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Sempokuya T, Pan CW, Pattison RJ, Choi C, Nogimura A, Wong LL. Disparities in Hepatocellular Carcinoma Outcomes Among Subgroups of Asians and Pacific Islanders: A SEER Database Study. J Immigr Minor Health 2023; 25:824-834. [PMID: 37004678 DOI: 10.1007/s10903-023-01478-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2023] [Indexed: 04/04/2023]
Abstract
Hepatocellular carcinoma (HCC) is highly prevalent in Asians and Pacific Islanders (API) but this heterogenous group is often aggregated into a single category, despite vast differences in culture, socioeconomic status, education, and access to care among subgroups. There remains a significant knowledge gap in HCC outcomes among different subgroups of API. The Surveillance, Epidemiology, and End Results (SEER) database was accessed, and site/ICD codes were used to identify HCC patients during 2010-2019 who were API ethnicity. Data collected: demographics, socioeconomic status, tumor characteristics, treatment, and survival. Subgroup analyses were performed among different Asian ethnicities in a secondary analysis. 8,249 patients were identified/subdivided into subgroups of Asian ethnicities and Other Pacific Islanders (NHOPI) groups. The median age was 65 years for Asians and 62 years for NHOPI (p < 0.01), and significant differences were found in income (p < 0.01). A higher proportion of NHOPI lived in rural areas compared to Asians (8.1 vs. 1.1%, p < 0.01). There were no statistically significant differences in tumor size, stage, pre-treatment AFP level, or surgical treatments between the two groups. However, Asians had higher overall median survival than NHOPI (20 months v 12 months, p < 0.01). Secondary analyses among different subgroups of Asian ethnicities revealed significant differences in tumor size and staging, surgical resection, transplant rates, and median survival. While API had similar tumor characteristics and treatment, Asians had much higher survival than NHOPI. Socioeconomic differences and access to care may contribute to these differences. This study also found significant survival disparities within API ethnicities.
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Affiliation(s)
- Tomoki Sempokuya
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Nebraska Medical Center, 982000 Nebraska Medical Center, Omaha, NE, 68198, USA.
| | - Chun-Wei Pan
- Department of Medicine, John H. Stroger Jr Hospital of Cook County, Chicago, IL, USA
| | - Robert J Pattison
- Department of Gastroenterology and Hepatology, HCA Healthcare, Sunrise Consortium Graduate Medical Education, Las Vegas, NV, USA
| | - Chansong Choi
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Nebraska Medical Center, 982000 Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Akane Nogimura
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
- Division of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
| | - Linda L Wong
- Department of Surgery, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA
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Sempokuya T, Warner J, Azawi M, Nogimura A, Wong LL. Current status of disparity in liver disease. World J Hepatol 2022; 14:1940-1952. [PMID: 36483604 PMCID: PMC9724102 DOI: 10.4254/wjh.v14.i11.1940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 11/09/2022] [Accepted: 11/16/2022] [Indexed: 11/24/2022] Open
Abstract
Disparities have emerged as an important issue in many aspects of healthcare in developed countries and may be based on race, ethnicity, sex, geographical location, and socioeconomic status. For liver disease specifically, these potential disparities can affect access to care and outcome in viral hepatitis, chronic liver disease, and hepatocellular carcinoma. Shortages in hepatologists and medical providers versed in liver disease may amplify these disparities by compromising early detection of liver disease, surveillance for hepatocellular carcinoma, and prompt referral to subspecialists and transplant centers. In the United States, continued efforts have been made to address some of these disparities with better education of healthcare providers, use of telehealth to enhance access to specialists, reminders in electronic medical records, and modifying organ allocation systems for liver transplantation. This review will detail the current status of disparities in liver disease and describe current efforts to minimize these disparities.
