Racial disparities in the presentation of hepatocellular carcinoma in the population 65+ years in the United States.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 249-249
Author(s):  
Michael Ross Kaufman ◽  
David J. Delgado ◽  
Stephanie Costa ◽  
Brandon George ◽  
Edith P. Mitchell
Keyword(s):  
United States ◽  
Hepatocellular Carcinoma ◽  
Racial Disparities ◽  
Late Stage ◽  
The United States ◽  
Pacific Islanders ◽  
Stage Iii ◽  
Ajcc Stage ◽  
Asian Pacific Islanders ◽  
Asian Pacific

249 Background: Insufficient evidence exists regarding the presentation and management of elderly patients with hepatocellular carcinoma (HCC). The purpose of this study was to describe racial differences in cancer staging of elderly (65+) patients with HCC diagnosed in the United States. Methods: A retrospective cohort study was conducted using the 1973-2014 Surveillance, Epidemiology and End Results Program (SEER) database of the National Cancer Institute. Patients with primary hepatocellular carcinoma, diagnosed between 2004 and 2014, and with complete information on race, gender, year of diagnosis, age, marital status, region and stage at diagnosis (Derived SEER Summary Stage 2000, and Derived American Joint Committee on Cancer (AJCC) Stage Group, 6th Edition) were included. Descriptive statistics were used to compare sociodemographic and clinical variables with race. Univariate and multivariate logistic regressions were preformed to describe the association of race with the diagnosis of late stage HCC (Regional/Distant vs Localized Stage for SEER Summary Stage, and Stage III/IV vs Stage I/II for AJCC Stage Group). Results: The sample consisted of 19,902 HCC patients: 69.7% White, 9.2% Black, 20.2% API, 1.0% AI; 69.1% male; 45.1% diagnosed in 2004-2009; 56.2% age 65-74, 35.6% 75-84, and 8.2% 85 and older; 58.3% married; 7.4% Midwest, 12.4% Northeast, 17.0% Southeast, 63.2% Pacific West; 44.9% Regional/Distant Stage (SEER Summary Stage) and 41.2% Stage III/IV (AJCC Stage Group). After controlling for confounding variables, Asian/Pacific Islanders had a decreased odds of presenting with late stage disease relative to whites in both the SEER Summary Stage (OR: 0.867, CI:0.805-0.934) and AJCC Stage Group (OR: 0.904, CI:0.838-0.975). Conclusions: Racial disparities exist at the presentation of HCC in the 65+ population. Asian/Pacific Islanders are less likely to be diagnosed with late stage HCC compared to whites. There is a need to study further these relationships in subpopulations.

Racial disparities and treatment outcomes among patients admitted with a diagnosis of colorectal cancer: Analysis of the 2014 national inpatient sample database.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 529-529
Author(s):  
Ikponmwosa Enofe ◽  
Manoj P. Rai ◽  
Osamuyimen Osaghae
Keyword(s):  
Colorectal Cancer ◽  
United States ◽  
Cancer Treatment ◽  
Racial Disparities ◽  
The United States ◽  
Pacific Islanders ◽  
National Inpatient Sample ◽  
Asian Pacific Islanders ◽  
Asian Pacific ◽  
Colorectal Cancer Treatment

529 Background: Colorectal cancer is the fourth most common cancer in the United states and the second most common cause of death. Despite universal advocacy for screening colonoscopies and early diagnosis, racial disparities in screening and diagnosis of colorectal cancer exist and affect patients outcomes. In this analysis we determine racial disparities and treatment outcomes for colorectal cancer treatment in the United States. Methods: We performed a retrospective analysis of the National Inpatient Sample 2014 Database (HCUP_NIS) which contains records of all hospital discharges in the United States Patients 18 years and older with a diagnosis of colorectal cancer were identified by their ICD 9 codes along with treatment they had for colorectal cancer. We then used multivariable regression to identify the effect of race on receiving a therapeutic procedure (open surgical, laparoscopic or robotic) during hospitalization and outcomes as it relates to inpatient mortality. We adjusted for patients age, sex, number of comorbidities (elixhauser comorbidity score), insurance type, and hospital level charactertistics (i.e. size, teaching status) and location (urban and rural location). Results: There were 25,749 discharge diagnosis of colorectal cancer in the United States in 2014 of which 19,300 were associated with undergoing a procedure for colorectal cancer treatment. Whites accounted for the majority of colorectal cancer admissions (65%) while blacks 11.4 %, Hispanics 8.0%, Asian/Pacific Islanders 3.2 %, and Native Americans 0.4%. Blacks had the lowest frequency of procedure related admissions and were less likely to undergo a therapeutic procedure relating to colorectal cancer treatment (67.5 vs. 76.6 OR 0.84 CI 0.75 - 0.93) compared to whites. For specific procedures, blacks (OR 0.81, CI 0.72-0.91) and Hispanics (OR 0.85, CI 0.74-0.98) had a significantly lesser odds of undergoing open surgical procedures when compared to whites but were similarly likely (Blacks OR 0.93, CI 0.81-1.05, Hispanics OR 0.84, CI 0.61-1.14) to undergo laparoscopic/robotic surgical procedure. On multivariable analysis, Asian/Pacific Islanders had a significantly higher mortality (OR 1.61 CI 1.01-2.60) for non-procedure related colorectal cancer admissions. However, this increase mortality was not seen in procedure related colorectal cancer admissions. Overall, after adjusting for potential confounders and treatment, there was no significant variation amongst different races for colorectal cancer mortality in patients admitted to the hospital. Conclusions: Among patients with colorectal cancer there was no procedure related mortality differences between various races. However, for some reason Asian/Pacific Islanders had a significantly higher mortality for non-procedure related colorectal cancer admissions. Further studies are warranted to understand the above findings.

