Comparison of Hispanic and non-Hispanic patients with HCC.

Abstract

294 Background: In the U.S., Hispanics have a higher incidence of hepatocellular cancer (HCC) and higher disease-specific mortality. The country of origin for Hispanics varies throughout the U.S. However, little is known about Hispanics with HCC in the Northeast. We compared Hispanic and non-Hispanic patients with HCC at a Boston teaching hospital. Methods: Hispanic patients with HCC seen at Beth Israel Deaconess Medical Center (BIDMC) from 1998-2012 were identified in our database. Ethnicity was determined from demographic and language preference information in electronic medical records and supplemented by comparing surnames with the 1990 Census Spanish Surname List. The comparison group was identified by randomly choosing non-Hispanic patients diagnosed the same years as Hispanic patients. We compared both groups using Chi Squared test. Results: 59 Hispanic and 89 non-Hispanic patients with HCC were included in the analysis. The majority (48%) of Hispanic HCC patients were Puerto Rican. Although the median age at diagnosis was similar (59.1 vs 60.3 years for Hispanics and non-Hispanics), there were more women in the Hispanic cohort (28.8% vs 12.4% p0.012). Hispanics had greater odds of not having private insurance (OR 4.24, 95%CI: 2.101, 8.554). Evaluation of HCC risk factors revealed Hispanics were significantly more likely to have hepatitis C (OR 3.68, 95% CI: 1.830, 7.420). In addition, the incidence of Metabolic Syndrome was significantly higher for Hispanics (44.7% vs. 21.7% p0.025). Although individual components of metabolic syndrome were higher in Hispanics, they were not statistically significant: hypertension (52.5% vs 40.4%), Diabetes Mellitus (39% vs 25%), BMI ≥ 30 (39% vs 27%), hypertrigylceridemia (57% vs 52%) and low HDL levels (50% vs 41%). Hispanics were more likely to have received Transarterial Chemoembolization (TACE) and Radiofrequency ablation (RFA) treatments (OR 2.48, 95% CI: 1.261, 4.858). Conclusions: Hispanic HCC patients at BIDMC were more likely to have hepatitis C, metabolic syndrome and to be female than their non-Hispanic counterparts. Outreach to Hispanic communities to identify patients with hepatitis C and metabolic syndrome, particularly in women, may improve HCC prevention, screening and treatment outcomes.