MedStar Georgetown University Hospital Washington, DC, United States
Nuval Cherian, MD, Esha Parikh, DO, Arul Thomas, MD MedStar Georgetown University Hospital, Washington, DC
Introduction: Primary sclerosing cholangitis (PSC) is often associated with male sex, concurrent inflammatory bowel disease (IBD) and hepatopancreatobiliary malignancies (cholangiocarcinoma, hepatocellular carcinoma, gallbladder adenocarcinoma and pancreatic cancers). Traditionally, the epidemiology of PSC and its clinical associations is described from predominantly white European cohorts. There is less data about PSC epidemiology in diverse North American populations, particularly in black populations.
Methods: A retrospective chart review of patients with PSC was conducted using the electronic medical record of a large Mid-Atlantic U.S. hospital system. A total of 411 patients with PSC were identified during encounters from January 2010 through December 2019. Of these, 115 patients were black and 233 were white. Patients from other races or without documented race were excluded from this analysis. Using Fisher’s exact test, race was analyzed in relation to patient characteristics. For continuous variables, a two-tailed t-test was used.
Results: 59 black patients (51.3%) and 145 white patients (62.2%) were male (p=0.06). Average age at diagnosis with PSC was 38.5 years (n=109) for black patients and 38.4 years (n=204) among white patients (p=0.96). 75 black patients (68.8%) and 180 white patients (80.7%) had concurrent IBD (p=0.02). Average age at IBD diagnosis was 30.7 years (n=67) among black patients and 26.7 years (n=143) among white patients (p=0.05). 18 black patients (15.7%) and 19 white patients (8.2%) had some form of hepatopancreatobiliary malignancy (p=0.04). 11 black patients (9.6%) and 12 white patients (5.2%) had cholangiocarcinoma (p=0.17). 4 black patients (3.5%) and 0 white patients (0%) had hepatocellular carcinoma (p=0.01). 1 black patient (0.9 %) and 4 white patients (1.7%) had gallbladder adenocarcinoma(p=1). 2 black patients (1.7%) and 2 white patients (0.9%) had pancreatic cancer (p=1).
Discussion: In this cohort of PSC patients in a large Mid-Atlantic U.S. hospital system, hepatopancreatobiliary malignancies were significantly more common in black compared to white patients. Cholangiocarcinoma was the most common type in both black and white populations. Concurrent IBD was significantly less common among black patients compared to white patients. More studies are needed to better understand the genetic, medical and social underpinnings of these differences in diverse North American populations.
Nuval Cherian indicated no relevant financial relationships.
Esha Parikh indicated no relevant financial relationships.
Arul Thomas indicated no relevant financial relationships.
Nuval Cherian, MD, Esha Parikh, DO, Arul Thomas, MD. P0724 - Hepatopancreatobiliary Malignancy and Inflammatory Bowel Disease Occurrence in Black and White Patient Populations With Primary Sclerosing Cholangitis Seen in a Large U.S. Health Care Network, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.