Abstract C084: Quantifying racial disparities in hepatocellular carcinoma: A comprehensive meta-analysis of survival and early presentation

Abstract

Abstract Background: Hepatocellular carcinoma (HCC) constitutes a significant burden on global cancer mortality, with distinct disparities in survival and early presentation observed across racial and ethnic groups. Despite previous research recognizing race as a critical prognostic factor in HCC, these studies have been limited by inconsistent findings and a lack of comprehensive, multi-population analysis. Given the diverse global demographics affected by HCC and the critical necessity of equitable healthcare, a detailed investigation of these disparities is crucial. Aim: Our study aimed to quantitatively synthesize existing literature on racial disparities in the early presentation and survival of HCC, comparing White patients to Black, Asian, and Hispanic groups. Methods: We searched PubMed, Embase, and Cochrane Library databases for studies published until May 2022 that reported racial disparities in HCC survival and early presentation. For early presentation, we employed relative risk (RR), and for survival outcomes, we utilized the hazard ratio (HR), applying random-effect models in both instances. All statistical analyses were conducted using R software (version 4.0.3) with metafor and meta packages. Results: Our search yielded 16 eligible studies, representing 241962 patients from various racial and ethnic backgrounds (172268 white, 33656 black, 12837 Hispanic, 23201 Asian). The pooled RR for early presentation was 0.89 (95% CI: 0.85-0.93, P<0.01, I2=58%) for Black, 1.01 (95% CI: 0.98-1.03, P=0.39, I2=0%) for Asian, and 0.96 (95% CI: 0.88-1.04, P=0.35, I2=77%) for Hispanic patients compared to White patients. These results suggest a lower rate of early presentation among Black and Hispanic patients, with no significant difference observed in the Asian cohort. The pooled HR for survival was 1.09 (95% CI: 1.06-1.12, P<0.01, I2=30%) for Black, 0.83 (95% CI: 0.75-0.92, P<0.01, I2=78%) for Asian, and 0.93 (95% CI: 0.89-0.98, P=0.02, I2=67%) for Hispanic patients compared to White patients. These findings point towards worse survival outcomes for Black patients and improved survival outcomes for Asian and Hispanic patients. Conclusion: This study underscores the significant racial disparities in HCC outcomes and early presentation, highlighting the need for targeted strategies to enhance health equity in HCC care. Future research should prioritize investigating the factors contributing to lower early presentation rates among Black and Hispanic populations and the varied survival outcomes across racial groups to inform the development of race-specific prevention, early detection, and treatment strategies. Citation Format: Muhammed Khaled Elfaituri, Ala Khaled. Quantifying racial disparities in hepatocellular carcinoma: A comprehensive meta-analysis of survival and early presentation [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr C084.