Disparities in the Receipt of Palliative-Intent Treatment Among Disaggregated Hispanic Populations With Stage IV Liver Cancer in the United States.

OBJECTIVES

Our study investigates disparities in receipt of palliative-intent care among broad racial/ethnic and disaggregated Hispanic subgroups with stage IV liver cancer.

METHODS

This retrospective cohort study included patients with stage IV liver cancer diagnosed between 2004 and 2021 from the National Cancer Database. The primary outcome was the receipt of palliative-intent intervention. Multivariate regressions controlling for age group, country of origin, year group, sex, insurance status, 2016 median income quartiles, facility type, Charlson-Deyo comorbidity index score, stage group, and facility location quantified disparities in palliative-intent intervention. Further difference-in-differences analyses were conducted.

RESULTS

Among 37,987 patients with stage IV liver cancer, 6573 (17.30%) received palliative-intent treatment. Compared to non-Hispanic White (NHW) patients, disaggregated analyses revealed significantly lower odds of receiving palliative-intent interventions for Black patients (AOR=0.93, 95% CI: 0.86-1.00, P =0.050) and patients of Hispanic descent (AOR=0.76, CI: 0.69-0.84, P <0.001). Furthermore, patients with stage IV liver cancer of Mexican and Cuban descent had lower odds of obtaining palliative-intent treatment compared with NHW patients (AOR=0.70, 95% CI: 0.54-0.90, P =0.006; AOR=0.44, 95% CI: 0.19-1.02, P =0.056). Difference-in-differences analyses revealed a significant association between palliative-intent intervention and 2014 to 2021, suggesting potential temporal differences in the primary outcome.

CONCLUSIONS

Our study highlights the significant disparities in receipt of palliative-intent care among Hispanic subgroups upon disaggregation, underscoring the need for continued disaggregated research and targeted community- and patient-level solutions to close care gaps.