Comparing barriers to early stage diagnosis of hepatocellular carcinoma between safety net hospitals and academic medical centers: An analysis from the United States Safety‐Net Collaborative

Background and Objectives Early detection of hepatocellular carcinoma (HCC) is associated with improved survival. However, a greater proportion of patients treated at safety net hospitals (SNHs) present with late‐stage disease compared to those at academic medical centers (AMCs). This study aims to...

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Bibliographic Details
Published in:Journal of surgical oncology 2024-09, Vol.130 (3), p.493-503
Main Authors: Stylianos, Sophia L., Goel, Caroline R., Lee, Rachel M., Yopp, Adam, Kronenfeld, Joshua, Goel, Neha, Datta, Jashodeep, Lee, Ann, Silberfein, Eric, Russell, Maria C.
Format: Article
Language:English
Subjects:
Academic Medical Centers - statistics & numerical data
Aged
Carcinoma, Hepatocellular - diagnosis
Carcinoma, Hepatocellular - epidemiology
Carcinoma, Hepatocellular - pathology
Collaboration
Early Detection of Cancer - statistics & numerical data
Female
Follow-Up Studies
HCC
Healthcare Disparities - statistics & numerical data
Humans
Liver cancer
Liver Neoplasms - diagnosis
Liver Neoplasms - epidemiology
Liver Neoplasms - pathology
Male
Middle Aged
Neoplasm Staging
Prognosis
racial bias
Retrospective Studies
Safety-net Providers - statistics & numerical data
screening
social determinants of health
United States - epidemiology
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Summary:Background and Objectives Early detection of hepatocellular carcinoma (HCC) is associated with improved survival. However, a greater proportion of patients treated at safety net hospitals (SNHs) present with late‐stage disease compared to those at academic medical centers (AMCs). This study aims to identify barriers to diagnosis of HCC, highlighting differences between SNHs and AMCs. Methods The US Safety Net Collaborative‐HCC database was queried. Patients were stratified by facility of diagnosis (SNH or AMC). Patient demographics and HCC screening rates were examined. The primary outcome was stage at diagnosis (AJCC I/II—“early”; AJCC III/IV—“late”). Results 1290 patients were included; 50.2% diagnosed at SNHs and 49.8% at AMCs. At SNHs, 44.4% of patients were diagnosed late, compared to 27.6% at AMCs. On multivariable regression, Black race was associated with late diagnosis in both facilities (SNH: odds ratio 1.96, p = 0.03; AMC: 2.27,
ISSN:0022-4790
1096-9098
1096-9098
DOI:10.1002/jso.27787