Gastroenterol Res

Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access

Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc

Journal website https://www.gastrores.org

Original Article

Volume 16, Number 4, August 2023, pages 203-208

Sex and Race Disparities in Hepatocellular Carcinoma Surveillance in Patients With Chronic Hepatitis B During COVID-19: A Single-Center Retrospective Review

Figure 1. Patient flowchart for inclusion and exclusion criteria. AASLD: American Association for the Study of Liver Diseases; HCC: hepatocellular carcinoma; HbSAg: hepatitis B surface antigen.

**Table 1.** Patient Demographics
Variable	ID clinic (n = 6)	GI clinic (n = 46)	Not in clinic (n = 22)	Both ID and GI clinics (n = 2)
Other race includes patients who identify as native Hawaiian or other Pacific Islander or declined to provide information regarding race. GI: gastroenterology; ID: infectious disease; SD: standard deviation.
Gender, no. (%)
Male	5 (83.3)	35 (76.1)	14 (63.6)	2 (100)
Female	1 (16.7)	11 (23.9)	8 (36.4)	0 (0)
Race, no. (%)
Asian	6 (100)	29 (63.0)	12 (54.5)	1 (50)
Black	0 (0)	8 (17.4)	9 (40.9)	0 (0)
White	0 (0)	4 (8.7)	1 (4.6)	1 (50)
Other	0 (0)	5 (10.9)	0 (0)	0 (0)
Ethnicity, no. (%)
Not Hispanic	6 (100)	44 (95.7)	22 (100)	2 (100)
Hispanic	0 (0)	2 (4.3)	0 (0)	0 (0)
Non-English speaking, no. (%)	5 (83.3)	25 (54.3)	13 (59.1)	1 (50)
Insurance, no. (%)
Public	1 (16.7)	15 (32.6)	6 (27.3)	1 (50)
Private	5 (83.3)	29 (63.0)	14 (63.6)	1 (50)
No insurance	0 (0)	2 (4.4)	2 (9.1)	0 (0)
Age (mean ± SD), years	49 ± 12	51 ± 12	53 ± 11	59 ± 9

Table 1. Patient Demographics

Variable

ID clinic (n = 6)

GI clinic (n = 46)

Not in clinic (n = 22)

Both ID and GI clinics (n = 2)

Other race includes patients who identify as native Hawaiian or other Pacific Islander or declined to provide information regarding race. GI: gastroenterology; ID: infectious disease; SD: standard deviation.

Gender, no. (%)

Male

5 (83.3)

35 (76.1)

14 (63.6)

2 (100)

Female

1 (16.7)

11 (23.9)

8 (36.4)

0 (0)

Race, no. (%)

Asian

6 (100)

29 (63.0)

12 (54.5)

1 (50)

Black

0 (0)

8 (17.4)

9 (40.9)

0 (0)

White

0 (0)

4 (8.7)

1 (4.6)

1 (50)

Other

0 (0)

5 (10.9)

0 (0)

Ethnicity, no. (%)

Not Hispanic

6 (100)

44 (95.7)

22 (100)

2 (100)

Hispanic

0 (0)

2 (4.3)

0 (0)

Non-English speaking, no. (%)

5 (83.3)

25 (54.3)

13 (59.1)

1 (50)

Insurance, no. (%)

Public

1 (16.7)

15 (32.6)

6 (27.3)

1 (50)

Private

5 (83.3)

29 (63.0)

14 (63.6)

1 (50)

No insurance

0 (0)

2 (4.4)

2 (9.1)

0 (0)

Age (mean ± SD), years

49 ± 12

51 ± 12

53 ± 11

59 ± 9

**Table 2.** HCC Surveillance Data Stratified by 6-Month Intervals Throughout the Study Period and Sex
Interval	1 (July 2018 - January 2019)	2 (January 2019 - July 2019)	3 (July 2019 - January 2020)	4 (January 2020 - July 2020)	5 (July 2020 - January 2021)	6 (January 2021 - July 2021)	7 (July 2021 - January 2022)
The COVID-19 surge occurred during study intervals 4-6. ^aP = 0.026. HCC: hepatocellular carcinoma.
HCC surveillance indicated, no.
Men	19	25	31	37	41	49	56
Women	4	8	9	12	14	15	20
HCC surveillance indicated and performed, no.
Men	10	7	9	7	8	10	15
Women	1	3	5	6	5	3	7
HCC surveillance completion percentage (%)
Men	52.6	28	29	18.9^a	19.5	20.4	26.8
Women	25	37.5	55.6	50.0^a	35.7	20.0	35.0

