Adult African Americans undergoing cadaveric liver transplantation for hepatocellular carcinoma within the Milan criteria have the lowest 5-year survival among all the ethnic groups in the United States: analysis of USA national data between January 2002

Abstract Abstract 2492 Poster Board II-469 Objective: Understanding the overall prevalence of VTE is paramount in estimating the burden of illness associated with this disease. This study aims to assess the number of VTE cases in the United States across ethnic groups based on recent data. Methods: Data from the Marketscan® Medicaid database from Thomson Reuters (Jan 2002–Dec 2005) were extracted for patients aged ≥18 years. Patients were evaluated for VTE in each year, defined by the presence of a VTE diagnosis on an inpatient claim or on ≥1 outpatient claim with evidence of anticoagulant administration. Age-, sex- and race-specific VTE prevalence rates were derived by dividing the number of VTE cases identified by the number of individuals in the underlying MarketScan populations during that time. These rates were then multiplied by 100,000 to obtain a VTE prevalence rate per 100,000. Results: In 2002, there were 276 individuals with evidence of VTE per 100,000 plan enrollees. In 2005, that number grew to 358, a 30% increase. African American males had the highest overall observed prevalence rate of 584 per 100,000 enrollees in 2002, growing to 785 in 2005 (Table). Caucasian males had the next highest observed prevalence at 457 per 100,000 enrollees in 2002, growing to 643 per 100,000 in 2005. Females generally had lower observed prevalence of VTE than males, although Hispanic females had similar prevalence's to Hispanic males (94 vs 93 in 2002, 149 vs 154 in 2005). Following multivariate adjustment for comorbidities and conditions known to be strong risk factors associated with developing VTE, African Americans were at significantly increased risk for VTE than Caucasians (Odds Ratio 1.04, 95% CI 1.00–1.07, p<0.05). Conclusions: VTE prevalence increased during the study period for the overall US Medicaid population. African Americans had the highest rate of VTE, followed by Caucasians and Hispanics. There is a need for improved VTE awareness and prevention across all ethnic groups. Disclosures: Deitelzweig: sanofi-aventis: Honoraria, Research Funding, Speakers Bureau, The authors received editorial/writing support in the preparation of this abstract funded by sanofi-aventis U.S., Inc.; Bristol-Myers Squibb: Honoraria, Research Funding, Speakers Bureau; Scios: Honoraria, Research Funding, Speakers Bureau; Pfizer: Speakers Bureau. Lin:sanofi-aventis: Employment. Johnson:sanofi-aventis: Research Funding. Schulman:sanofi-aventis: Research Funding.

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Racial disparities in outcome among head and neck cancer patients in the United States: An analysis using SEER-Medicare linked database.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.6051 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. 6051-6051 ◽

Cited By ~ 3

Author(s):

Ikumi Suzuki ◽

Kevin J. Cullen ◽

Ranee Mehra ◽

Søren Bentzen ◽

Olga G. Goloubeva

Keyword(s):

United States ◽

Overall Survival ◽

Head And Neck Cancer ◽

African Americans ◽

Oral Cavity ◽

Head And Neck ◽

Cancer Patients ◽

Ethnic Groups ◽

Neck Cancer ◽

The United States

6051 Background: Despite overall decline in cancer mortality, African Americans suffer from higher mortality in most cancer types including cancers of the head and neck. These differences likely result from a complex interplay of clinical and non-clinical factors. We aim to estimate disparities in overall survival across racial groups in HNSCC in the United States. Methods: This study used SEER-Medicare linked database. We identified all patients aged 66 years or older diagnosed with HNSCC as their first cancer from 1992 to 2011. We excluded those in HMO, diagnosed by death certificate or autopsy, non-SCC, unknown race, and missing month and/or year of diagnosis. Further exclusions included metastatic disease, salivary gland cancers, receiving no treatment in the first 180 days, and unknown stage. Analytic data set included oropharynx, oral cavity, nasopharynx, hypopharynx, and larynx. Primary treatment was defined as any treatment modality received within 180 days after diagnosis. Overall survival (OS) parameters were estimated across ethnic groups by the Cox regression model stratified by site and stage of cancer at diagnosis, adjusted for clinical and demographic characteristics, and propensity score weighted. Results: Our study population included 15, 547 patients. Median OS was 3.5 years (95% CI: 3.4-3.7) across all ethnic groups. African Americans (AA) had inferior outcome with median OS of 2.0 years (95% CI: 1.9-2.3) compared to 3.7 years (95% CI: 3.6-3.8) for Caucasian Americans (CA) (p < 0.0001). This difference was seen despite AA patients receiving comparable treatments and presenting at similar stage of disease, except for cancers of the oral cavity where AA were more likely to present with advanced disease (67% versus 47%; P < 0.001). The difference was most pronounced in the oropharynx where median OS was 1.9 years (95% CI: 1.7-2.1) for AA and 3.8 years (95% CI: 3.5-4.1) in CA (P < 0.0001). AA also had consistently worse OS over time from 1992 to 2011. This study clearly demonstrated AA have inferior outcomes despite similar treatments, comorbidities, age at diagnosis, stage at presentation, tumor location, year of diagnosis and sex. Conclusions: The current study demonstrates inferior overall survival for African American head and neck cancer patients independent of primary site and treatment modalities.

