Introduction: Centers for Disease Control Cancer Data show that death rates from HCC exceed expectations from incident rates in Mississippi, therefore we hypothesized that socioeconomic factors influence stage at diagnosis or referral to tertiary care center for HCC in Mississippi (MS).

Methods: Patients diagnosed with HCC between 1995 and 2015 were identified in our institutional cancer registry. Demographic factors including zip code, age and race for each patient and median income, racial distribution and percent rural for each zip code of origin were collected using publically available data. Tumors were dichotomized as early (AJCC Stage I and II) and late (AJCC Stage III and IV). Univariable logistic regression was used to select variables for inclusion in a multivariable logistic regression model to determine factors associated with increased odds of late stage diagnosis. Interactions amongst variables included in the final model.

Results: 421 patients were identified in the cancer registry. 233 patients (55%) identified as Caucasian (European Americans, EA) 170 (40%) identified as African Americans (AA). In an unadjusted, univariable logistic regression, AA were found to have 89 times the odds of being diagnosed with late-stage cancer as compared to EA (p=0.0033). As age increases by 5 years, the odds of diagnosis with late-stage cancer decreases by 12% (p=0.0263). As median income for zip code increases by $10,000 the odds of being diagnosed with late-stage cancer decreases by 18% (p=0.0150). In multivariable logistic regression, AA race was significantly associated with greater odds of late stage diagnosis (OR 1.92 (1.17, 3.14); p = 0.0093). Increasing age and higher median household income trended toward significantly decreased odds of late stage diagnosis (OR 0.91 (0.81, 1.01); p = 0.0831 and OR 0.82 (0.66, 1.02); p = 0.0730, respectively). There was no significant interaction between median income and race.

Conclusion: In MS AA are at significantly greater odds for late stage diagnosis of HCC when compared to EA independent of other socioeconomic factors such as median income, surrounding population and racial make-up. It appears that low median income and younger age also increase odds for diagnosis at advanced stage. We believe these data point out significant disparities in access to care for young, low-income AA. Clearly there is great opportunity for intervention in at-risk populations.

CITATION INFORMATION: Aru M, Seals S, Ingram B, Seawright A, Anderson C, Earl T. African Americans Have Greater Odds of Late Stage Diagnosis of Hepatocellular Carcinoma in Mississippi. Am J Transplant. 2016;16 (suppl 3).

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