Department of Internal Medicine, UT Southwestern Medical Center, Parkland Health & Hospital System, Dallas, Texas.
Department of Internal Medicine, University of Miami, Sylvester Comprehensive Cancer Center, Miami, Florida.
Clin Gastroenterol Hepatol. 2023 Apr;21(4):1094-1096.e2. doi: 10.1016/j.cgh.2021.12.027. Epub 2021 Dec 26.
Hepatocellular carcinoma (HCC) is a leading cause of death in patients with cirrhosis and has a rising mortality rate in the United States. Racial and ethnic minorities experience a disproportionate burden of HCC, including higher incidence rates, more late-stage diagnoses, and worse survival. These disparities are complex in nature and can be attributed to many proximal, intermediate, and distal determinants, such as health literacy and behaviors, social support, social needs, social determinants of health, and access to health care. Prior studies have identified racial and ethnic differences in clinical factors, including receipt of HCC surveillance and tumor stage; however, few studies have examined differences in patient-reported barriers that may partly explain observed disparities. Understanding these data is essential to inform interventions to address and mitigate disparities. Therefore, we described patient-reported barriers to medical care and examined differences in barriers by race and ethnicity in a large, diverse population of patients newly diagnosed with HCC.
肝细胞癌 (HCC) 是肝硬化患者死亡的主要原因，其死亡率在美国呈上升趋势。少数族裔承受着 HCC 的不成比例的负担，包括更高的发病率、更晚期的诊断和更差的生存率。这些差异本质上很复杂，可以归因于许多近端、中间和远端决定因素，如健康素养和行为、社会支持、社会需求、健康的社会决定因素和获得医疗保健的机会。先前的研究已经确定了临床因素中的种族和民族差异，包括 HCC 监测的接受情况和肿瘤分期；然而，很少有研究检查可能部分解释观察到的差异的患者报告的障碍的差异。了解这些数据对于为解决和减轻差异提供信息的干预措施至关重要。因此，我们描述了新诊断为 HCC 的大量不同人群的患者报告的医疗保健障碍，并检查了种族和民族之间障碍的差异。
