African Americans are less likely to receive curative treatment for hepatocellular carcinoma

AIM To determine if racial disparities continue to exist in the treatment of hepatocellular carcinoma(HCC).METHODS A retrospective database analysis using the Nationwide Inpatient Sample was performed including patients with a primary diagnosis of HCC. Univariate and multivariate analyses were utilized to determine racial disparities in liver decompensation, treatment, inpatient mortality, and metastatic disease.RESULTS A total of 62604 patients with HCC were included consisting of 32428 Caucasian, 9726 African-American, 8988 Hispanic, and 11462 patients of other races. Caucasian patients were more likely to undergo curative therapies of liver transplant(OR: 2.66, 95%CI: 1.92-3.68), resection(OR: 1.82, 95%CI: 1.48-2.23), and ablation(OR: 1.77, 95%CI: 1.36-2.30) than African-American patients. Hispanic patients were more likely to undergo transplant(OR: 2.18, 95%CI: 1.40-3.39) and ablation(OR: 1.46, 95%CI:1.05-2.03) than African-American patients. Patients of other races were more likely to receive a liver transplant(OR: 2.41, 95%CI: 1.62-3.61), resection(OR: 1.79 95%CI: 1.39-2.32), and ablation(OR: 2.03, 95%CI: 1.47-2.80) than African-American patients. There are no differences in the rates of transarterial chemoembolization between races.CONCLUSION Racial disparities in HCC treatment exist despite emphasis to support equality in healthcare. African-American patients are less likely to undergo curative treatments for HCC.