Racial and Geographic Disparities in Hepatocellular Carcinoma Outcomes
Racial and Geographic Disparities in Hepatocellular Carcinoma Outcomes
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DOI：
10.1016/j.amepre.2018.05.030
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发表时间：
2018-11-01
影响因子：
5.5
通讯作者：
Galbraith, James
中科院分区：
文献类型：
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作者：
Franco, Ricardo A.;Fan, Yunhua;Galbraith, James
简介：肝细胞癌不成比例地影响少数民族。南方各州黑人人口比例高，已知的危险因素普遍存在。需要进一步的研究来了解南方地理在肝细胞癌差异中的作用。本文研究了在南方和非南方癌症登记处肝细胞癌发病率、人口统计学、肿瘤特征、接受治疗和全因死亡率方面的种族差异。2015年对监测流行病学和最终结果数据进行了调查，以确定2000年至2012年诊断为肝细胞癌的43，868例患者（5，455例在南部登记[亚特兰大、路易斯安那、农村和大格鲁吉亚]）。南方登记显示，与非南方地区（从3.58例/10万人增加到5.54例/10万人）相比，年龄调整后的肝细胞癌发病率（从2.89例/10万人增加到5.29例/10万人）急剧增加。黑人过度集中在南部登记处（32%对10%）。与白人相比，黑人在诊断时明显更年轻，更可能被诊断为转移，并且在两个登记组中接受手术治疗的可能性更小。调整后，在南方（危险比=1.10，p=0.007）和非南方地区（危险比=1.08，p=0.007），黑人的全因死亡率显著高于白人。
Introduction: Hepatocellular carcinoma disproportionately affects minorities. Southern states have high proportions of black populations and prevalence of known risk factors. Further research is needed to understand the role of southern geography in hepatocellular carcinoma disparities. This paper examined racial disparities in hepatocellular carcinoma incidence, demographics, tumor characteristics, receipt of treatment, and all-cause mortality in southern and non-southern cancer registries.Methods: Surveillance Epidemiology and End Results data were probed in 2015 to identify 43,868 patients diagnosed with hepatocellular carcinoma from 2000 to 2012 (5,455 in southern registries [Atlanta, Louisiana, and Rural and Greater Georgia]).Results: Southern registries showed steeper increases of age-adjusted hepatocellular carcinoma incidence (from 2.89 to 5.29 cases/100,000 people) versus non-southern areas (from 3.58 to 5.54 cases/100,000 people). Blacks were over-concentrated in southern registries (32% vs 10%). Compared with whites, blacks were significantly younger at diagnosis, more likely diagnosed with metastasis, and less likely to receive surgical therapies in both registry groups. After adjustment, blacks had a significantly higher risk of all-cause mortality compared with whites in southern (hazard ratio=1.10, p=0.007) and non-southern areas (hazard ratio=1.08, p