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Liver Cancer Patients Face Racial Disparities in Survival, Despite Receiving Equal Treatment

Atlanta 2010/01/25 -A new analysis has found that Black patients with hepatocellular carcinoma (HCC), or liver cancer, have worse survival than patients of other races, even after receiving comparable treatments. Published early online in CANCER, a peer-reviewed journal of the American Cancer Society, the study indicates that Further investigation is warranted to identify the reasons for the stark disparity in outcomes between Blacks and other patients following transplant for liver cancer.

Studies have shown that racial, ethnic, and socioeconomic disparities exist in survival from HCC. The disparities have been thought to be due to differences in the cancers themselves as well as to differences in health care utilization and access to surgical therapy. To explore the issue, researchers led by Joseph Kim, MD, of City of Hope in Duarte, California reviewed data from 20,920 patients in the Surveillance, Epidemiology and End Results (SEER) registry diagnosed with HCC between 1973 and 2004 as well as information from 4,735 patients in the United Network for Organ Sharing (UNOS) who underwent liver transplantation for HCC between 1987 and 2008. By studying patients who had all undergone liver transplantation, the researchers hoped to eliminate differences caused by access to care and type of therapy received.


The investigators found that survival from HCC has improved over time for all race, ethnic, and income groups, indicating that all groups have benefited from advances in screening, diagnosis, and treatment. Among the SEER group, Black and low-income patients had the poorest long-term survival. Black patients had a 15 percent increased risk of death compared with Whites, while Asian patients had a 13 percent reduced risk. The reasons for these survival disparities are unclear but may be related to differences in patients’ underlying disease as well as inconsistencies in access to appropriate care; however, additional analyses showed that Black patients continued to do worse even after adjusting for the type of therapy patients received.


In patients who underwent liver transplantation, Black patients again demonstrated a significant survival deficit compared to all other groups, leading the investigators to say their study demonstrates that survival disparities by race and ethnicity cannot be explained by access issues alone, and other factors need to be considered.


Article: “Race, ethnicity and socioeconomic status influence survival from hepatocellular carcinoma in the United States.” Avo Artinyan, Brian Mailey, Nicelio Sanchez-Luege, Joshua Khalili, Can-Lan Sun, Smita Bhatia, Lawrence D. Wagman, Nicholas Nissen, Steven D. Colquhoun, and Joseph Kim. CANCER; Published Online: January 25, 2010 (DOI: 10.1002/cncr.24817).