33%), followed by nonalcoholic fatty liver disease (NAFLD) (31%), and different by ethnicity (p < 0.0001). African Americans (AA) (59.5%) and Latinos (40.6%) were more likely to be diagnosed with HCV-related HCC. In Japanese Americans (33.1%), Native Hawaiians (39.1%), and whites (34.8%), NAFLD was the most common etiology. Receipt of treatment varied across ethnic groups (p = 0.0005); AA had the highest proportion of no treatment (50.0%), followed by Latinos (45.3%), vs. whites (15.2%). HCC (72.2%) was the most common cause of death. In a multivariate analysis, AA (HR = 1.87; 95% CI: 1.06–3.28) had significantly higher mortality compared to whites. Conclusions: We found significant ethnic differences in HCC underlying etiology, receipt of treatment, and outcome. The findings are important for reducing disparities.
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1975年至2012年，向国家报告癌症状况的年度报告，其发病率不断增加。
影响因子：
6.2
作者：
Ryerson AB;Eheman CR;Altekruse SF;Ward JW;Jemal A;Sherman RL;Henley SJ;Holtzman D;Lake A;Noone AM;Anderson RN;Ma J;Ly KN;Cronin KA;Penberthy L;Kohler BA
通讯作者：
Kohler BA
DOI：
10.1002/hep.28677
发表时间：
2016-12
期刊：
Hepatology (Baltimore, Md.)
影响因子：
--
作者：
Setiawan VW;Stram DO;Porcel J;Lu SC;Le Marchand L;Noureddin M
通讯作者：
Noureddin M
影响因子：
5.1
作者：
Bogumil, David;Park, Song-Yi;Setiawan, Veronica Wendy
通讯作者：
Setiawan, Veronica Wendy
影响因子：
5.1
作者：
Brar G;Greten TF;Graubard BI;McNeel TS;Petrick JL;McGlynn KA;Altekruse SF
通讯作者：
Altekruse SF
影响因子：
5.1
作者：
McGlynn KA;Petrick JL;London WT
通讯作者：
London WT