Hepatocellular carcinoma amongst Aboriginal and Torres Strait Islander peoples of Australia.

Epidemiology Indigenous Australians Liver cancer Survival

Journal

EClinicalMedicine
ISSN: 2589-5370
Titre abrégé: EClinicalMedicine
Pays: England
ID NLM: 101733727

Informations de publication

Date de publication:
Jun 2021
Historique:
received: 09 02 2021
revised: 25 04 2021
accepted: 06 05 2021
entrez: 18 6 2021
pubmed: 19 6 2021
medline: 19 6 2021
Statut: epublish

Résumé

Liver disease and hepatocellular carcinoma (HCC) are important contributors to the mortality gap between Indigenous and non-Indigenous Australians. However, there is a lack of population based high quality data assessing the differences in HCC epidemiology and outcomes according to Indigenous status. The aim of this study was therefore to perform a large epidemiological study of HCC investigating differences between Indigenous and non-Indigenous Australians with HCC. Study design was a retrospective cohort study. Data linkage methodology was used to link data from cancer registries with hospital separation summaries across three Australian jurisdictions during 2000-2017. Cumulative survival (Kaplan-Meier) and the differences in survival (Multivariable Cox-regression) by Indigenous status were assessed. A total of 229 Indigenous and 3587 non-Indigenous HCC cases were included in the analyses. Significant epidemiological differences identified for Indigenous HCC cases included younger age at onset, higher proportion of females, higher rurality, lower socioeconomic status, and higher comorbidity burden (all Such data provide a call to action to help design and implement health literacy, liver management and HCC surveillance programs for Indigenous people to help close the liver cancer mortality gap.

Sections du résumé

BACKGROUND BACKGROUND
Liver disease and hepatocellular carcinoma (HCC) are important contributors to the mortality gap between Indigenous and non-Indigenous Australians. However, there is a lack of population based high quality data assessing the differences in HCC epidemiology and outcomes according to Indigenous status. The aim of this study was therefore to perform a large epidemiological study of HCC investigating differences between Indigenous and non-Indigenous Australians with HCC.
METHODS METHODS
Study design was a retrospective cohort study. Data linkage methodology was used to link data from cancer registries with hospital separation summaries across three Australian jurisdictions during 2000-2017. Cumulative survival (Kaplan-Meier) and the differences in survival (Multivariable Cox-regression) by Indigenous status were assessed.
FINDINGS RESULTS
A total of 229 Indigenous and 3587 non-Indigenous HCC cases were included in the analyses. Significant epidemiological differences identified for Indigenous HCC cases included younger age at onset, higher proportion of females, higher rurality, lower socioeconomic status, and higher comorbidity burden (all
INTERPRETATION CONCLUSIONS
Such data provide a call to action to help design and implement health literacy, liver management and HCC surveillance programs for Indigenous people to help close the liver cancer mortality gap.

Identifiants

pubmed: 34142069
doi: 10.1016/j.eclinm.2021.100919
pii: S2589-5370(21)00199-1
pmc: PMC8187829
doi:

Types de publication

Journal Article

Langues

eng

Pagination

100919

Informations de copyright

Crown Copyright © 2021 Published by Elsevier Ltd.

Déclaration de conflit d'intérêts

Authors disclose the following interests related to this manuscript. Alan Wigg; Gastroenterology Society of Australia Members’ Grant 2019, National Health and Medical Research Council Partnership Grant (GN1170032) 2019, Roche Pharmaceuticals honorarium. Jane Davies; Medical Research Future Fund Investigator Grant, National Health and Medical Research Council Early Career Fellowship, Australian Society for HIV Medicine honorarium. All other authors have nothing to disclose.

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Auteurs

Alan J Wigg (AJ)

Hepatology and Liver Transplant Medicine Unit, Southern Adelaide Local Health Network, Adelaide, SA, Australia.
Flinders University of South Australia, Adelaide, South Australia, Australia.

Sumudu K Narayana (SK)

Hepatology and Liver Transplant Medicine Unit, Southern Adelaide Local Health Network, Adelaide, SA, Australia.
Flinders University of South Australia, Adelaide, South Australia, Australia.

Gunter Hartel (G)

QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia.

Linda Medlin (L)

Aboriginal and Torres Strait Islander Health and Wellbeing, Central Queensland Hospital and Health Service, Queensland, Australia.

Greg Pratt (G)

QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia.

Elizabeth E Powell (EE)

Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
Centre for Liver Disease Research, Translational Research Institute, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.

Paul Clark (P)

Mater Hospitals, Brisbane, Queensland, Australia.

Jane Davies (J)

Menzies School of Health Research, Royal Darwin Hospital, Darwin, The Northern Territory, Australia.
Royal Darwin Hospital, Darwin, The Northern Territory, Australia.

Kirsty Campbell (K)

Royal Darwin Hospital, Darwin, The Northern Territory, Australia.

Maree Toombs (M)

University of Queensland, Herston, Queensland, Australia.

Michael Larkin (M)

The Aboriginal Health Council of South Australia, Adelaide, Australia.

Patricia C Valery (PC)

QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia.

Classifications MeSH