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Affiliation(s)
- Tomoki Sempokuya
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68198, United States
| | - Josh Warner
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68198, United States
| | - Muaataz Azawi
- Division of Gastroenterology and Hepatology, Sanford Center for Digestive Health, Sioux Falls 57105, SD, Uruguay
| | - Akane Nogimura
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Aichi, Japan
- Division of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Aichi, Japan
| | - Linda L Wong
- Department of Surgery, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI 96813, United States
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Nogimura A, Noguchi T, Otani T, Kamiji K, Yasuoka M, Watanabe R, Ojima T, Kondo K, Kojima M. Chronic obstructive pulmonary disease and the mortality risk in male older adults: role of socioeconomic factors. Arch Gerontol Geriatr 2022; 102:104741. [DOI: 10.1016/j.archger.2022.104741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/23/2022] [Accepted: 05/31/2022] [Indexed: 11/25/2022]
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Noguchi T, Wakabayashi R, Nishiyama T, Otani T, Nakagawa-Senda H, Watanabe M, Hosono A, Shibata K, Kamishima H, Nogimura A, Nagaya K, Yamada T, Suzuki S. The Impact of Job Conditions on Health-Related Quality of Life among Working Japanese Older Adults: A Five-Year Longitudinal Study Using J-MICC Okazaki Study Data. Arch Gerontol Geriatr 2021; 95:104385. [PMID: 33713878 DOI: 10.1016/j.archger.2021.104385] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 01/08/2021] [Accepted: 02/28/2021] [Indexed: 02/04/2023]
Abstract
OBJECTIVES The number of older adults who continue working after retirement is increasing in Japan. Little is known about how job conditions affect older adults' health. We examined the association between job conditions and health-related quality of life (HRQOL) during a five-year follow-up study. METHODS This study included participants aged 65 years or older from the Japan Multi-Institutional Collaborative Cohort Study in the Okazaki area recruited at baseline between 2007 and 2011 and followed up five years later. Participants completed a self-reported questionnaire on the physical and mental health aspects of HRQOL (SF-8™), employment status, and job conditions (job satisfaction, skill use, and job suitability). RESULTS Data of 1,146 men and 522 women were analyzed (mean age: 69.1 and 68.6 years, respectively). Generalized mixed linear regression analysis revealed that, compared to the not-working group, skill use was positively associated with mental health aspects among men (skill use × time: β = 0.16, SE = 0.08, p < 0.05), while poor job satisfaction and job suitability were negatively associated with mental health aspects among women (job satisfaction, not satisfied × time: β = -0.93, SE = 0.47, p < 0.05; job suitability, not suitable × time: β = -1.06, SE = 0.50, p < 0.05). CONCLUSIONS Regarding job conditions among older adults, skill use in men was marginally associated with mental health, and poor job satisfaction and suitability in women were negatively associated with mental health. Considering the job conditions of older workers is necessary to protect their mental health.
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Affiliation(s)
- Taiji Noguchi
- Department of Social Science, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan; Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
| | - Ryozo Wakabayashi
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
| | - Takeshi Nishiyama
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
| | - Takahiro Otani
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
| | - Hiroko Nakagawa-Senda
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
| | - Miki Watanabe
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
| | - Akihiro Hosono
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan; Atsuta Public Health Center, City of Nagoya, Aichi, Japan
| | - Kiyoshi Shibata
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan; Department of Health and Nutritional Sciences, Nagoya Keizai University, Aichi, Japan
| | - Hiroyuki Kamishima
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan; Department of Home Economics, Aichi Gakusen University, Aichi, Japan
| | - Akane Nogimura
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan; Department of Anesthesiology and Intensive Care Medicine, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
| | - Kenji Nagaya
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
| | - Tamaki Yamada
- Okazaki Public Health Center, Okazaki Medical Association, Aichi, Japan
| | - Sadao Suzuki
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan.
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Noguchi T, Kondo F, Nishiyama T, Otani T, Nakagawa-Senda H, Watanabe M, Imaeda N, Goto C, Hosono A, Shibata K, Kamishima H, Nogimura A, Nagaya K, Yamada T, Suzuki S. The impact of marital transitions on vegetable intake in middle-aged and older Japanese adults: a five-year longitudinal study. J Epidemiol 2020; 32:89-95. [PMID: 33071250 PMCID: PMC8761567 DOI: 10.2188/jea.je20200343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Marital transitions are associated with adverse health events, such as mortality and cardiovascular disease. Since marital transitions (eg, becoming widowed) are unavoidable life events, it is necessary to identify modifiable intermediate outcomes. Thus, we examined the association between marital transitions and vegetable intake among middle-aged and older Japanese adults. Methods This longitudinal study included Japanese adults aged 40–79 years who received an annual health checkup between 2007 and 2011 (baseline) and 5 years later (follow-up). Marital transitions were classified as whether and what type of transition occurred during the 5-year period and comprised five groups: consistently married, married to widowed, married to divorced, not married to married, and remained not married. Changes in total vegetable, green and yellow vegetable, and light-colored vegetable intake from baseline to follow-up were calculated using the Food Frequency Questionnaire. Results Data from 4,813 participants were analyzed (mean age, 59.4 years; 44.1% women). Regarding marital transitions, 3,960 participants were classified as “consistently married,” 135 as “married to widowed,” 40 as “married to divorced,” 60 as “not married to married,” and 529 as “remained not married.” Multivariable linear regression analysis revealed that compared to consistently married, married to widowed was inversely associated with the change in total vegetable intake (β = −16.64, SE = 7.68, P = 0.030) and light-colored vegetable intake (β = −11.46, SE = 4.33, P = 0.008). Conclusion Our findings suggest that being widowed could result in a reduced intake of vegetables. Hence, dietary counseling according to marital situation is necessary.
