Healthcare disparities in Asians and Pacific Islanders with hepatocellular cancer

• Published in: The American journal of surgery Vol. 203; no. 6; pp. 726 - 732
• Main Authors: Wong, Linda L., M.D, Hernandez, Brenda, Ph.D., M.P.H, Kwee, Sandi, M.D, Albright, Cheryl L., Ph.D., M.P.H, Okimoto, Gordon, Ph.D, Tsai, Naoky, M.D
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.06.2012; Elsevier; Elsevier Limited
• Subjects: Adult; Aged; Aged, 80 and over; Asian Americans; Biological and medical sciences; Cancer; Carcinoma, Hepatocellular - diagnosis; Carcinoma, Hepatocellular - ethnology; Carcinoma, Hepatocellular - mortality; Carcinoma, Hepatocellular - surgery; Early Detection of Cancer - statistics & numerical data; European Continental Ancestry Group; Female; Gastroenterology. Liver. Pancreas. Abdomen; General aspects; Hawaii; Health Services Accessibility - statistics & numerical data; Healthcare Disparities - ethnology; Healthcare Disparities - statistics & numerical data; Hepatocellular cancer; Humans; Liver cancer; Liver Neoplasms - diagnosis; Liver Neoplasms - ethnology; Liver Neoplasms - mortality; Liver Neoplasms - surgery; Liver transplantation; Liver Transplantation - ethnology; Liver Transplantation - statistics & numerical data; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Logistic Models; Male; Medical sciences; Middle Aged; Mortality; Oceanic Ancestry Group; Prevention and actions; Public health. Hygiene; Public health. Hygiene-occupational medicine; Retrospective Studies; Screening; Surgery; Survival Analysis; Transplants & implants; Tumors; Hawaii; Pacific Islands Us; Polynesia; Oceania; United States > US; Screening; Hepatocellular cancer; Liver transplantation; Asiatic; Health; Hepatic disease; Hepatocellular carcinoma; Malignant tumor; Medical screening; Care; Medicine; Treatment; Surgery; Digestive diseases; Disparity; Cancer
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2011.06.055

Abstract Background Hawaii has the highest incidence of hepatocellular cancer (HCC) in the United States and the largest proportion of Asians and Pacific Islanders. HCC studies generally combine these groups into 1 ethnicity, and we sought to examine differences between Asian and Pacific Islander subpopulations. Methods Demographic, clinical, and treatment data for 617 patients with HCC (420 Asians, 114 whites, and 83 Pacific Islanders) were reviewed. Main outcome measures included HCC screening and liver transplantation. Results Asian and Pacific Islander subgroups had significantly more immigrants, and age was different between groups. Compared with whites, Pacific Islanders and Filipinos had less HCC screening and liver transplantation procedures, fewer met Milan criteria, and a smaller proportion of those with Milan criteria actually underwent transplantation. Conclusions There were significant differences in risk factors, clinical presentation, treatment, and access to care among Asian, Pacific Islander, and white patients with HCC. Future HCC studies may benefit from differentiating subgroups within Asian and Pacific Islander populations to better focus these efforts.