The Progression of Cirrhosis to Hepatocellular Carcinoma (HCC) in Hispanic and Non-Hispanic Patients at a Tertiary Care Center

Abstract

Introduction: HCC affects approximately half a million persons worldwide. It is the 6th most frequently occurring cancer in the world, and the second most common cause of cancer-related mortality. The incidence of HCC has nearly tripled over the past 2 decades, and the fastest rise in the incidence of HCC has been observed in Hispanic men and women followed by non-Hispanic Caucasians and African Americans. The aim of our study is to compare the rate of progression to HCC in Hispanics and non-Hispanic patients with cirrhosis. Methods: We performed a retrospective study at a tertiary regional hospital where we collected data from 1999 to 2014. We analyzed 73 Hispanics and 70 non-Hispanic patients ages 21-97 years who had cirrhosis and developed HCC. Results: Of the 143 patients analyzed, the most common underlying liver disease was hepatitis C (74% Hispanics and 73% non-Hispanics), followed by alcoholic liver disease (43.8% Hispanics vs 21.4% non-Hispanics) followed by NASH (9.59% Hispanics vs 10% non-Hispanics). The mean age at the time of cirrhosis diagnosis for Hispanics and non-Hispanics was 52.4 (95% CL 49.8-55.1 years) and 53.2 (95% CL 50.2-56.3 years), respectively (Fig 1). The mean age at diagnosis of HCC for Hispanics vs non-Hispanics was 57.5 (95% CL 55.3-59.6 years) vs 61.2 (95% CL 58.9-63.6 years), respectively (Fig 2). The mean MELD score for Hispanics vs non-Hispanics was 13.4 (95% CL 12.2-14.6) vs 11.5 (95% CL 10.1-12.8), respectively (Fig 3). Hispanics on average were 3.8 years younger than non-Hispanics when diagnosed with HCC (p=0.02). On average Hispanics were found to have a 1.97 higher MELD score than non-Hispanics at the time that HCC was diagnosed (p=0.03).Figure 1Figure 2Figure 3Conclusion: Hispanics are diagnosed with HCC at an earlier age than non-Hispanics and therefore may need to be monitored more closely with frequent screenings and earlier intervention. Another study looking closely at the Hispanic population may be warranted to further evaluate this difference in age of diagnosis.