The Impact of Ethnic Subgroups on Tumor Stage at Diagnosis, Treatment Received, and Long-Term Survival Among Asian Adults With Hepatocellular Carcinoma

BACKGROUND & AIMS

Hepatocellular carcinoma (HCC) outcomes among Asians may differ by the Asian ethnic subgroup. We aim to evaluate the impact of the Asian ethnic subgroup on HCC tumor stage, treatment received, and overall survival among US adults.

METHODS

Using the 2004-2012 Surveillance, Epidemiology, and End Results U.S. cancer registry, we retrospectively evaluated disparities in HCC tumor stage at diagnosis, HCC treatment received, and overall survival among Asian adults, stratified by Asian ethnic subgroups. Multivariate regression models evaluated the independent impact of Asian ethnic subgroups on the HCC tumor stage at diagnosis, treatment received, and overall long-term survival.

RESULTS

Among 8160 Asians with HCC, Southeast Asian (SEA) patients accounted for 26% of all HCC, followed by Chinese (CH) (22%), and Filipinos (FP) (14.0%) patients. Japanese (JP) patients were significantly older than those of the other subgroups (mean 71.1, SD 10.8, P < 0.01). When evaluating HCC stage, FP patients were less likely to have localized HCC and less likely to have HCC within the Milan criteria than CH HCC patients. When evaluating HCC treatment, pacific islanders (PI), FP and SEA patients were significantly less likely to any receive HCC treatment than CH patients. Overall five-year HCC survival was highest among CH HCC patients (33.1%) and lowest among FP (19.9%) and JP patients (22.0%).

CONCLUSION

Among Asians with HCC in the US, significant disparities among Asian ethnic subgroups exist. More advanced disease was seen among FP patients, less HCC treatment was seen among FP and SEA patients, and significantly higher mortality was seen among FP, SEA, and JP patients with HCC.

BMI and cardiovascular function in children and adolescents of Mauritius Island

Among countries which have undergone a rapid socio-economic and nutrition transition over the past few decades, the Indian Ocean island of Mauritius is among those with the greatest surge in the prevalence of type 2 diabetes and CVD. The aim of the present study was to characterise the BMI and cardiovascular functions of children and adolescents of this at-risk population. Data were collected through measurements of anthropometry, resting heart rate and blood pressure in a nationally representative sample (n 2489) of children (5–10 years) and adolescents (11–18 years), and analysed according to sex and ethnic identity: South Asian Hindus and Muslims (both of Indian ancestry), Creole (of varying degrees of African ancestry) and Chinese (of mainland China ancestry). Based on standards of the WHO or International Obesity Task Force, one in six of these young individuals exhibit a high BMI-for-age. Analysis by ethnicity revealed that Creole males and females show higher BMI-for-age but also lower heart rate (P < 0·001) even after adjustment for BMI. Additionally, Chinese males and females show higher systolic blood pressure (P < 0·01), independently of BMI. None of these ethnic differences could be related to household income, diet type (vegetarian v. non-vegetarian) or to fruit consumption. This study in children and adolescents of this multi-ethnic at-risk population for CVD reveal ethnic differences in BMI-for-age as well as consistent BMI-independent ethnic differences in heart rate and systolic blood pressure. These findings underscore the need to establish the BMI–fat % relationship across the various ethnic groups and for more detailed investigations about their differences in lifestyle and dietary habits that might explain their differential cardiovascular functions prior to adulthood.