Title: Ethnicity as a predictive factor for hepatocellular carcinoma screening among patients in Hawaii
Country: United States
Age: Adult Only
Sex: All Sexes
Population: Multiple Groups
Care Setting: Outpatient Ambulatory and Primary Care
Clinical Setting: Other: Cancer Screening
Data Level: State
Data Type: EHR
Data Source: Local data
Conclusion: Disparities In Some Minority Groups
Health OutComes Reported: No
Free Text Conclusion: Some Asian ethnic minority groups less likely than White or Korean patients to get HCC screening.
Abstract: Objectives: Although hepatocellular carcino ma (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. Design, Setting, Patients: 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. Main Outcome Measures: 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.