{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T02:44:59Z","timestamp":1789267499666,"version":"build-2803163510"},"reference-count":53,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,2,25]],"date-time":"2021-02-25T00:00:00Z","timestamp":1614211200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["1R03CA164546\u201001A1"],"award-info":[{"award-number":["1R03CA164546\u201001A1"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000125","name":"National Institute for Occupational Safety and Health","doi-asserted-by":"publisher","award":["U01OH011489"],"award-info":[{"award-number":["U01OH011489"]}],"id":[{"id":"10.13039\/100000125","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>In the United States, mortality after a diagnosis of hepatocellular carcinoma (HCC) is higher in patients who are Black than in patients of other racial groups. The objective of this study was to clarify factors contributing to this disparity by analyzing liver and tumor characteristics in patients with HCC who have a history of hepatitis C virus (HCV) infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Records of patients with HCV and HCC at the authors' institution from 2003 to 2018 were retrospectively reviewed. Race and ethnicity were self\u2010identified. Imaging, laboratory, and pathologic features were compared between Black and non\u2010Black cohorts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 1195 individuals with HCC, 390 identified as Black. At the time of HCC diagnosis, Black patients had better liver function, as measured by Child\u2010Pugh score, Model of End\u2010Stage Liver Disease score, histology of nontumor tissue, and fibrosis\u20104 (FIB\u20104) score (all <jats:italic>P<\/jats:italic> &lt; .05). FIB\u20104 scores were &lt;3.25 in 31% of Black patients. In addition, Black patients had less early stage HCC (20.2% vs 32.3%; <jats:italic>P<\/jats:italic> &lt; .05), larger tumors (median [interquartile range]: 3.5 cm [2.2\u20106.2 cm] vs 3.1 cm [2.1\u20105.1 cm]; <jats:italic>P<\/jats:italic> &lt; .01), more multiple tumors (median, [interquartile range]: 1 tumor [1\u20103 tumors] vs 1 tumor [1\u20102 tumors]; <jats:italic>P<\/jats:italic> = .03), more poorly differentiated tumors (30.3% vs 20.5%; <jats:italic>P<\/jats:italic> &lt; .05), and more microvascular invasion (67.2% vs 56.5%; <jats:italic>P<\/jats:italic> &lt; .05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Black patients with HCV exposure develop HCC at earlier stages of liver disease than members of other racial groups. Nearly one\u2010third would not qualify for HCC screening using the common FIB\u20104 cirrhosis threshold. Practice guidelines that stress HCC surveillance for cirrhotic patients with HCV may need to be revised to be more inclusive for Black patients. In addition, tumors in Black patients carry worse prognostic features, and molecular studies are needed to characterize their biologic properties.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.33377","type":"journal-article","created":{"date-parts":[[2021,2,25]],"date-time":"2021-02-25T08:05:27Z","timestamp":1614240327000},"page":"1395-1406","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Hepatitis C\u2010positive Black patients develop hepatocellular carcinoma at earlier stages of liver disease and present with a more aggressive phenotype"],"prefix":"10.1002","volume":"127","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2794-4584","authenticated-orcid":false,"given":"Tali","family":"Shaltiel","sequence":"first","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery Icahn School of Medicine at Mount Sinai New York New 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