scholarly journals Acculturative heterogeneity among Asian/Pacific Islanders in the United States: Associations with DSM mental and substance use disorders.

2015 ◽  
Vol 85 (4) ◽  
pp. 362-370 ◽  
Author(s):  
Christopher P. Salas-Wright ◽  
Sharon Lee ◽  
Michael G. Vaughn ◽  
Yuri Jang ◽  
Cindy C. Sanglang
Keyword(s):  
United States ◽  
Substance Use ◽  
Substance Use Disorders ◽  
The United States ◽  
Pacific Islanders ◽  
Asian Pacific Islanders ◽  
Asian Pacific

Racial disparities in the initial treatment of hepatocellular carcinoma in the population 65+ years in the United States.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 431-431
Author(s):  
Stephanie Costa ◽  
David J. Delgado ◽  
Michael Ross Kaufman ◽  
Brandon George ◽  
Edith P. Mitchell
Keyword(s):  
United States ◽  
Hepatocellular Carcinoma ◽  
African American ◽  
Racial Disparities ◽  
Initial Treatment ◽  
The United States ◽  
Asian Pacific Islander ◽  
Receive Treatment ◽  
Asian Pacific ◽  
To Receive

431 Background: Insufficient evidence exists regarding the initial management of elderly patients with hepatocellular carcinoma (HCC). The purpose of this study was to describe racial differences in initial treatment of 65+ year old patients with HCC diagnosed in the United States (2004-2014). Methods: A retrospective cohort study was conducted using the 1973-2014 Surveillance, Epidemiology and End Results Program (SEER) database of the National Cancer Institute. Patients with primary hepatocellular carcinoma, diagnosed between 2004 and 2014, and with complete information on race, gender, year of diagnosis, age, marital status, region, tumor status at diagnosis and initial treatment were included. Descriptive statistics were used to compare race with sociodemographic and clinical variables. Univariate and multivariate logistic regressions were performed to describe the association of race with receiving any treatment for HCC (local hepatic therapy and surgical treatment versus no treatment). Results: The sample consisted of 25,499 HCC patients: 70.0% White, 9.1% Black, 19.8% API, 1.0% AI; 68.6% male; 46.8% diagnosed in 2004-2009; 54.8% age 65-74, 45.2% 75 and older; 54.7% married, 7.3% Midwest, 13.8% Northeast, 15.7% Southeast; 81.3% first malignant primary indicator, 13.8% metastasis, 49.3% localized site, and 20.9% receiving initial treatment. After controlling for confounding variables, as compared to White patients, African American patients (OR:0.739 95% CI:0.652, 0.839) had decreased odds of receiving initial treatment; and Asian/Pacific Islander patients (OR:1.490 95% CI:1.371,1.618) had increased odds of receiving initial treatment. Conclusions: Racial disparities exist at the presentation of HCC in the 65+ population. African American patients are less likely to receive treatment and Asian/Pacific Islander patients are more likely to receive treatment. Further research is needed to understand these relationships in subpopulations.

