Blacks with liver cancer more likely to die, study finds

Black, Latino patients less likely to receive treatment for early disease

ANN ARBOR, Dec. 2010: Black people with early stage liver cancer were more likely than white patients to die from their disease, according to a new study from the University of Michigan Comprehensive Cancer Center.

Five years after diagnosis, 18 percent of white liver cancer patients were alive but only 15 percent of Latino patients and 12 percent of black patients were. Median survival times ranged from 10 months for whites and Latinos to 8 months for blacks.

The researchers also found racial and ethnic disparities in how often patients received treatment, with black and Latino patients less likely than whites to have any kind of treatment.

When researchers looked at survival only among patients who had been treated, the disparity in survival persisted, but the gap narrowed, especially for Latinos. Blacks who had surgery lived a median 29 months, Latinos 40 months and whites 43 months. Median survival for all races was only four to six months without treatment.

“Just under a third of the patients we looked at received treatment, which is a significant underuse of appropriate interventions for the most treatable stages of liver cancer,” says study author Christopher J. Sonnenday, M.D., M.H.S., assistant professor of surgery at the U-M Medical School and assistant professor of health management and policy at the U-M School of Public Health.

Researchers looked at data from 13,244 patients with early stage hepatocellular carcinoma, or liver cancer. Patients were identified through the Surveillance and Epidemiology End Results registry, a database from the National Cancer Institute that collects information on cancer incidence, prevalence and survival.

Results of the study appear in the December issue of Archives of Surgery.

Liver cancer incidence is increasing, and the disease is difficult to treat in its later stages. Patients diagnosed with advanced disease have only a 5 percent chance of living five years after diagnosis. Early stage disease is more treatable, with options including tumor ablation, surgery to remove a portion of the liver or liver transplant surgery.

“Liver cancer requires highly complex care that is available only in larger referral hospitals. Our study suggests that not only do members of different racial and ethnic groups face barriers to accessing this care, but the survival of blacks and Latinos even after receiving these treatments appears to be inferior to whites,” Sonnenday says.

Liver cancer statistics: About 24,000 Americans will be diagnosed with liver cancer this year and 18,900 will die from the disease, according to the American Cancer Society

Los negros con cáncer de hígado tienen más probabilidades que los blancos de morir por la enfermedad, indica un estudio

Los pacientes negros e hispanos tienen menos probabilidades de recibir tratamiento temprano

ANN ARBOR: Las personas negras con cáncer en sus etapas iniciales tienen más probabilidades que los pacientes blancos de morir por esa enfermedad, según un nuevo estudio del Centro Integral del Cáncer de la Universidad de Michigan.

Cinco años después del diagnóstico, el 18 por ciento de los pacientes con cáncer de hígado estaba vivo, pero sólo el 15 por ciento de los pacientes hispanos y el 12 por ciento de los pacientes negros estaban vivos. Los períodos medios de supervivencia van de 10 meses para los blancos e hispanos a 8 meses para los negros.

 

Los investigadores encontraron asimismo disparidades raciales y étnicas en la forma en que los pacientes recibieron tratamiento, ya que los pacientes negros e hispanos tienen menos probabilidades de recibir cualquier tipo de tratamiento.

Cuando los investigadores observaron solamente la supervivencia entre los pacientes que habían recibido tratamiento persistió la desigualdad en la supervivencia, pero la diferencia se estrechó, especialmente para los hispanos. Los negros que tuvieron cirugía sobrevivieron una media de 19 meses, los hispanos 40 meses y los blancos 43 meses. La supervivencia media de todas las razas fue de solamente cuatro a seis meses cuando no hubo tratamiento.

“Apenas un tercio de los pacientes que observamos recibió tratamiento, lo cual es un desuso significativo de las intervenciones apropiadas para las etapas más tratables del cáncer de hígado”, dijo el autor del estudio, Christopher J. Sonnenday, profesor asistente de cirugía en la Escuela de Medicina de la UM y profesor asistente de gestión de salud y políticas en la Escuela de Salud Pública de la UM.

 Los investigadores observaron los datos de 13.244 pacientes con la etapa temprana de carcinoma hepatoceular, o cáncer de hígado. Se identificó  a los pacientes mediante el registro Encuesta y Epidemiología de Resultados, un banco de datos del Instituto Nacional del Cáncer que recolecta información sobre la incidencia, prevalencia y supervivencia del cáncer.

 Los resultados del estudio se publican en la edición de diciembre de la revista Archives of Surgery.

La incidencia del cáncer está aumentando y es difícil el tratamiento de la enfermedad en sus etapas avanzadas. Los pacientes a quienes se les diagnostica la enfermedad avanzada tienen sólo un 5 por ciento de probabilidades de vivir cinco años después del diagnóstico. La enfermedad es más tratable en sus etapas tempranas y las opciones incluyen la ablación del tumor, la cirugía para extirpar una porción del hígado o la cirugía de transplante de hígado.

“El cáncer de hígado requiere un cuidado altamente complejo que está disponible solamente en los grandes hospitales. Nuestro estudio indica que los miembros de diferentes grupos étnicos y raciales encaran obstáculos para acceder a este cuidado, y además que la supervivencia de los negros y los hispanos aún después que reciban esos tratamientos parecen ser inferior a la de los blancos”, dijo Sonnenday.

 Estadísticas del cáncer de hígado: Este año unas 24.000 personas en Estados Unidos tendrán un diagnóstico de cáncer de hígado y alrededor de 18.900 morirán por esa enfermedad, según la Sociedad Estadounidense del Cáncer.

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