953 Race/Ethnicity-Specific Disparities in Cancer Incidence, Burden of Disease, and Overall Survival Among Patients With Hepatocellular Carcinoma in the U.S.: An Updated Analysis of the Surveillance, Epidemiology, and End Results Cancer Registry

Abstract

Background: Hepatocellular carcinoma (HCC) is a leading cause of cancer-related deaths in the U.S. The aging population coupled with the rising incidence of HCC will result in an emerging cohort of older patients with HCC needing treatment. Understanding the agespecific epidemiology and long term outcomes among HCC patients will help guide effective management among this cohort. Our study aims to evaluate age-specific HCC incidence, burden of disease, treatment rates, and overall survival outcomes. Methods: We retrospectively evaluated all U.S. adults with HCC using population-based cancer registry data from the 2003 2011 Surveillance, Epidemiology, and End Results database. Age-specific analyses utilized four age groups ( 70 years old). Age-specific disparities in stage of disease at presentation and HCC treatment were evaluated using multivariate logistic regression models. Age-specific disparities in overall survival were calculated using Kaplan Meier methods and multivariate Cox proportional hazards models (adjusted for age, sex, race/ethnicity, stage of disease, year of diagnosis, and treatment received). Results: Overall, the highest HCC incidence was seen among patients > 70 years old, nearly double that of patients 50-59 years old (28.4 vs. 16.2 per 100,000/year, p 70 years old: 28.4 per 100,000/year in men vs. 18.0 per 100,000/year in women, p 70 years old were significantly more likely to have localized disease at time of diagnosis (OR, 0.87; 95% CI, 0.79-0.96, p=0.01). Older age was also associated with significantly lower rates of receiving HCC treatment. Even after adjusting for stage of disease, patients > 70 years old were significantly less likely to receive any HCC treatment compared to patients 70 years old had significantly lower 5-year survival (HR, 1.22; 95% CI, 1.14-1.31, p 70 years old were more likely to have localized disease at presentation, but significantly less likely to receive any HCC treatment, and thus had significantly lower overall survival. Understanding age-specific disparities in HCC epidemiology and outcomes will be especially important given the increasing age of HCC patients in the U.S.