Impact of country of birth on age at the time of diagnosis of hepatocellular carcinoma in the United States

Ju Dong Yang, Sean F. Altekruse, Mindie H. Nguyen, Gregory James Gores, Lewis Rowland Roberts

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

BACKGROUND: There is global variation in the onset of hepatocellular carcinoma (HCC). The objective of the current study was to investigate the impact of country of birth on age at the time of HCC diagnosis in the United States. METHODS: Incident HCC cases diagnosed between 2000 and 2012 in the Surveillance, Epidemiology, and End Results program 18 registry were included. Factors associated with very early onset (age at diagnosis < 40 years) and early onset (age at diagnosis < 50 years) were identified by logistic regression. RESULTS: A total of 59,907 patients were included. The median age at the time of diagnosis of HCC was 62 years and 76% of the patients were male. Of the 75% of patients for whom information regarding birth country was available, 29% were foreign born. In multivariate logistic regression, birth in West Africa (adjusted odds ratio [AOR], 16.3; 95% confidence interval [95% CI], 9.2-27.9 [P<.01]), Central/South/other Africa (AOR, 11.0; 95% CI, 4.5-23.7 [P<.01]), Oceania (AOR, 4.9; 95% CI, 2.9-8.0 [P<.01]), and East Africa (AOR, 3.5; 95% CI, 1.5-6.8 [P<.01]) was found to have the strongest association with very early-onset HCC after adjusting for sex and race/ethnicity. Birth in West Africa, Central/South/other Africa, Oceania, or East Africa also was found to be strongly associated with early-onset HCC. CONCLUSIONS: Birth country was found to be independently associated with age at the time of HCC diagnosis in the United States. Birth in Africa (except for North Africa) and Oceania was strongly associated with very early-onset HCC. These findings have implications for the design of comprehensive HCC surveillance programs in the United States. Cancer 2016.

Original languageEnglish (US)
Pages (from-to)81-89
Number of pages9
JournalCancer
Volume123
Issue number1
DOIs
StatePublished - Jan 1 2017

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Hepatocellular Carcinoma
Parturition
Oceania
Odds Ratio
Confidence Intervals
Eastern Africa
Western Africa
South Africa
Age of Onset
Logistic Models
SEER Program
Northern Africa
Registries
Neoplasms

Keywords

  • Africa
  • age
  • early onset
  • liver cancer
  • Oceania

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Impact of country of birth on age at the time of diagnosis of hepatocellular carcinoma in the United States. / Yang, Ju Dong; Altekruse, Sean F.; Nguyen, Mindie H.; Gores, Gregory James; Roberts, Lewis Rowland.

In: Cancer, Vol. 123, No. 1, 01.01.2017, p. 81-89.

Research output: Contribution to journalArticle

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title = "Impact of country of birth on age at the time of diagnosis of hepatocellular carcinoma in the United States",
abstract = "BACKGROUND: There is global variation in the onset of hepatocellular carcinoma (HCC). The objective of the current study was to investigate the impact of country of birth on age at the time of HCC diagnosis in the United States. METHODS: Incident HCC cases diagnosed between 2000 and 2012 in the Surveillance, Epidemiology, and End Results program 18 registry were included. Factors associated with very early onset (age at diagnosis < 40 years) and early onset (age at diagnosis < 50 years) were identified by logistic regression. RESULTS: A total of 59,907 patients were included. The median age at the time of diagnosis of HCC was 62 years and 76{\%} of the patients were male. Of the 75{\%} of patients for whom information regarding birth country was available, 29{\%} were foreign born. In multivariate logistic regression, birth in West Africa (adjusted odds ratio [AOR], 16.3; 95{\%} confidence interval [95{\%} CI], 9.2-27.9 [P<.01]), Central/South/other Africa (AOR, 11.0; 95{\%} CI, 4.5-23.7 [P<.01]), Oceania (AOR, 4.9; 95{\%} CI, 2.9-8.0 [P<.01]), and East Africa (AOR, 3.5; 95{\%} CI, 1.5-6.8 [P<.01]) was found to have the strongest association with very early-onset HCC after adjusting for sex and race/ethnicity. Birth in West Africa, Central/South/other Africa, Oceania, or East Africa also was found to be strongly associated with early-onset HCC. CONCLUSIONS: Birth country was found to be independently associated with age at the time of HCC diagnosis in the United States. Birth in Africa (except for North Africa) and Oceania was strongly associated with very early-onset HCC. These findings have implications for the design of comprehensive HCC surveillance programs in the United States. Cancer 2016.",
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T1 - Impact of country of birth on age at the time of diagnosis of hepatocellular carcinoma in the United States