Table 2. HCC Surveillance Data Stratified by 6-Month Intervals Throughout the Study Period and Sex

Interval

1 (July 2018 - January 2019)

2 (January 2019 - July 2019)

3 (July 2019 - January 2020)

4 (January 2020 - July 2020)

5 (July 2020 - January 2021)

6 (January 2021 - July 2021)

7 (July 2021 - January 2022)

The COVID-19 surge occurred during study intervals 4-6. ^aP = 0.026. HCC: hepatocellular carcinoma.

HCC surveillance indicated, no.

Men

Women

HCC surveillance indicated and performed, no.

Men

Women

HCC surveillance completion percentage (%)

Men

52.6

18.9^a

19.5

20.4

26.8

Women

37.5

55.6

50.0^a

35.7

20.0

35.0

**Table 3.** HCC Surveillance Data Before or During the COVID-19 Pandemic
Variable	Male	Female	P-value
COVID-19: coronavirus disease 2019; HCC: hepatocellular carcinoma; NS: not significant.
COVID-19 surge HCC screening when indicated (%)	38	47	0.60
Non-surge screening when indicated (%)	62	53	0.62

Table 3. HCC Surveillance Data Before or During the COVID-19 Pandemic

Variable

Male

Female

P-value

COVID-19: coronavirus disease 2019; HCC: hepatocellular carcinoma; NS: not significant.

COVID-19 surge HCC screening when indicated (%)

0.60

Non-surge screening when indicated (%)

0.62

**Table 4.** HCC Surveillance Data Stratified by 6-Month Intervals Throughout the Study Period and Race
Interval	1 (July 2018 - January 2019)	2 (January 2019 - July 2019)	3 (July 2019 - January 2020)	4 (January 2020 - July 2020)	5 (July 2020 - January 2021)	6 (January 2021 - July 2021)	7 (July 2021 - January 2022)
Other race includes patients who identify as native Hawaiian or other Pacific Islander or declined to provide information regarding race. The COVID-19 surge occurred during study intervals 4-6. HCC: hepatocellular carcinoma.
HCC surveillance indicated, no.
Asian	13	17	22	30	35	40	47
Black	5	7	9	11	11	13	16
White	3	5	6	6	6	6	8
Other	2	3	3	3	2	5	5
HCC surveillance indicated and performed, no.
Asian	5	5	9	7	10	4	12
Black	3	3	2	5	2	5	4
White	2	2	3	1	1	2	4
Other	1	1	0	1	0	2	2
HCC surveillance completion percentage (%)
Asian	38.5	29.4	40.9	23.3	28.6	10	25.5
Black	60	42.9	22.2	45.5	18.2	38.5	25
White	66.7	40	50	16.7	16.7	33.3	50
Other	50	33.3	0	33.3	0	40	40

Table 4. HCC Surveillance Data Stratified by 6-Month Intervals Throughout the Study Period and Race

Interval

1 (July 2018 - January 2019)

2 (January 2019 - July 2019)

3 (July 2019 - January 2020)

4 (January 2020 - July 2020)

5 (July 2020 - January 2021)

6 (January 2021 - July 2021)

7 (July 2021 - January 2022)

Other race includes patients who identify as native Hawaiian or other Pacific Islander or declined to provide information regarding race. The COVID-19 surge occurred during study intervals 4-6. HCC: hepatocellular carcinoma.

HCC surveillance indicated, no.

Asian

Black

White

Other

HCC surveillance indicated and performed, no.

Asian

Black

White

Other

HCC surveillance completion percentage (%)

Asian

38.5

29.4

40.9

23.3

28.6

25.5

Black

42.9

22.2

45.5

18.2

38.5

White

66.7

16.7

33.3

Other

33.3