Background: Previous survival studies on hepatocellular carcinoma (HCC) by etiology are limited to hospital-based series, restricted cohorts, and monolithic etiologic categories. We studied population-based survival by seven mutually exclusive HCC etiologic groups—standalone hepatitis-C virus (HCV), hepatitis-B virus (HBV), alcohol-related liver disease (ALD), nonalcoholic fatty liver disease (NAFLD), and dual etiology HCV–HBV, HCV–ALD, and HBV–ALD—accounting for clinical and sociodemographic characteristics. Methods: All HCC cases diagnosed during 2005 to 2018 from the Florida Cancer Registry were linked for etiology using statewide discharge and viral hepatitis data. We performed a cause-specific survival analysis including Cox regression for the matched 15,616 cases by HCC etiology. Results: The leading etiology was HCV only (n = 4,983; 31.9%); the leading dual etiology was HCV–ALD (n = 2,552; 16.3%). The five-year adjusted survival was low—17.6% overall and <22% across all HCC etiologies. ALD-related etiologies [ALD only (14.4%; 95% confidence interval (CI), 12.7–16.0), HCV–ALD (10.2%; 95% CI, 8.7–11.7), and HBV–ALD (8.2%; 95% CI, 2.2–14.1)] showed lower survival than non-ALD causes—HCV only, HBV only, and NAFLD only. After adjustment for clinical and sociodemographic covariates, ALD and HBV–ALD HCC had 1.20 (95% CI, 1.13–1.27) and 1.28 (95% CI, 1.06–1.54) times higher risk of death compared with those with HCV-only HCC. Conclusions: ALD only and dual etiologies involving ALD show worse prognosis for HCC compared with viral etiology alone. To increase survival, improved screening and treatment are needed for patients with multiple HCC risk factors. Impact: Understanding US disparities in HCC survival by etiology can help guide the identification of etiologically specific biomarkers and potential therapeutic targets and inform public health measures.

Without a cure, dementia affects about 50 million people worldwide. Understanding the effects of dietary habits, a key lifestyle behavior, on memory impairment is critical to inform early behavioral modification to delay further memory loss and progression to dementia. We examined the associations of total energy intake and energy intake from macronutrients with memory impairment among older US adults using data from the nationally representative National Health and Nutrition Examination Survey study 2011–2014. A total of 3623 participants aged ≥60 years were analyzed. Comparing to those with low total energy intake, individuals with high intake were more likely to have severe memory impairment (OR: 1.52, 95% CI: 1.15 to 2.02; p_trend = 0.005). Specifically, higher energy intake from carbohydrate (OR: 1.59, 95% CI: 1.12 to 2.26) and sugar (OR: 1.54, 95% CI: 1.11 to 2.16) were both significantly associated with the presence of memory impairment. Additionally, higher energy intake from fat, carbohydrate and sugar were significantly associated with more server memory impairment (fat: p_trend = 0.04; carbohydrate: p_trend = 0.03; sugar: p_trend = 0.02). High energy intake, either total or from carbohydrates, fat or sugar, is associated with memory impairment severity in the older US population. No such association was found in energy intake from protein.

Background: Despite the increasing adoption of stereotactic body radiotherapy (SBRT) as a recommended alternative for early-stage non–small cell lung cancer (NSCLC), population-based research on racial/ethnic disparities in curative-intent treatment accounting for SBRT remains limited. This study investigated trends and disparities in receiving curative-intent surgery and/or SBRT in a diverse, retrospective cohort. Methods: Early-stage NSCLC cases (2005–2017) from the Florida cancer registry were linked to individual-level statewide discharge data containing comorbidities and specific treatment information. Joinpoint regression assessed trends in treatment receipt. Multivariable logistic regression examined associations between race/ethnicity and treatment type. Results: Among 64,999 patients with early-stage NSCLC, 71.6% received curative-intent treatment (surgery and/or SBRT): 73.1%, 72.4%, and 60.3% among Hispanic, White, and Black patients, respectively (P < 0.01). SBRT use increased steeply from 2005 to 2007 and then by 7.9% annually from 2007 to 2017 (P < 0.01); curative-intent surgery remained stable from 2005 to 2014 before declining by 6.2% annually during 2014–2017 (P = 0.04). The Black-White disparity in receipt of curative-intent treatment was significant [ORadj, 0.65; 95% confidence interval (CI), 0.60–0.71]. Patients with Charlson comorbidity index (CCI)≥3 had 36% (ORadj, 0.64; 95% CI, 0.60–0.69) lower odds of receiving curative-intent surgery and no significant difference for SBRT (ORadj, 1.06; 95% CI, 0.93–1.20) compared with CCI = 0. Conclusions: Racial disparities in receiving curative-intent treatment for early-stage NSCLC persist despite the availability of SBRT, suggesting the full potential of curative-intent treatment for early-stage NSCLC remains unachieved. Impact: Addressing disparities in early-stage NSCLC requires addressing differential treatment patterns and enhancing accessibility to treatments like underutilized SBRT, particularly for high-comorbidity populations such as Black patients.

