Hepatocellular Carcinoma in Pacific Islanders vs. Whites

Area of Science:

• Hepatology
• Oncology
• Epidemiology

Background:

• Pacific Islanders (PI) exhibit high rates of hepatocellular carcinoma (HCC).
• Limited large-scale studies exist for HCC in this demographic.
• Understanding treatment and outcome disparities is critical.

Purpose of the Study:

• To compare HCC treatment and outcomes between Pacific Islanders and Whites.
• To identify demographic and clinical factors influencing disparities.
• To inform targeted interventions for HCC in PI populations.

Main Methods:

• Retrospective analysis of 1608 HCC patients (252 PI, 338 White) from 1993-2022.
• Data collected: demographics, medical history, labs, tumor characteristics, treatment, survival.
• Statistical analyses included chi-square, t-test, logistic regression, and Kaplan-Meier survival analysis.

Main Results:

• PIs were younger, less educated, and more likely to be HBV-infected with metabolic comorbidities.
• Whites had higher rates of Hepatitis C, cirrhosis, and high-risk behaviors.
• PIs were diagnosed less often through screening, presenting with larger, more advanced tumors.
• Treatment rates, including surgical, were similar; survival was comparable between groups.

Conclusions:

• Disparities in HCC screening and presentation in PIs are linked to high rates of occult Hepatitis B (HBV) infection.
• Initiatives should focus on expanding viral hepatitis screening and addressing care delivery barriers for PIs.
• Improving early diagnosis and access to care can enhance HCC outcomes in Pacific Islander populations.