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The Impact of Liver Transplantation on Hepatocellular Carcinoma Mortality in the United States

Cancer Epidemiology Biomarkers & Prevention ◽

10.1158/1055-9965.epi-20-1188 ◽

2020 ◽

pp. cebp.1188.2020

Author(s):

Parag Mahale ◽

Meredith S. Shiels ◽

Charles F. Lynch ◽

Srinath Chinnakotla ◽

Linda L Wong ◽

...

Keyword(s):

United States ◽

Hepatocellular Carcinoma ◽

Liver Transplantation ◽

The United States ◽

The Impact

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How do older people describe others with cognitive impairment? A multiethnic study in the United States

Ageing and Society ◽

10.1017/s0144686x11001255 ◽

2012 ◽

Vol 33 (3) ◽

pp. 369-392 ◽

Cited By ~ 15

Author(s):

SARAH B. LADITKA ◽

JAMES N. LADITKA ◽

RUI LIU ◽

ANNA E. PRICE ◽

DANIELA B. FRIEDMAN ◽

...

Keyword(s):

United States ◽

Cognitive Impairment ◽

African Americans ◽

Older People ◽

Ethnic Groups ◽

American Indians ◽

Chinese Americans ◽

The United States ◽

Vietnamese Americans ◽

Cognitive Health

ABSTRACTWe studied how older people describe others with cognitive impairment. Forty-two focus groups represented African Americans, American Indians, Chinese Americans, Latinos, Vietnamese Americans, and Whites other than Latinos (Whites) (N = 396, ages 50+), in nine locations in the United States of America. Axial coding connected categories and identified themes. The constant comparison method compared themes across ethnic groups. African Americans, American Indians and Whites emphasised memory loss. African Americans, American Indians, Latinos and Whites stressed withdrawal, isolation and repetitive speech. African Americans, American Indians, Vietnamese Americans and Whites emphasised ‘slow thinking’. Only Whites described mood swings and personality changes. Many participants attributed dementia to stress. Terms describing others with dementia included ‘Alzheimer's’, ‘dementia’, ‘senile’ and ‘crazy’. Euphemisms were common (‘senior moment’, ‘old timer's disease’). Responses focused on memory, with limited mention of other cognitive functions. Differences among ethnic groups in descriptions of cognitive health and cognitive impairment underscore the need to tailor public health messages about cognitive health to ways that people construe its loss, and to their interest in maintaining it, so that messages and terms used are familiar, understandable and relevant to the groups for which they are designed. Health promotion efforts should develop ethnically sensitive ways to address the widely held misperception that even serious cognitive impairment is a normal characteristic of ageing and also to address stigma associated with cognitive impairment.

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Significantly Higher Mortality Following Liver Transplantation Among Patients Aged 70 Years and Older

Progress in Transplantation ◽

10.1177/1526924817715468 ◽

2017 ◽

Vol 27 (3) ◽

pp. 225-231 ◽

Cited By ~ 6

Author(s):

Mokshya Sharma ◽

Aijaz Ahmed ◽

Robert J. Wong

Keyword(s):

United States ◽

Hepatocellular Carcinoma ◽

Liver Transplantation ◽

Hepatitis C ◽

Proportional Hazards ◽

The United States ◽

Cox Proportional Hazards ◽

Cox Proportional Hazards Models ◽

Using Data ◽

The Impact

Introduction: The age of liver transplantation recipients in the United States is steadily increasing. However, the impact of age on liver transplant outcomes has demonstrated contradictory results. Research Questions: We aim to evaluate the impact of age on survival following liver transplantation among US adults. Design: Using data from the United Network for Organ Sharing registry, we retrospectively evaluated all adults undergoing liver transplantation from 2002 to 2012 stratified by age (aged 70 years and older vs aged <70 years), presence of hepatocellular carcinoma, and hepatitis C virus status. Overall survival was evaluated with Kaplan-Meier methods and multivariate Cox proportional hazards models. Results: Compared to patients aged <70 years, those aged 70 years and older had significantly lower 5-year survival following transplantation among all groups analyzed (hepatocellular carcinoma: 59.9% vs 68.6%, P < .01; nonhepatocellular carcinoma: 61.2% vs 74.2%, P < .001; hepatitis C: 60.7% vs 69.0%, P < .01; nonhepatitis C: 62.6% vs 78.5%, P < .001). On multivariate regression, patients aged 70 years and older at time of transplantation was associated with significantly higher mortality compared to those aged <70 years (hazards ratio: 1.67; 95% confidence interval: 1.48-1.87; P < .001). Conclusion: The age at the time of liver transplantation has continued to increase in the United States. However, patients aged 70 years and older had significantly higher mortality following liver transplantation. These observations are especially important given the aging cohort of patients with chronic liver disease in the United States.

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