Racial and Ethnic Disparities in Survival Among Patients With Hepatocellular Carcinoma in the United States: A Systematic Review and Meta-Analysis.
Racial and Ethnic Disparities in Survival Among Patients With Hepatocellular Carcinoma in the United States: A Systematic Review and Meta-Analysis.
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DOI：
10.1016/j.cgh.2020.12.029
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发表时间：
2022-03
期刊：
影响因子：
--
通讯作者：
Singal AG
中科院分区：
文献类型：
--
作者：
Rich NE;Carr C;Yopp AC;Marrero JA;Singal AG
在美国，肝细胞癌（HCC）是癌症相关死亡增长最快的原因；然而，HCC的发病率和死亡率在种族/民族群体中分布并不均匀。我们的目的是描述HCC患者总生存率和早期肿瘤检测中种族/民族差异的方向和程度。我们检索了MEDLINE、EMBASE和Cochrane数据库，从成立到2020年8月，按种族和民族报告HCC结局（早期表现和总生存期）的研究。我们使用DerSimonian和Laird方法对随机效应模型计算了每个种族/族裔群体（白人、黑人、西班牙裔、亚洲人）的合并风险比（hr）和优势比（ORs）。我们确定了35篇文章，包括563,097例患者（53.0%白人，17.3%黑人，18.4%西班牙裔，5.0%亚洲人）。与白人患者相比，黑人患者的生存率较差（总危险度1.08,95%CI 1.05 - 1.12），而西班牙裔患者（总危险度0.92,95%CI 0.87 - 0.97）和亚裔患者（总危险度0.81,95%CI 0.73 - 0.88）的生存率较好。在报道肿瘤分期的文章中（n=20），黑人患早期HCC的几率低于白人（OR 0.66, 95%CI 0.54 - 0.78）。相反，与白人相比，亚洲人（OR 1.01, 95%CI 0.97 - 1.05）或西班牙裔患者（OR 0.87, 95%CI 0.74 - 1.01）早期HCC检测的几率没有差异。研究中最常见的局限性是社会经济地位和肝功能障碍的残留混杂风险。在美国，HCC预后存在明显的种族差异，与白人患者相比，黑人患者的总生存期较差，西班牙裔和亚裔患者的总生存期较好。需要采取干预措施来减少HCC早期发现的差异，以改善HCC预后。
Hepatocellular carcinoma (HCC) is the fastest rising cause of cancer-related death in the United States; however, HCC incidence and mortality are not equally distributed among racial/ethnic groups. Our aim was to characterize the direction and magnitude of racial/ethnic disparities in overall survival and early tumor detection among patients with HCC. We searched MEDLINE, EMBASE and Cochrane databases from inception through August 2020 for studies reporting HCC outcomes (early stage presentation and overall survival) by race and ethnicity. We calculated pooled hazard ratios (HRs) and odds ratios (ORs) for each racial/ethnic group (White, Black, Hispanic, Asian) using the DerSimonian and Laird method for a random-effects model. We identified 35 articles comprising 563,097 patients (53.0% White, 17.3% Black, 18.4% Hispanic, 5.0% Asian). Compared to Whites, Black patients had worse survival (pooled HR 1.08, 95%CI 1.05 – 1.12), whereas Hispanic (pooled HR 0.92, 95%CI 0.87 – 0.97) and Asian (pooled HR 0.81, 95%CI 0.73 – 0.88) patients had better survival. Among articles reporting tumor stage (n=20), Blacks had lower odds of early stage HCC compared to Whites (OR 0.66, 95%CI 0.54 – 0.78). Conversely, there was no difference in odds of early HCC detection for Asian (OR 1.01, 95%CI 0.97 – 1.05) or Hispanic patients (OR 0.87, 95%CI 0.74 – 1.01) compared to Whites. The most common limitation of studies was risk of residual confounding from socioeconomic status and liver dysfunction. There are significant racial and ethnic disparities in HCC prognosis in the United States, with Black patients having worse overall survival and Hispanic and Asian patients having better overall survival compared to White patients. Interventions are needed to reduce disparities in early HCC detection to improve HCC prognosis.
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DOI：
10.1016/j.bbcan.2017.01.001
发表时间：
2017-08
期刊：
Biochimica et biophysica acta. Reviews on cancer
影响因子：
--
作者：
Ahmad A;Azim S;Zubair H;Khan MA;Singh S;Carter JE;Rocconi RP;Singh AP
通讯作者：
Singh AP
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：
--
作者：
El-Serag, Hashem B.;Lau, Melvin;Goodwin, James
通讯作者：
Goodwin, James
影响因子：
3.8
作者：
Jan, Thomas;Medvedev, Sabeen;Buell, Joseph F.
通讯作者：
Buell, Joseph F.
影响因子：
3.5
作者：
Lariscy, Joseph T.;Hummer, Robert A.;Hayward, Mark D.
通讯作者：
Hayward, Mark D.