Background: Ewing sarcoma (ES) is a malignant bone tumor most commonly affecting non‐Hispanic White (NHW) adolescent males, though recognition among Hispanic individuals is rising. Prior population‐based studies in the United States (US), utilizing Surveillance, Epidemiology, and End Results (SEER) have shown higher all‐cause mortality among White Hispanics, Blacks, and those of low socioeconomic status (SES). Florida is not part of SEER but is home to unique Hispanic populations including Cubans, Puerto Ricans, South Americans that contrasts with the Mexican Hispanic majority in other US states. This study aimed to assess racial/ethnic disparities on incidence and survival outcomes among this diverse Florida patient population.Methodology: Our study examined all patients diagnosed with osseous ES (2005–2018) in Florida (n = 411) based on the state's population‐based cancer registry dataset. Florida Age‐adjusted Incidence Rates (AAIRs) were computed by sex and race‐ethnicity and compared to the equivalent populations in SEER. Cause‐specific survival disparities among Florida patients were examined using Kaplan–Meier analysis. Univariable and multivariable analyses using Cox regression were performed for race/ethnicity, with adjustment for age, sex, year of diagnosis, site of disease, staging, SES, and insurance type.Results: There was a significantly higher incidence of osseous ES in Florida Hispanic males (AAIR 2.6/1,000,000); (95% CI: 2.0–3.2 per 1,000,000; n = 84) compared to the SEER Hispanic males (AAIR 1.2/1,000,000;1.1–1.4 per 1,000,000; n = 382). Older age, distant metastasis, lack of chemotherapy or surgical resection were statistically significant determinants of poor survival while SES, insurance status and race‐ethnicity were not. However, among nonmetastatic ES, Florida Hispanics had an increased risk of death compared to Florida NHW (adjusted Hazard Ratio 2.32; 95%CI: 1.20–4.46; p = 0.012).Conclusions: Florida Hispanic males have a higher‐than‐expected incidence of osseous ES compared to the US. Hispanics of both sexes show remarkably worse survival for nonmetastatic disease compared to NHW. This disparity is likely multifactorial and requires further in‐depth studies.

Background: Despite the importance of early detection for lung cancer outcomes, staging disparities among the growing US Hispanic population remain underexplored. This population-based study aimed to identify racial/ethnic disparities among non-Hispanic White, non-Hispanic Black, and Hispanic (including specific subgroups) patients in stage at diagnosis for potentially curable non-small cell lung cancer (NSCLC). Methods: Incident NSCLC cases (2005-2018) were extracted from the Florida cancer registry. Stage was categorized as early (localized/regional) or advanced (distant). Multivariable logistic regression assessed the association between race/ethnicity and stage at diagnosis, adjusting for socioeconomic status, smoking, and clinical factors. Results: Among 157 034 NSCLC patients, 47.8% were diagnosed at an advanced stage. Multivariable models showed higher odds of advanced-stage diagnosis for non-Hispanic Blacks (adjusted odds ratio [ORadj] = 1.22, 95% confidence interval [CI] = 1.17 to 1.26) and Hispanics (ORadj = 1.03, 95% CI = 1.00 to 1.08) compared with non-Hispanic Whites. Regional differences were stark for Hispanics compared with non-Hispanic Whites: ORadj = 0.96 (95% CI = 0.91 to 1.01) in South Florida vs 1.12 (95% CI = 1.05 to 1.19) in the rest of Florida. In South Florida, Central Americans (ORadj = 1.49, 95% CI = 1.20 to 1.85) were the only Hispanic group showing a staging disadvantage compared with non-Hispanic Whites. Conclusion: Pronounced disparities in NSCLC staging among non-Hispanic Black and Hispanic populations, with notable regional variations within Florida’s Hispanic communities, indicate that targeted interventions could significantly enhance early detection. The relative advantage observed in nearly all minority groups in multicultural South Florida compared with the rest of Florida underscores the need for future research exploring how specific Hispanic and multiracial sociocultural contexts can positively influence the landscape of cancer early detection across the United States.