Issue: February 2021
Disclosures: Rich reports no relevant financial disclosures. Please see the full study for all other authors' relevant financial disclosures.
December 30, 2020
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Black patients with HCC have worse overall survival

Issue: February 2021
Disclosures: Rich reports no relevant financial disclosures. Please see the full study for all other authors' relevant financial disclosures.
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Black patients with hepatocellular carcinoma have worse overall survival compared with white patients, according to study results.

Nicole E. Rich, MD, MS, from the division of digestive and liver diseases at UT Southwestern Medical Center, and colleagues wrote that HCC is becoming a leading cause of cancer-related death in the United States and has disproportionate impact on minority populations.

“Disparities in HCC incidence have been consistently documented over the past three decades, with non-Hispanic Black, Hispanic and Asian populations having higher age-adjusted incidence rates compared to non-Hispanic whites,” they wrote. “Disparities also appear to exist for HCC prognosis, though data conflict on the direction and magnitude of racial and ethnic differences in overall survival.”

Investigators searched the literature for studies that reported HCC outcomes by race and ethnicity, including early-stage presentation and overall survival. They identified 35 studies comprising 563,097 patients that fit their criteria.

Compared with white patients, Black patients had worse overall survival (pooled HR = 1.08; 95% CI, 1.05-1.12). Researchers found that Hispanic patients (pooled HR = 0.92; 95% CI, 0.87-0.97) and Asian patients (pooled HR = 0.81; 95% CI, 0.73-0.88) had better survival compared with white patients.

In 20 studies that included tumor stage, Black patients had lower odds of early-stage HCC compared with white patients (OR = 0.66; 95% CI, 0.54-0.78). There was no difference in early HCC detection among Hispanic or Asian patients compared with white patients.

“Though considerable progress has been made in describing disparities in HCC, data are limited on the specific determinants driving these disparities,” Rich and colleagues wrote. “To achieve health equity, future studies must focus on taking the critical next steps to determine the root causes of disparities in HCC, identify actionable intervention targets, engage patient and provider stakeholders to implement interventions, and advocate for system-level change to eliminate disparities.”