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: 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: < 0.001; unadjusted hazard ratio (HR) =1.42 96%CI 1.21-1.65) compared to non-Indigenous Australians. The strength of the association between indigenous status and survival was weaker and statistically non-significant after adjusting for rurality, comorbidity burden and lack of curative therapy (adjusted-HR=1.20 95%CI 0.97-1.47). Interpretation: 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.
Authors | Wigg, Alan J; Narayana, Sumudu K; Hartel, Gunter; Medlin, Linda; Pratt, Greg; Powell, Elizabeth E; Clark, Paul; Davies, Jane; Campbell, Kirsty; Toombs, Maree; Larkin, Michael; Valery, Patricia C |
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Journal | EClinicalMedicine |
Pages | 100919 |
Volume | 36 |
Date | 1/01/2021 |
Grant ID | |
Funding Body | |
URL | http://www.ncbi.nlm.nih.gov/pubmed/?term=10.1016/j.eclinm.2021.100919 |