Hawa Ali
University of Minnesota Rochester
Hepatocellular Carcinoma Characteristics and Outcomes among Somali Immigrants vs. non-Hispanic Whites
Photo credit: Hassan Shaleh
AIM
The aim of this study is to compare the risk factors, stage, surveillance, treatment intent, and outcomes of HCC in Somalis to a matched cohort of Non-Hispanic whites (NHW) with hepatocellular carcinoma (HCC) seen at Mayo Clinic.
METHODS
The Mayo Clinic Advanced Cohort Explorer query tool was used to identify Somali HCC patients seen at Mayo Clinic from March 1, 1998 to December 31, 2015. The diagnosis of HCC was further verified using histopathology and imaging reports. Variables abstracted from the electronic medical records include demographics, etiology, diagnosis date, date of death or last contact, Barcelona Clinic Liver Cancer (BCLC) stage, treatments and HCC surveillance. NHW cohort was matched 2:1 to Somali HCC patients by age (±5 yrs), sex and date of diagnosis (±3 yrs).
CONCLUSIONS
These findings provide a starting point to address HCC disparities among Somalis. Improving the identification of individuals with chronic HBV or HCV who are at increased risk for HCC and implementing more comprehensive HCC surveillance is likely to reduce the burden of HCC among Somalis.
RESULTS
60 Somalis and 120 NHW diagnosed with HCC were identified. The main risk factors for HCC among Somalis was hepatitis B virus and hepatits C virus whereas hepatitis C, alcohol and nonalcoholic fatty liver disease were the main etiologies among the NHW cohort. At the time of diagnosis, Somalis were more likely to present with advanced or terminal stage HCC compared to NHW. As a result Somalis were more likely to receive palliative rather than curative treatments.
There was no significant difference in 1, 2 and 5 year survival rates seen between the two groups following HCC diagnosis. There was also no statistical difference in the surveillance of HCC prior to diagnosis between the two groups.
ACKNOWLEDGMENTS
Photo credit: Mayo Intranet