title: Ethnicity as a predictive factor for hepatocellular carcinoma screening among patients in Hawaii.
abstract: OBJECTIVE
  Although hepatocellular carcinoma (HCC) surveillance is associated with mortality reduction, it continues to be underutilized. The failure to conduct screening tests is a significant factor in the late diagnosis of hepatocellular carcinoma when curative interventions may not be feasible. Reasons for these low surveillance rates are unclear and need to be elucidated.
  
  
  METHODS
  This retrospective study reviewed 616 cases of HCC from a hepatobiliary surgery office in Hawaii for age, sex, ethnicity, birthplace, residence, education, employment, insurance, and obesity to determine their influence on HCC screening.
  
  
  METHODS
  HCC screening.
  
  
  RESULTS
  Of the 616 cases, only 132 patients (21.4%) had undergone screening. Although the majority of patients were male, those who were screened were more likely to be female (P = .0082). However, multivariate analysis found ethnicity to be the sole determinant of screening (P < .0005). Koreans were more likely than Whites to have had screening, whereas Japanese, Pacific Islanders, and Filipinos were less likely. Age > 60 years, sex, American birthplace, urban residence, high school completion, employment status, insurance, and BMI > 35 kg/m2 were not predictors of screening.
  
  
  CONCLUSIONS
  Of the sociodemographic factors, ethnicity was important in predicting screening. Further research is needed to understand the reasons for these ethnic differences and to develop targeted interventions to improve hepatocellular carcinoma surveillance utilization rates.
authors: Catherine L
authors: CL
authors: Ly
authors: Linda L
authors: LL
authors: Wong
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000208:ethnology*; D005006:Ethnicity; D005260:Female; D006254:Hawaii; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000208:ethnology*; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D011159:Population Surveillance; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult