Racial, Ethnic, and Socioeconomic Disparities in Curative Treatment Receipt and Survival in Hepatocellular Carcinoma
Hepatocellular carcinoma (HCC) disproportionately affects racial, ethnic, and low socioeconomic status (SES) populations. However, the interaction between race, ethnicity, and neighborhood SES in HCC prognosis is not well explored. This study evaluates the interaction between race and ethnicity and...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Health/LWW
2022-05-01
|
| Series: | Hepatology Communications |
| Online Access: | https://doi.org/10.1002/hep4.1863 |
| _version_ | 1811174198729506816 |
|---|---|
| author | Nikita Sandeep Wagle Sulki Park David Washburn Robert L. Ohsfeldt Nicole E. Rich Amit G. Singal Hye‐Chung Kum |
| author_facet | Nikita Sandeep Wagle Sulki Park David Washburn Robert L. Ohsfeldt Nicole E. Rich Amit G. Singal Hye‐Chung Kum |
| author_sort | Nikita Sandeep Wagle |
| collection | DOAJ |
| description | Hepatocellular carcinoma (HCC) disproportionately affects racial, ethnic, and low socioeconomic status (SES) populations. However, the interaction between race, ethnicity, and neighborhood SES in HCC prognosis is not well explored. This study evaluates the interaction between race and ethnicity and neighborhood SES on curative treatment utilization and overall survival among patients with HCC in the United States. We conducted a retrospective cohort study of 13,874 patients aged ≥65 years diagnosed with HCC from 2001 through 2015 using the Surveillance, Epidemiology, and End Results Medicare‐linked database. We performed multivariable logistic regression to examine the association between race, ethnicity, and curative treatment receipt across SES. We also evaluated the association between curative treatment receipt and overall survival using a Cox proportional hazards model. Among 13,874 patients, only 2,617 (18.9%) patients received curative treatment. Overall, Black patients had lower odds of receiving curative treatment than White patients (odds ratio [OR], 0.76; 95% confidence interval [CI], 0.64‐0.91). When stratified by neighborhood SES, Black patients living in high‐poverty neighborhoods had lower odds of curative treatment receipt (OR, 0.64; 95% CI, 0.49‐0.84) and worse survival (hazard ratio, 1.13; 95% CI, 1.02‐1.25). Conversely, Hispanic and Asian patients had similar curative treatment receipt compared to White patients across all socioeconomic levels. Conclusion: Disparities in curative treatment receipt and overall survival are pronounced between Black and White patients. Black–White disparities appear to be moderated by neighborhood SES and are particularly evident among those living in high‐poverty neighborhoods. |
| first_indexed | 2024-04-10T17:59:14Z |
| format | Article |
| id | doaj.art-37ae8103c44e486c80b0ec67cad900fb |
| institution | Directory Open Access Journal |
| issn | 2471-254X |
| language | English |
| last_indexed | 2024-04-10T17:59:14Z |
| publishDate | 2022-05-01 |
| publisher | Wolters Kluwer Health/LWW |
| record_format | Article |
| series | Hepatology Communications |
| spelling | doaj.art-37ae8103c44e486c80b0ec67cad900fb2023-02-02T16:26:46ZengWolters Kluwer Health/LWWHepatology Communications2471-254X2022-05-01651186119710.1002/hep4.1863Racial, Ethnic, and Socioeconomic Disparities in Curative Treatment Receipt and Survival in Hepatocellular CarcinomaNikita Sandeep Wagle0Sulki Park1David Washburn2Robert L. Ohsfeldt3Nicole E. Rich4Amit G. Singal5Hye‐Chung Kum6Population Informatics Lab Texas A&M School of Public Health College Station TX USAPopulation Informatics Lab Texas A&M School of Public Health College Station TX USAPopulation Informatics Lab Texas A&M School of Public Health College Station TX USAPopulation Informatics Lab Texas A&M School of Public Health College Station TX USADivision of Digestive and Liver Diseases University of Texas Southwestern Medical Center Dallas TX USADivision