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Tytuł pozycji:

Patients with hepatocellular carcinoma from more rural and lower-income households have more advanced tumor stage at diagnosis and significantly higher mortality.

Tytuł:
Patients with hepatocellular carcinoma from more rural and lower-income households have more advanced tumor stage at diagnosis and significantly higher mortality.
Autorzy:
Wong RJ; Division of Gastroenterology and Hepatology, Veterans Affairs Palo Alto Health Care System, Palo Alto, California.; Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, California.
Kim D; Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, California.
Ahmed A; Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, California.
Singal AK; Division of Gastroenterology and Hepatology, University of South Dakota, Sioux Falls, South Dakota.
Źródło:
Cancer [Cancer] 2021 Jan 01; Vol. 127 (1), pp. 45-55. Date of Electronic Publication: 2020 Oct 26.
Typ publikacji:
Journal Article
Język:
English
Imprint Name(s):
Publication: <2005- >: Hoboken, NJ : Wiley
Original Publication: New York [etc.] Published for the American Cancer Society by J. Wiley [etc.]
MeSH Terms:
Carcinoma, Hepatocellular/*epidemiology
Liver Neoplasms/*epidemiology
Adult ; Aged ; Carcinoma, Hepatocellular/mortality ; Humans ; Incidence ; Liver Neoplasms/mortality ; Male ; Middle Aged ; Neoplasm Staging ; Poverty ; Retrospective Studies ; Rural Population ; Young Adult
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Contributed Indexing:
Keywords: Surveillance, Epidemiology, and End Results (SEER); hepatocellular carcinoma; household income; mortality; rural
Entry Date(s):
Date Created: 20201026 Date Completed: 20210907 Latest Revision: 20230117
Update Code:
20240105
DOI:
10.1002/cncr.33211
PMID:
33103243
Czasopismo naukowe
Background: Patients from rural and low-income households may have suboptimal access to liver disease care, which may translate into worse HCC outcomes. The authors provide a comprehensive update of HCC incidence and outcomes among US adults, focusing on the effect of rural geography and household income on tumor stage and mortality.
Methods: The authors retrospectively evaluated adults with HCC using Surveillance, Epidemiology, and End Results data from 2004 to 2017. HCC incidence was reported per 100,000 persons and was compared using z-statistics. Tumor stage at diagnosis used the Surveillance, Epidemiology, and End Results staging system and was evaluated with multivariate logistic regression. HCC mortality was evaluated using Kaplan-Meier and multivariate Cox proportional hazards methods.
Results: HCC incidence plateaued for most groups, with the exception of American Indians/Alaska Natives (2004-2017: APC, 4.17%; P < .05) and patients in the lowest household income category (<$40,000; 2006-2017: APC, 2.80%; P < .05). Compared with patients who had HCC in large metropolitan areas with a population >1 million, patients in more rural regions had higher odds of advanced-stage HCC at diagnosis (odds ratio, 1.10; 95% CI, 1.00-1.20; P = .04) and higher mortality (hazard ratio, 1.05; 95% CI, 1.01-1.08; P = .02). Compared with the highest income group (≥$70,000), patients with HCC who earned <$40,000 annually had higher odds of advanced-stage HCC (odds ratio, 1.15; 95% CI, 1.01-1.32; P = .03) and higher mortality (hazard ratio, 1.23; 95% CI, 1.16-1.31; P < .001).
Conclusions: Patients from rural regions and lower-income households had more advanced tumor stage at diagnosis and significantly higher HCC mortality. These disparities likely reflect suboptimal access to consistent high-quality liver disease care, including HCC surveillance.
(© 2020 American Cancer Society.)

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