Alan Wigg|Sumudu Narayana|Günter Härtel|Linda Medlin|Greg Pratt|Elizabeth E. Powell|Paul J. Clark|Jane Davies|Kirsty Campbell|Maree Toombs|Michael Larkin|Patricia C. Valery
Hepatocellular carcinoma amongst Aboriginal and Torres Strait Islander peoples of Australia
Flinders University|Women's and Children's Health Network|Flinders University|Women's and Children's Health Network|QIMR Berghofer Medical Research Institute|Children’s Health Queensland Hospital and Health Service|QIMR Berghofer Medical Research Institute|University of Queensland|Translational Research Institute|Princess Alexandra Hospital|Mater Adult Hospital|Royal Darwin Hospital|Menzies School of Health Research|Royal Darwin Hospital|University of Queensland|Aboriginal Health Council of South Australia|QIMR Berghofer Medical Research Institute
h2abstracth2h3backgroundh3 liver disease hepatocellular carcinoma hcc important contributors mortality gap indigenous nonindigenous australians however lack population based high quality data assessing differences hcc epidemiology outcomes according indigenous status aim study therefore perform large epidemiological study hcc investigating differences indigenous nonindigenous australians hcc h3methodsh3 study design retrospective cohort study data linkage methodology used link data cancer registries hospital separation summaries across three australian jurisdictions 20002017 cumulative survival kaplanmeier differences survival multivariable coxregression indigenous status assessed h3findingsh3 total 229 indigenous 3587 nonindigenous hcc cases included analyses significant epidemiological differences identified indigenous hcc cases included younger age onset higher proportion females higher rurality lower socioeconomic status higher comorbidity burden ipi 0001 distribution cofactors also significantly different indigenous australians including higher prevalence alcohol misuse hepatitis b diabetes frequent presence multiple hcc cofactors ipi 0001 indigenous australians received curative hcc therapies less frequently 66 vs 145 ipi 0001 poorer 5year survival 100 vs 173 ipi 0001 unadjusted hazard ratio hr 142 96ci 121165 compared nonindigenous australians strength association indigenous status survival weaker statistically nonsignificant adjusting rurality comorbidity burden lack curative therapy adjustedhr120 95ci 097147 h3interpretationh3 data provide call action help design implement health literacy liver management hcc surveillance programs indigenous people help close liver cancer mortality gap h3fundingh3 work supported unrestricted educational grant gastroenterology society australia patricia valery elizabeth powell supported metro south health indigenous health research grants