Trends and presentation patterns of acute rheumatic fever hospitalisations in the United States

2019 ◽  
Vol 29 (11) ◽  
pp. 1387-1390
Author(s):  
Tyler Bradley-Hewitt ◽  
Chris T. Longenecker ◽  
Vuyisile Nkomo ◽  
Whitney Osborne ◽  
Craig Sable ◽  
...  
Keyword(s):  
United States ◽  
Length Of Stay ◽  
Rheumatic Fever ◽  
Private Insurance ◽  
Case Fatality ◽  
The United States ◽  
Hospital Charges ◽  
The South ◽  
Asian Pacific Islanders ◽  
Asian Pacific

AbstractObjective:Rheumatic fever, an immune sequela of untreated streptococcal infections, is an important contributor to global cardiovascular disease. The goal of this study was to describe trends, characteristics, and cost burden of children discharged from hospitals with a diagnosis of RF from 2000 to 2012 within the United States.Methods:Using the Kids’ Inpatient Database, we examined characteristics of children discharged from hospitals with the diagnosis of rheumatic fever over time including: overall hospitalisation rates, age, gender, race/ethnicity, regional differences, payer type, length of stay, and charges.Results:The estimated national cumulative incidence of rheumatic fever in the United States between 2000 and 2012 was 0.61 cases per 100,000 children. The median age was 10 years, with hospitalisations significantly more common among children aged 6–11 years. Rheumatic fever hospitalisations among Asian/Pacific Islanders were significantly over-represented. The proportion of rheumatic fever hospitalisations was greater in the Northeast and less in the South, although the highest number of rheumatic fever admissions occurred in the South. Expected payer type was more likely to be private insurance, and the median total hospital charges (adjusted for inflation to 2012 dollars) were $16,000 (interquartile range: $8900–31,200). Median length of stay was 3 days, and the case fatality ratio for RF in the United States was 0.4%.Conclusions:Rheumatic fever persists in the United States with an overall downwards trend between 2003 and 2012. Rheumatic fever admissions varied considerably based on age group, region, and origin.

Racial Disparities in Inhospital Outcomes for Hepatocellular Carcinoma in the United States

2016 ◽  
Vol 91 (9) ◽  
pp. 1173-1182 ◽  
Author(s):  
Ruma Rajbhandari ◽  
Rachel E. Simon ◽  
Raymond T. Chung ◽  
Ashwin N. Ananthakrishnan
Keyword(s):  
United States ◽  
Hepatocellular Carcinoma ◽  
Racial Disparities ◽  
The United States

scholarly journals Racial disparities in pedestrian-related injury hospitalizations in the United States

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Cara Hamann ◽  
Corinne Peek-Asa ◽  
Brandon Butcher
Keyword(s):  
United States ◽  
Length Of Stay ◽  
Racial Disparities ◽  
The United States ◽  
Pacific Islanders ◽  
Admission Rates ◽  
Pedestrian Injury ◽  
Race Ethnicity ◽  
Per Capita ◽  
Pedestrian Injuries

Abstract Background Racial/ethnic disparity has been documented in a wide variety of health outcomes, and environmental components are contributors. For example, food deserts have been tied to obesity rates. Pedestrian injuries are strongly tied to environmental factors, yet no studies have examined racial disparity in pedestrian injury rates. We examine a nationally-representative sample of pedestrian-related hospitalizations in the United States to identify differences in incidence, severity, and cost by race/ethnicity. Methods Patients with ICD diagnosis E-codes for pedestrian injuries were drawn from the United States Nationwide Inpatient Sample (2009–2016). Rates were calculated using the United States Census. Descriptive statistics and generalized linear regression were used to examine characteristics (age, sex, severity of illness, mortality rates, hospital admissions, length of stay, total costs) associated with hospitalizations for pedestrian injuries. Results The annual average of pedestrian-related deaths exceeded 5000 per year and hospitalizations exceeded 47,000 admissions per year. The burden of injury from pedestrian-related hospitalizations was higher among Black, Hispanic, and Multiracial/Other groups in terms of admission rates, costs per capita, proportion of children injured, and length of stay compared to Whites and Asian or Pacific Islander race/ethnicities. Compared to Whites, hospital admission rates were 1.92 (95% CI: 1.89–1.94) and 1.20 (95% CI: 1.19–1.21) times higher for Multiracial/Other and Blacks, respectively. Costs per capita ($USD) were $6.30, $4.14, and $3.22 for Multiracial/Others, Blacks, and Hispanics, compared to $2.88 and $2.32 for Whites and Asian or Pacific Islanders. Proportion of lengths of stay exceeding one week were larger for Blacks (26.4%), Hispanics (22.6%), Asian or Pacific Islanders (23.1%), and Multiracial/Other (24.1%), compared to Whites (18.6%). Extreme and major loss of function proportions were also highest among Black (34.5%) and lowest among Whites (30.2%). Conclusions Results from this study show racial disparities in pedestrian injury hospitalization rates and outcomes, particularly among Black, Hispanic, and Multiracial/Other race/ethnicity groups and support population and system-level approaches to prevention. Access to transportation is an indicator for health disparity, and these results indicate that access to safe transportation also shows inequity by race/ethnicity.

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