Ajayi Faith, Jan Jenny, Singal Amit G, Rich Nicole E
Division of Digestive and Liver Diseases, Department of Internal Medicine.
Harold C. Simmons Comprehensive Cancer Center.
Curr Hepatol Rep. 2020 Dec;19(4):462-469. doi: 10.1007/s11901-020-00554-6. Epub 2020 Nov 12.
In this review, we aim to provide a summary of the current literature on race and gender disparities in hepatocellular carcinoma (HCC) incidence, stage at diagnosis, treatment and prognosis in the United States.
HCC incidence rates are rising in the U.S. in all racial/ethnic groups except for Asian/Pacific Islanders, with disproportionate rises and the highest rates among Hispanics compared to Blacks and non-Hispanic whites. There are striking sex disparities in HCC incidence and mortality; however, with the shifting epidemiology of HCC risk factors in the U.S, there is recent evidence that HCC is trending towards less male predominance, particularly among younger birth cohorts. Despite significant advances in HCC treatment over the past decade, disparities in HCC surveillance and treatment receipt persist among racial and ethnic minorities and the socioeconomically disadvantaged. Black patients continue to experience worse survival outcomes than non-Black patients with HCC.
There are significant racial and gender disparities in HCC incidence, treatment, and mortality in the U.S. Though these disparities are well-documented, data are still limited on the specific determinants driving disparities in HCC. To achieve health equity for all patients with HCC, we must advance beyond simply reporting on disparities and begin implementing targeted interventions to eliminate disparities.
在本综述中,我们旨在总结美国目前关于肝细胞癌(HCC)发病率、诊断分期、治疗及预后方面种族和性别差异的文献。
在美国,除亚裔/太平洋岛民外,所有种族/族裔群体的HCC发病率均在上升,其中西班牙裔的上升幅度不成比例且发病率高于黑人和非西班牙裔白人。HCC发病率和死亡率存在显著的性别差异;然而,随着美国HCC危险因素流行病学的变化,最近有证据表明HCC的男性主导趋势有所减弱,尤其是在年轻出生队列中。尽管在过去十年中HCC治疗取得了重大进展,但种族和族裔少数群体以及社会经济弱势群体在HCC监测和治疗接受方面的差异仍然存在。黑人HCC患者的生存结果仍比非黑人患者差。
在美国,HCC发病率、治疗和死亡率存在显著的种族和性别差异。尽管这些差异有充分记录,但关于导致HCC差异的具体决定因素的数据仍然有限。为了实现所有HCC患者的健康公平,我们必须超越简单地报告差异,开始实施有针对性的干预措施以消除差异。