Racial disparities in hepatocellular carcinoma admissions, comorbidities, and outcomes: A nationwide analysis from 2016-2021.

Abstract

e16266 Background: Hepatocellular carcinoma (HCC) has had a rising incidence and mortality rate in recent years. Various risk factors have been identified, with notable shifts in their prevalence across races and sexes, and a significant contribution from the increasing prevalence of non-alcoholic fatty liver disease (NAFLD). This study aimed to explore the demographic characteristics and outcomes of HCC patients to identify disparities and inform targeted public health interventions. Methods: Data from the National Inpatient Sample (NIS) database were analyzed for adult patients admitted primarily for HCC between 2016 and 2021. Demographic characteristics, in-hospital mortality, total hospital charges, and length of stay were assessed. Multivariate logistic regression was used to adjust for confounders. Results: Among HCC admissions, 27.3% (n = 81,880) were female, with a mean age of 65.4 years. Patients were whites (59.1%), Blacks (15.7%), Hispanics (17.5%), Asians/Pacific Islanders (6.7%), and Native Americans (1%). Asians/Pacific Islanders had 2.36 times higher odds of HCC admission than Whites, followed by Native Americans (+58.4%) and Hispanics (+52.4%). Native Americans had the lowest admissions to urban teaching hospitals (75.7%), while Blacks (OR = 3.11), Hispanics (OR = 4.14), and Asians/Pacific Islanders (OR = 8.04) were more likely to be admitted to such facilities. Asians/Pacific Islanders had higher odds of admission to larger hospitals and public insurance use, while Blacks and Native Americans were less likely to have public insurance. Asians/Pacific Islanders were less likely to belong to the lowest income group, while Blacks had the highest proportion (54.2%). Asians/Pacific Islanders had the highest odds of hepatitis B (OR = 12.7), while Blacks had the highest odds of hepatitis C (OR = 1.93). Hispanics were most associated with diabetes (OR = 1.44), and Whites had the highest odds of hemochromatosis. Asians and Blacks had lower odds of obesity and NAFLD compared to Whites. Blacks had longer hospital stays, while females, older patients, Hispanics, and Asians incurred higher charges. Mortality odds were higher for Blacks (OR = 1.24) and Asians (OR = 1.19) compared to Whites (p < 0.05). Conclusions: HCC incidence and mortality have increased, with notable racial disparities in distribution and outcomes. Asians/Pacific Islanders had the highest odds of admission, while Blacks and Asians experienced higher mortality rates. These findings emphasize the urgent need for targeted interventions to reduce disparities in prevention, treatment, and outcomes for HCC.