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Affiliation(s)
- Taiji Noguchi
- Department of Social Science, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology.,Department of Public Health, Nagoya City University Graduate School of Medical Sciences
| | - Fumi Kondo
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences
| | - Takeshi Nishiyama
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences
| | - Takahiro Otani
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences
| | - Hiroko Nakagawa-Senda
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences
| | - Miki Watanabe
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences
| | - Nahomi Imaeda
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences.,Department of Nutrition Science, Faculty of Health Science, Shigakkan University
| | - Chiho Goto
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences.,Department of Health and Nutrition, Faculty of Health and Living, Nagoya Bunri University
| | - Akihiro Hosono
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences.,Atsuta Public Health Center, City of Nagoya
| | - Kiyoshi Shibata
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences.,Department of Health and Nutritional Sciences, Nagoya Keizai University
| | - Hiroyuki Kamishima
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences.,Department of Home Economics, Aichi Gakusen University
| | - Akane Nogimura
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences.,Department of Anesthesiology and Intensive Care Medicine, Nagoya City University Graduate School of Medical Sciences
| | - Kenji Nagaya
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences
| | - Tamaki Yamada
- Okazaki Public Health Center, Okazaki Medical Association
| | - Sadao Suzuki
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences
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Yamaguchi M, Kojima T, Kanekawa M, Aihara N, Nogimura A, Kasai K. Neuropeptides stimulate production of interleukin-1 beta, interleukin-6, and tumor necrosis factor-alpha in human dental pulp cells. Inflamm Res 2004; 53:199-204. [PMID: 15105969 DOI: 10.1007/s00011-003-1243-z] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2003] [Accepted: 12/17/2003] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE Orthodontic tooth movement causes inflammatory reactions in the periodontal membrane and dental pulp. It has been reported that substance P (SP) and calcitonin gene-related peptide (CGRP), both sensory neuropeptides, are manifested in the dental pulp of rats during experimental tooth movement, suggesting that they might be involved in the dental pulp inflammation during orthodontic tooth movement. However, the relationships between neuropeptides and pro-inflammatory cytokines have not been fully elucidated. MATERIALS AND METHODS Human dental pulp (HDP) fibroblasts were prepared from 6 healthy young volunteers (3 males, 3 females; 15-25 years old) during the course of orthodontic treatment. HDP cells were incubated for 24 h in fresh medium containing 2% FCS in the presence of various concentrations of CGRP (10(-12) to 10(-4) M) and SP (10(-12) to 10(-4) M), and the levels of interleukin (IL)-1 beta, IL-6, and tumor necrosis factor (TNF)-alpha present in the media were determined using commercially available high-sensitivity enzyme-linked immunosorbent assay kit. RESULTS We examined the effects of stimulation by these neuropeptides on the production of inflammatory cytokines in HDP fibroblasts, and found that the levels of IL-1 beta, IL-6, and TNF-alpha increased in a time- and concentration-dependent manner. However, the neuropeptides did not act synergistically to increase cytokine secretion in HDP cells or significantly modify LPS-induced cytokine production by HDP cells. CONCLUSIONS Our results suggest that human pulp fibroblasts may be involved in the progress of inflammation in pulp tissue during orthodontic tooth movement, as they produced large amounts of IL-1 beta, IL-6, and TNF-alpha following stimulation with neuropeptides.
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Affiliation(s)
- M Yamaguchi
- Department of Orthodontics, Nihon University School of Dentistry at Matsudo, 2-870-1 Sakaecho-Nishi, Matsudo, Chiba 271-8587, Japan.
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