Survival of primary liver cancer for people from culturally and linguistically diverse backgrounds in Australia

Background: Survival for Primary Liver Cancer (PLC) has been investigated in Australia, but limited work has been conducted on the burden for people with different socioeconomic status, region of residence, causes of PLC, and culturally and linguistically diverse (CALD) backgrounds. This study aimed to cover this gap in the literature by investigating PLC survival with the aforementioned factors.Methods: This study linked four administrative datasets: Victorian Cancer Registry, Admitted Episodes Dataset, Emergency Minimum Dataset, and Death Index. The cohort was all cases with a PLC notification within the Victorian Cancer Registry between 01/01/2008 and 01/01/2016. The Kaplan-Meier method was used to esti-mate survival probabilities and the log-rank test was used to compare the difference in survival between sub-groups. The Cox proportional hazard model was used to explore factors associated with PLC survival.Results: The 1-, 3-and 5-year survival rates were 50.0%, 28.1% and 20.6%, respectively, with a median survival of 12.0 months (95% confidence interval (CI): 11.0 - 12.9 months). Higher survival was associated with younger age, hepatocellular carcinoma, and higher socio-economic status. People born in Asian, African, and American regions had higher survival than those born in Australia and New Zealand. Cases with viral hepatitis as an identified aetiology had higher survival than those whose PLC was related to alcohol consumption (hazard ratio=1.52, 95% CI: 1.19 - 1.96), diabetes and fatty liver disease (hazard ratio=1.35, 95% CI: 1.08 - 1.68).Conclusion: Survival outcomes for people diagnosed with PLC were still poor and affected by many factors. Asian and African cases had better survival than Australian and New Zealand patients as PLC in Asian and African cases was mostly caused by viral hepatitis. Metropolitan areas were associated with a higher survival than rural areas, not only due to accessibility to surveillance and healthcare services but also because the majority of overseas -born patients reside in metropolitan areas.

Automated summary

This study aimed to fill the gap in the literature by investigating the survival of Primary Liver Cancer (PLC) and its association with various factors. The results showed that younger age, hepatocellular carcinoma, higher socioeconomic status, and being born in Asian, African or American regions were associated with better survival outcomes for PLC patients. The study also found that viral hepatitis as a cause of PLC had higher survival rates compared to alcohol consumption, diabetes, and fatty liver disease as causes.