AU - Yang, Ju Dong

AU - Altekruse, Sean F.

AU - Nguyen, Mindie H.

AU - Gores, Gregory James

AU - Roberts, Lewis Rowland

PY - 2017/1/1

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N2 - BACKGROUND: There is global variation in the onset of hepatocellular carcinoma (HCC). The objective of the current study was to investigate the impact of country of birth on age at the time of HCC diagnosis in the United States. METHODS: Incident HCC cases diagnosed between 2000 and 2012 in the Surveillance, Epidemiology, and End Results program 18 registry were included. Factors associated with very early onset (age at diagnosis < 40 years) and early onset (age at diagnosis < 50 years) were identified by logistic regression. RESULTS: A total of 59,907 patients were included. The median age at the time of diagnosis of HCC was 62 years and 76% of the patients were male. Of the 75% of patients for whom information regarding birth country was available, 29% were foreign born. In multivariate logistic regression, birth in West Africa (adjusted odds ratio [AOR], 16.3; 95% confidence interval [95% CI], 9.2-27.9 [P<.01]), Central/South/other Africa (AOR, 11.0; 95% CI, 4.5-23.7 [P<.01]), Oceania (AOR, 4.9; 95% CI, 2.9-8.0 [P<.01]), and East Africa (AOR, 3.5; 95% CI, 1.5-6.8 [P<.01]) was found to have the strongest association with very early-onset HCC after adjusting for sex and race/ethnicity. Birth in West Africa, Central/South/other Africa, Oceania, or East Africa also was found to be strongly associated with early-onset HCC. CONCLUSIONS: Birth country was found to be independently associated with age at the time of HCC diagnosis in the United States. Birth in Africa (except for North Africa) and Oceania was strongly associated with very early-onset HCC. These findings have implications for the design of comprehensive HCC surveillance programs in the United States. Cancer 2016.

AB - BACKGROUND: There is global variation in the onset of hepatocellular carcinoma (HCC). The objective of the current study was to investigate the impact of country of birth on age at the time of HCC diagnosis in the United States. METHODS: Incident HCC cases diagnosed between 2000 and 2012 in the Surveillance, Epidemiology, and End Results program 18 registry were included. Factors associated with very early onset (age at diagnosis < 40 years) and early onset (age at diagnosis < 50 years) were identified by logistic regression. RESULTS: A total of 59,907 patients were included. The median age at the time of diagnosis of HCC was 62 years and 76% of the patients were male. Of the 75% of patients for whom information regarding birth country was available, 29% were foreign born. In multivariate logistic regression, birth in West Africa (adjusted odds ratio [AOR], 16.3; 95% confidence interval [95% CI], 9.2-27.9 [P<.01]), Central/South/other Africa (AOR, 11.0; 95% CI, 4.5-23.7 [P<.01]), Oceania (AOR, 4.9; 95% CI, 2.9-8.0 [P<.01]), and East Africa (AOR, 3.5; 95% CI, 1.5-6.8 [P<.01]) was found to have the strongest association with very early-onset HCC after adjusting for sex and race/ethnicity. Birth in West Africa, Central/South/other Africa, Oceania, or East Africa also was found to be strongly associated with early-onset HCC. CONCLUSIONS: Birth country was found to be independently associated with age at the time of HCC diagnosis in the United States. Birth in Africa (except for North Africa) and Oceania was strongly associated with very early-onset HCC. These findings have implications for the design of comprehensive HCC surveillance programs in the United States. Cancer 2016.

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KW - liver cancer

KW - Oceania

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