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Racial disparities in alpha‐fetoprotein testing and alpha‐fetoprotein status associated with the diagnosis and outcome of hepatocellular carcinoma patients
BACKGROUND: The use of alpha‐fetoprotein (AFP) testing for the surveillance, diagnosis, and prognosis of hepatocellular carcinoma (HCC) remains controversial. Here, we compared AFP testing rates, elevated AFP rates, factors associated with elevated AFP levels, and prognostic factors associated with...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6825973/ https://www.ncbi.nlm.nih.gov/pubmed/31517445 http://dx.doi.org/10.1002/cam4.2549 |
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author | Wu, Guoyi Wu, Jing Pan, Xiaoben Liu, Bo Yao, Zhicheng Guo, Yuan Shi, Xiaolei Ding, Yitao |
author_facet | Wu, Guoyi Wu, Jing Pan, Xiaoben Liu, Bo Yao, Zhicheng Guo, Yuan Shi, Xiaolei Ding, Yitao |
author_sort | Wu, Guoyi |
collection | PubMed |
description | BACKGROUND: The use of alpha‐fetoprotein (AFP) testing for the surveillance, diagnosis, and prognosis of hepatocellular carcinoma (HCC) remains controversial. Here, we compared AFP testing rates, elevated AFP rates, factors associated with elevated AFP levels, and prognostic factors associated with overall survival (OS) in HCC patients from different ethnic groups. METHODS: Patients with HCC were identified from the Surveillance, Epidemiology, and End Results registries. Race was categorized as white, black, and others. AFP testing rates and elevated AFP rates were analyzed. Multivariable logistic regression and Cox regression analyses were used to identify independent factors associated with elevated AFP levels and prognosis, respectively. All statistical tests were two sided. RESULTS: A proportion of 79.2% of total HCC patients had AFP testing reports; 77.3% of white, 79.7% of black, and 81.2% of other races underwent AFP testing. Compared with white and other races, black HCC patients had a higher rate of elevated AFP levels among all patients and the early‐stage HCC patient cohort. Elevated AFP level was a significant prognostic factor for all HCC patients in different race groups. Factors associated with elevated AFP level and prognostic factors associated with OS varied significantly by race. CONCLUSIONS: AFP testing, elevated AFP rates, predictors of elevated AFP level, and prognostic factors associated with OS differed significantly according to race after adjusting for AFP levels among the three groups. AFP testing for the surveillance, diagnosis, and prognosis of HCC patients is strongly recommended, although racial disparities need to be considered. |
format | Online Article Text |
id | pubmed-6825973 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-68259732019-11-07 Racial disparities in alpha‐fetoprotein testing and alpha‐fetoprotein status associated with the diagnosis and outcome of hepatocellular carcinoma patients Wu, Guoyi Wu, Jing Pan, Xiaoben Liu, Bo Yao, Zhicheng Guo, Yuan Shi, Xiaolei Ding, Yitao Cancer Med Clinical Cancer Research BACKGROUND: The use of alpha‐fetoprotein (AFP) testing for the surveillance, diagnosis, and prognosis of hepatocellular carcinoma (HCC) remains controversial. Here, we compared AFP testing rates, elevated AFP rates, factors associated with elevated AFP levels, and prognostic factors associated with overall survival (OS) in HCC patients from different ethnic groups. METHODS: Patients with HCC were identified from the Surveillance, Epidemiology, and End Results registries. Race was categorized as white, black, and others. AFP testing rates and elevated AFP rates were analyzed. Multivariable logistic regression and Cox regression analyses were used to identify independent factors associated with elevated AFP levels and prognosis, respectively. All statistical tests were two sided. RESULTS: A proportion of 79.2% of total HCC patients had AFP testing reports; 77.3% of white, 79.7% of black, and 81.2% of other races underwent AFP testing. Compared with white and other races, black HCC patients had a higher rate of elevated AFP levels among all patients and the early‐stage HCC patient cohort. Elevated AFP level was a significant prognostic factor for all HCC patients in different race groups. Factors associated with elevated AFP level and prognostic factors associated with OS varied significantly by race. CONCLUSIONS: AFP testing, elevated AFP rates, predictors of elevated AFP level, and prognostic factors associated with OS differed significantly according to race after adjusting for AFP levels among the three groups. AFP testing for the surveillance, diagnosis, and prognosis of HCC patients is strongly recommended, although racial disparities need to be considered. John Wiley and Sons Inc. 2019-09-13 /pmc/articles/PMC6825973/ /pubmed/31517445 http://dx.doi.org/10.1002/cam4.2549 Text en © 2019 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Clinical Cancer Research Wu, Guoyi Wu, Jing Pan, Xiaoben Liu, Bo Yao, Zhicheng Guo, Yuan Shi, Xiaolei Ding, Yitao Racial disparities in alpha‐fetoprotein testing and alpha‐fetoprotein status associated with the diagnosis and outcome of hepatocellular carcinoma patients |
title | Racial disparities in alpha‐fetoprotein testing and alpha‐fetoprotein status associated with the diagnosis and outcome of hepatocellular carcinoma patients |
title_full | Racial disparities in alpha‐fetoprotein testing and alpha‐fetoprotein status associated with the diagnosis and outcome of hepatocellular carcinoma patients |
title_fullStr | Racial disparities in alpha‐fetoprotein testing and alpha‐fetoprotein status associated with the diagnosis and outcome of hepatocellular carcinoma patients |
title_full_unstemmed | Racial disparities in alpha‐fetoprotein testing and alpha‐fetoprotein status associated with the diagnosis and outcome of hepatocellular carcinoma patients |
title_short | Racial disparities in alpha‐fetoprotein testing and alpha‐fetoprotein status associated with the diagnosis and outcome of hepatocellular carcinoma patients |
title_sort | racial disparities in alpha‐fetoprotein testing and alpha‐fetoprotein status associated with the diagnosis and outcome of hepatocellular carcinoma patients |
topic | Clinical Cancer Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6825973/ https://www.ncbi.nlm.nih.gov/pubmed/31517445 http://dx.doi.org/10.1002/cam4.2549 |
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