Hepatocellular carcinoma (HCC) comprises 75% of all liver cancer diagnoses in the United States, with prevalence rising in recent years, according to Joseph Bettag. The time to treatment initiative (TTI), he explained, is an aspect of treatment for HCC linked with lower patient anxiety and better outcomes. “We hypothesized that demographic factors play a role in how fast a patient with HCC receives treatment,” Bettag wrote.
Bettag and colleagues presented their research at the 2023 American Society for Clinical Oncology annual meeting recently held in Chicago and online.
This study team analyzed data from 112,615 patients from the National Cancer Database with an HCC diagnosis from 2004 to 2019. They examined key demographic factors, including age, race, biological sex, cancer stage, year of diagnosis, household income, insurance status, Charlson-Deyo score, and type of treatment facility. Analysis of Variance was used for cross-tabulation analysis, and ICD-O-3 coding was used to determine histology.
Determining Which Patients Are Likely to Experience TTI Delay
The study team observed that patients with delayed TTI were more often older (aged 61-70), male, Black, with stage 3 cancer, receiving government insurance, year of diagnosis between 2016 and 2019, earning less than $40,227 annually, and received treatment at integrated cancer network programs. Compared with patients receiving government insurance, patients with no insurance received a TTI 4 days faster (P<0.001). Compared with patients earning higher incomes, patients with lower incomes experienced greater than 2-day delays in TTI (P<0.001). Patients who received treatment at an integrated cancer network were more likely to experience a 3-day delay, compared with patients who received treatment at a community cancer center (P<0.001). Female patients received treatment a half day earlier than their male counterparts (P<0.017).
“Discrepancies exist in TTI for [patients with] HCC, most notably for insurance status, race, year of diagnosis, income, and facility type, Bettag and colleagues wrote. “This data can be used when determining which patients may experience delays in TTI due to demographic factors.”