Observational Study
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Dec 27, 2018; 10(12): 956-965
Published online Dec 27, 2018. doi: 10.4254/wjh.v10.i12.956
One in five hepatocellular carcinoma patients in the United States are Hispanic while less than 40% were eligible for liver transplantation
Ann Robinson, Ajay Ohri, Benny Liu, Taft Bhuket, Robert J Wong
Ann Robinson, Ajay Ohri, Benny Liu, Taft Bhuket, Robert J Wong, Division of Gastroenterology and Hepatology, Alameda Health System, Highland Hospital, Oakland, CA 94620, United States
Author contributions: Robinson A and Wong RJ contributed to the study concept and design, acquisition of data, and drafting of the manuscript; Wong RJ contributed to statistical analysis and study supervision; all authors contributed to analysis and interpretation of data, and critical revision of the manuscript for important intellectual content.
Institutional review board statement: The study was reviewed and determined to be exempt by the Alameda Health System Institutional Review Board because human subjects were not involved, as per United States Department of Health and Human Services guidelines, and the SEER database is publicly available without individually identifiable private information.
Informed consent statement: Given the observational study design and large registry-based cohort, this study was granted IRB exemption by Alameda Health System Institutional Review Board because human subjects were not involved, as per United States Department of Health and Human Services guidelines, and the SEER database is publicly available without individually identifiable private information. Thus informed consent was not required and not possible.
Conflict-of-interest statement: Robert J Wong is a consultant, member of the advisory board, research grants, and speaker’s bureau for Gilead and member of speaker’s bureau for Bayer. The other authors declare no conflicts of interest related to this article.
STROBE statement: Guidelines of the STROBE statement have been adopted.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Robert J Wong, MD, MS, Division of Gastroenterology and Hepatology, Alameda Health System, Highland Hospital, 1411 East 31st Street, Oakland, CA 94620, United States. rowong@alamedahealthsystem.org
Telephone: +1-510-4376531
Received: May 22, 2018
Peer-review started: May 23, 2018
First decision: July 10, 2018
Revised: July 10, 2018
Accepted: August 20, 2018
Article in press: August 21, 2018
Published online: December 27, 2018
Processing time: 219 Days and 8.9 Hours
ARTICLE HIGHLIGHTS
Research background

Hepatocellular carcinoma (HCC) is a leading cause of morbidity and mortality worldwide. The Hispanic population represents a major contributor of HCC prevalence, particularly in the United States. Understanding HCC epidemiology and disparities in HCC outcomes among this cohort will help guide interventions to improve HCC care.

Research motivation

Given the significant burden of HCC among the Hispanic population, understanding HCC epidemiology and outcomes among this group is critical. Data gathered from studying HCC epidemiology can help identify potential areas where quality improvement programs can be developed and implemented to improve management of HCC.

Research objectives

The main objective of this study was to evaluate disparities in cancer stage at diagnosis among Hispanic HCC patients.

Research methods

The current study utilized a large United States national-based cancer registry. We utilized a retrospective observational cohort study design to evaluate HCC epidemiology and outcomes among Hispanic adults diagnosed with HCC from 2004 to 2014.

Research results

We identified that over 60% of Hispanic HCC patients were diagnosed with advanced cancer stage that was beyond eligibility for liver transplantation. This highlights an important disparity and may reflect suboptimal utilization of timely HCC screening and surveillance among this population.

Research conclusions

These findings may suggest that the Hispanic population at risk for HCC may experience suboptimal receipt of or delays in timely HCC screening and surveillance. These study findings further add to the existing literature highlighting the poor adherence to HCC screening and surveillance among at-risk populations. Specifically, our study identified a high-risk group in the Hispanic population, which is particularly concerning given the higher risk of nonalcoholic fatty liver disease in this population, a disease that is increasing in prevalence.

Research perspectives

Our study findings emphasize the importance of timely and consistent implementation of HCC screening and surveillance that will translate into improved early HCC detection. This will ultimately improve treatment options for curative intent and thus improve long-term survival outcomes among HCC patients.