Healthcare disparities in Asians and Pacific Islanders with hepatocellular cancer.
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.
University of Hawaii Cancer Center, Honolulu, HI, USA. hepatoma@aol.com
Linda L
LL
Wong
Brenda
B
Hernandez
Sandi
S
Kwee
Cheryl L
CL
Albright
Gordon
G
Okimoto
Naoky
N
Tsai
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001213:Asian; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000208:ethnology* / Q000401:mortality / Q000601:surgery; D055088:Early Detection of Cancer / Q000706:statistics & numerical data; D005260:Female; D006254:Hawaii; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D054625:Healthcare Disparities / Q000208:ethnology* / Q000706:statistics & numerical data; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000208:ethnology* / Q000401:mortality / Q000601:surgery; D016031:Liver Transplantation / Q000208:ethnology / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D044468:Native Hawaiian or Pacific Islander; D012189:Retrospective Studies; D016019:Survival Analysis; D044465:White People