ArticleClinics and research in hepatology and gastroenterology2025
Access to care and the Hispanic paradox among Hispanic patients with hepatocellular carcinoma.
Article in Clinics and research in hepatology and gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeDespite the disproportionate impact of hepatocellular carcinoma (HCC) on Hispanic patients, reported outcomes are limited, particularly among subpopulations. Our study aimed to evaluate outcomes in access to care and survival among racial and ethnic Hispanic subpopulations.
methodsThe National Cancer Database was utilized to identify patients diagnosed with HCC between 2004 and 2020. The independent variables of interest were racial/ethnic groups, with the Hispanic population disaggregated by race and Hispanic heritage. The primary outcomes were the presentation of early versus late-stage HCC, undergoing a curative-intent procedure, time to treatment, and overall survival. Logistic regression was performed with adjustments made for demographic, clinical, and socioeconomic variables.
resultsAmong 211,988 patients with HCC identified, 12.3 % (n = 26,085) were classified as Hispanic. In comparison with NHW patients, South/Central American patients had the lowest odds of early-stage presentation (OR=0.91; p = 0.1), Cuban patients had the lowest odds of undergoing a curative-intent procedure (OR=0.72; p = 0.04), and Mexican patients had the highest odds of delayed treatment (OR=1.45; p < 0.001). Hispanics had a longer median survival at 19 months than NHW patients (15 months, p < 0.001), with Hispanic Black (HR 0.59, p < 0.001) and Dominican (HR 0.56, p < 0.001) patients having the lowest mortality risk among Hispanic subpopulations. DISCUSSION: Despite decreased resection rates and increased likelihood of delayed treatment, Hispanics had improved survival across its subpopulations in comparison to NHW patients, further highlighting the Hispanic paradox.
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