Racial, Ethnic, and Socioeconomic Disparities in Curative Treatment Receipt and Survival in Hepatocellular Carcinoma.
Racial, Ethnic, and Socioeconomic Disparities in Curative Treatment Receipt and Survival in Hepatocellular Carcinoma.
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DOI：
10.1002/hep4.1863
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发表时间：
2022-05
影响因子：
5.1
通讯作者：
Kum, Hye-Chung
中科院分区：
文献类型：
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作者：
Wagle, Nikita Sandeep;Park, Sulki;Washburn, David;Ohsfeldt, Robert L.;Rich, Nicole E.;Singal, Amit G.;Kum, Hye-Chung
肝细胞癌（HCC）不成比例地影响种族、民族和低社会经济地位（SES）人群。然而，种族、民族和社区SES在HCC预后中的相互作用尚未得到很好的探讨。本研究评估了种族、民族和社区社会经济状况对美国HCC患者治愈性治疗利用和总生存期的相互作用。我们使用监测、流行病学和最终结果与医疗保险相关的数据库，对2001年至2015年诊断为HCC的年龄≥65岁的13874例患者进行了回顾性队列研究。我们采用多变量逻辑回归来检验种族、民族和治疗接受度之间的关系。我们还使用Cox比例风险模型评估了治疗接受与总生存率之间的关系。在13874例患者中，只有2617例（18.9%）患者得到了治愈治疗。总体而言，黑人患者接受根治性治疗的几率低于白人患者（优势比[OR]， 0.76； 95%可信区间[CI]， 0.64‐0.91）。当按社区SES分层时，生活在高贫困社区的黑人患者获得治愈治疗的几率较低（OR, 0.64; 95% CI, 0.49‐0.84），生存率较差（风险比，1.13;95% CI, 1.02‐1.25）。相反，与所有社会经济水平的白人患者相比，西班牙裔和亚裔患者的治疗收入相似。结论：黑人和白人患者的治愈治疗和总生存期差异明显。黑人与白人之间的差异似乎会受到社会经济地位的影响，这在生活在高贫困社区的人群中尤为明显。
Hepatocellular carcinoma (HCC) disproportionately affects racial, ethnic, and low socioeconomic status (SES) populations. However, the interaction between race, ethnicity, and neighborhood SES in HCC prognosis is not well explored. This study evaluates the interaction between race and ethnicity and neighborhood SES on curative treatment utilization and overall survival among patients with HCC in the United States. We conducted a retrospective cohort study of 13,874 patients aged ≥65 years diagnosed with HCC from 2001 through 2015 using the Surveillance, Epidemiology, and End Results Medicare‐linked database. We performed multivariable logistic regression to examine the association between race, ethnicity, and curative treatment receipt across SES. We also evaluated the association between curative treatment receipt and overall survival using a Cox proportional hazards model. Among 13,874 patients, only 2,617 (18.9%) patients received curative treatment. Overall, Black patients had lower odds of receiving curative treatment than White patients (odds ratio [OR], 0.76; 95% confidence interval [CI], 0.64‐0.91). When stratified by neighborhood SES, Black patients living in high‐poverty neighborhoods had lower odds of curative treatment receipt (OR, 0.64; 95% CI, 0.49‐0.84) and worse survival (hazard ratio, 1.13; 95% CI, 1.02‐1.25). Conversely, Hispanic and Asian patients had similar curative treatment receipt compared to White patients across all socioeconomic levels. Conclusion: Disparities in curative treatment receipt and overall survival are pronounced between Black and White patients. Black–White disparities appear to be moderated by neighborhood SES and are particularly evident among those living in high‐poverty neighborhoods.
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DOI：
10.1016/j.cgh.2020.12.029
发表时间：
2022-03
期刊：
Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
影响因子：
--
作者：
Rich NE;Carr C;Yopp AC;Marrero JA;Singal AG
通讯作者：
Singal AG
影响因子：
9.8
作者：
Altekruse, Sean F.;Henley, S. Jane;Cucinelli, James E.;McGlynn, Katherine A.
通讯作者：
McGlynn, Katherine A.
影响因子：
24.5
作者：
Nathani P;Gopal P;Rich N;Yopp A;Yokoo T;John B;Marrero J;Parikh N;Singal AG
通讯作者：
Singal AG
影响因子：
5.3
作者：
Johnson, Asal Mohamadi;Hines, Robert B.;Bayakly, A. Rana
通讯作者：
Bayakly, A. Rana
影响因子：
7.2
作者：
Klabunde, CN;Potosky, AL;Warren, JL
通讯作者：
Warren, JL