of Digestive and Liver Diseases University of Texas Southwestern Medical Center Dallas TX USAPopulation Informatics Lab Texas A&M School of Public Health College Station TX USAHepatocellular carcinoma (HCC) disproportionately affects racial, ethnic, and low socioeconomic status (SES) populations. However, the interaction between race, ethnicity, and neighborhood SES in HCC prognosis is not well explored. This study evaluates the interaction between race and ethnicity and neighborhood SES on curative treatment utilization and overall survival among patients with HCC in the United States. We conducted a retrospective cohort study of 13,874 patients aged ≥65 years diagnosed with HCC from 2001 through 2015 using the Surveillance, Epidemiology, and End Results Medicare‐linked database. We performed multivariable logistic regression to examine the association between race, ethnicity, and curative treatment receipt across SES. We also evaluated the association between curative treatment receipt and overall survival using a Cox proportional hazards model. Among 13,874 patients, only 2,617 (18.9%) patients received curative treatment. Overall, Black patients had lower odds of receiving curative treatment than White patients (odds ratio [OR], 0.76; 95% confidence interval [CI], 0.64‐0.91). When stratified by neighborhood SES, Black patients living in high‐poverty neighborhoods had lower odds of curative treatment receipt (OR, 0.64; 95% CI, 0.49‐0.84) and worse survival (hazard ratio, 1.13; 95% CI, 1.02‐1.25). Conversely, Hispanic and Asian patients had similar curative treatment receipt compared to White patients across all socioeconomic levels. Conclusion: Disparities in curative treatment receipt and overall survival are pronounced between Black and White patients. Black–White disparities appear to be moderated by neighborhood SES and are particularly evident among those living in high‐poverty neighborhoods.https://doi.org/10.1002/hep4.1863 |
| spellingShingle | Nikita Sandeep Wagle Sulki Park David Washburn Robert L. Ohsfeldt Nicole E. Rich Amit G. Singal Hye‐Chung Kum Racial, Ethnic, and Socioeconomic Disparities in Curative Treatment Receipt and Survival in Hepatocellular Carcinoma Hepatology Communications |
| title | Racial, Ethnic, and Socioeconomic Disparities in Curative Treatment Receipt and Survival in Hepatocellular Carcinoma |
| title_full | Racial, Ethnic, and Socioeconomic Disparities in Curative Treatment Receipt and Survival in Hepatocellular Carcinoma |
| title_fullStr | Racial, Ethnic, and Socioeconomic Disparities in Curative Treatment Receipt and Survival in Hepatocellular Carcinoma |
| title_full_unstemmed | Racial, Ethnic, and Socioeconomic Disparities in Curative Treatment Receipt and Survival in Hepatocellular Carcinoma |
| title_short | Racial, Ethnic, and Socioeconomic Disparities in Curative Treatment Receipt and Survival in Hepatocellular Carcinoma |
| title_sort | racial ethnic and socioeconomic disparities in curative treatment receipt and survival in hepatocellular carcinoma |
| url | https://doi.org/10.1002/hep4.1863 |
| work_keys_str_mv | AT nikitasandeepwagle racialethnicandsocioeconomicdisparitiesincurativetreatmentreceiptandsurvivalinhepatocellularcarcinoma AT sulkipark racialethnicandsocioeconomicdisparitiesincurativetreatmentreceiptandsurvivalinhepatocellularcarcinoma AT davidwashburn racialethnicandsocioeconomicdisparitiesincurativetreatmentreceiptandsurvivalinhepatocellularcarcinoma AT robertlohsfeldt racialethnicandsocioeconomicdisparitiesincurativetreatmentreceiptandsurvivalinhepatocellularcarcinoma AT nicoleerich racialethnicandsocioeconomicdisparitiesincurativetreatmentreceiptandsurvivalinhepatocellularcarcinoma AT amitgsingal racialethnicandsocioeconomicdisparitiesincurativetreatmentreceiptandsurvivalinhepatocellularcarcinoma AT hyechungkum racialethnicandsocioeconomicdisparitiesincurativetreatmentreceiptandsurvivalinhepatocellularcarcinoma |