ArticleHPB : the official journal of the International Hepato Pancreato Biliary Association2021
The role of racial segregation in treatment and outcomes among patients with hepatocellular carcinoma.
Article in HPB : the official journal of the International Hepato Pancreato Biliary Association, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 38 citations in OpenAlex.
- Residential and Transplant Center Neighborhood Segregation and Live Donor Liver Transplant.JAMA network open · 2026Article
- Disparities in Diagnosis, Management, and Outcomes of Hepatocellular Carcinoma: A Review of Global and Sociodemographic Factors.Journal of gastrointestinal cancer · 2026Review
- Sexual Dimorphism in the Initial Apoptotic Switch During MASH Progression in Mice.International journal of molecular sciences · 2026Article
- Intersectionality and the Association Between State-Level Structural Racism, Binge Alcohol Consumption, and Smoking Status Among Black Americans.Journal of racial and ethnic health disparities · 2025Article
- Segregation in hospital care for Medicare beneficiaries by race and ethnicity and dual-eligible status from 2013 to 2021.Health services research · 2025Article
- The Influence of Residential Segregation, Urbanicity, and Population Density on Hepatocellular Carcinoma Incidence among a Low Socioeconomic Population.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2025Article
- Instruments for racial health equity: a scoping review of structural racism measurement, 2019-2021.Epidemiologic reviews · 2024Article
- Social Inequities in the Survival of Liver Cancer: A Nationwide Cohort Study in Korea, 2007-2017.Journal of Korean medical science · 2024Article
- The Association between State-Level Structural Racism and Alcohol and Tobacco Use Behaviors among a National Probability Sample of Black Americans.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2024Article
- Opportunities, challenges, and future directions for simulation modeling the effects of structural racism on cancer mortality in the United States: a scoping review.Journal of the National Cancer Institute. Monographs · 2023Article
- Tools to Measure the Impact of Structural Racism and Discrimination on Gastrointestinal and Hepatology Disease Outcomes: A Scoping Review.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2023Article
- Disparities in Socioeconomic Factors Mediate the Impact of Racial Segregation Among Patients With Hepatopancreaticobiliary Cancer.Annals of surgical oncology · 2023Article
- Racial Segregation Among Patients with Cholangiocarcinoma-Impact on Diagnosis, Treatment, and Outcomes.Annals of surgical oncology · 2023Article
- Article
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
backgroundThere is a long history of segregation in the U.S.A with enduring impacts on cancer outcomes today. We evaluated the impact of segregation on racial disparities in Hepatocellular Carcinoma (HCC) treatment and outcomes.
methodsWe obtained data on black and white patients with HCC from the SEER program (2005-2015) within the 100 most populous participating counties. Our exposure was the index of dissimilarity (IoD), a validated measure of segregation. Outcomes were overall survival, advanced stage at diagnosis (Stage III/IV) and surgery for localized disease (Stage I/II). Cancer-specific survival was assessed using Kaplan-Meier estimates.
resultsBlack patients had a 1.18 times increased risk (95%CI 1.14,1.22) of presenting at advanced stage as compared to white patients and these disparities disappeared at low levels of segregation. In the highest quartile of IoD, black patients had a significantly lower survival than white (17 months vs 27 months, p < 0.001), and this difference disappeared at the lowest quartile of IoD.
conclusionsOur data illustrate that structural racism in the form racial segregation has a significant impact on racial disparities in the treatment of HCC. Urban and health policy changes can potentially reduce disparities in HCC outcomes.
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