Abstract 717: Racial and ethnic disparities in presentations and survival rates of hepatocellular carcinoma
Authors: Song Jingwei , Song Eric , Gharavi Daniel 
Published: April 2023

Abstract
Background: Liver cancer is one of the leading causes of malignant tumor deaths worldwide and Hepatocellular Carcinoma (HCC) accounts for approximately 90% of all liver cancer cases.
Methods:We examined data from the Surveillance, Epidemiology and End Results (SEER)Medicare database to identify patients diagnosed with primary HCC between 2004 and 2017.. Demographics such as race, age of diagnosis, and clinical information, such as the survival status also were collected. The disease specific and relative five year survival rates and 95% confidence intervals were also calculated.
Results:Among the 79819 patients selected, 55,484 (69.5 %) of them were White, 9,956 (12.5%) were Black, 1,158 (1.4%) were American Indian/Alaska Native, and 13211 (16.6%) were Asian or Pacific Islander. The incident trends indicated that incidence had been gradually increased for white, black, and American Indian/Alaska Natives with near identical slopes until they flattened into a plateau in 2014 or 2015 (61.8 per million to 96.9 per million for White with a P&gt;0.05, and 93.9 per million to 135.1 per million for Black with a P&gt;0.05). After 2014/2015 the incidences slightly decreased for both White and Black without being statistically significant (P&gt;0.05). The pattern for the American Indian/Alaska Native population was also similar without statistical significance (P&gt;0.05), possibly due to the sample size. Although HCC incidence among the Asian or Pacific Islander populations were much higher than other races in 2004, it steadily decreased during the observation period,from 188.7 per million to 142.5 per million, which was close to the incidences of other races. Age disparity in HCC diagnosis also existed. For example, in the Asian or Pacific Islander HCC patients, 38.2% were patients older than 70. Whereas, this number was 16.8% in Black patients.Our research also indicated that the Asian or Pacific Islander category had the highest HCC five year cause specific survival rate (32.0% with 95% CI 31.0% to 32.9%) and also the highest five year relative survival rate (27.8% with 95% CI 26.9% to 28.7%), followed by White (24.0% with 95% CI 23.6% to 24.5% and 19.9% with 95% CI 19.5% to 20.3% respectively), American Indian/Alaskan Native (21.5% with 95% CI 18.6% to 24.5% and 16.0% with 95% CI 13.6% to 18.5%% respectively), and Black (20.9% with 95% CI 19.9% to 21.9% and 16.6 with 95% CI 15.7% to 17.5% respectively). The statistical significance could be observed as early as the 6 month follow-up.
Conclusion:From 2004 to 2017, the HCC incidence steadily decreased for the Asian or Pacific Islander category, but not for other races. Now, with more advanced treatments being available, Asian or Pacific Islander HCC patients also have the highest five year survival rates. American Indian/Alaskan Native and Black have the lowest five year survival rates. The HCC racial and ethnic disparities still exist after two decades since we launched Healthy People 2000.
Citation Format: Jingwei Song, Eric Song, Daniel Gharavi. Racial and ethnic disparities in presentations and survival rates of hepatocellular carcinoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 717.