Racial, ethnic, and socioeconomic differences in hepatocellular carcinoma across the United States

Adrian Diaz , Samantha M. Ruff , Timothy M. Pawlik

Hepatoma Research ›› 2024, Vol. 10 : 6

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Hepatoma Research ›› 2024, Vol. 10:6 DOI: 10.20517/2394-5079.2023.114
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Racial, ethnic, and socioeconomic differences in hepatocellular carcinoma across the United States

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Abstract

Hepatocellular carcinoma (HCC) poses a significant public health challenge within the US, exerting an increasingly substantial influence on cancer-related deaths. However, the HCC burden is not uniformly distributed, with significant disparities related to race, ethnicity, and socioeconomic status. This manuscript comprehensively reviews the multifaceted origins of HCC disparities, exploring their roots in the sociocultural environment, socioeconomics, the physical/built environment, and the healthcare/political systems. The sociocultural environment highlights the unique challenges faced by racial and ethnic minority populations, including language barriers, cultural beliefs, and limited healthcare access. The socioeconomics and the physical/built environment section emphasize the impact of neighborhood poverty, geographic disparities, and healthcare infrastructure on HCC outcomes. The healthcare and political systems play a pivotal role in driving HCC disparities through practice guidelines, healthcare policies, insurance coverage, and access to care. Inconsistent practice guidelines across specialties and variations in insurance coverage contribute to disparities in HCC surveillance and treatment. In conclusion, addressing HCC disparities requires a multifaceted, patient-centered approach that includes cultural competence, infrastructure enhancements, policy changes, and improved access to care. Collaborative efforts among healthcare professionals, researchers, policymakers, and institutions are essential to reducing the burden of HCC on marginalized communities and ensuring equitable care for all individuals affected by this complex disease.

Keywords

Liver / cancer / hepatocellular / race / socioeconomic / United States

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Adrian Diaz, Samantha M. Ruff, Timothy M. Pawlik. Racial, ethnic, and socioeconomic differences in hepatocellular carcinoma across the United States. Hepatoma Research, 2024, 10: 6 DOI:10.20517/2394-5079.2023.114

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References

[1]

Rahib L,Aizenberg R,Fleshman JM.Correction: projecting cancer incidence and deaths to 2030: the unexpected burden of thyroid, liver, and pancreas cancers in the United States.Cancer Res2014;74:4006

[2]

Kim NJ,VoPham T.Addressing racial and ethnic disparities in US liver cancer care.Hepatol Commun2023;7:e00190. PMCID:PMC10289716

[3]

Bharmal N,Felician MF. Understanding the upstream social determinants of health. Available from: https://www.rand.org/pubs/working_papers/WR1096.html [Last accessed on 15 Jan 2024]

[4]

Liu JJ,Kia L.Towards health equity: the urgent need for upstream intervention studies in gastroenterology and hepatology.Lancet Gastroenterol Hepatol2022;7:203-4 PMCID:PMC9236852

[5]

Gehlert S,Sacks T,McClintock M.Targeting health disparities: a model linking upstream determinants to downstream interventions.Health Aff2008;27:339-49 PMCID:PMC2494954

[6]

Diaz A,Norman M,Dimick JB.Association of historic housing policy, modern day neighborhood deprivation and outcomes after inpatient hospitalization.Ann Surg2021;274:985-91

[7]

Diaz A,Dimick JB.Association of neighborhood deprivation, race, and postoperative outcomes: improvement in neighborhood deprivation is associated with worsening surgical disparities.Ann Surg2023;277:958-63

[8]

Moazzam Z,Endo Y.Association of historical redlining and present-day social vulnerability with cancer screening.J Am Coll Surg2023;237:454-64

[9]

Munir MM,Endo Y.Disparities in socioeconomic factors mediate the impact of racial segregation among patients with hepatopancreaticobiliary cancer.Ann Surg Oncol2023;30:4826-35

[10]

Ashing KT,Bedell F,Erhunmwunsee L. Calling attention to the role of race-driven societal determinants of health on aggressive tumor biology: a focus on black americans. Available from: https://ascopubs.org/doi/full/10.1200/OP.21.00297 [Last accessed on 15 Jan 2024]

[11]

Lin JS,Bean SI.Addressing racism in preventive services: methods report to support the us preventive services task force.JAMA2021;326:2412-20

[12]

Obeng-Gyasi S. Social determinants of health in surgery: a primer for the practicing surgeon. Elsevier Health Sciences; 2023.

[13]

Adler NE,Fielding J.Addressing social determinants of health and health inequalities.JAMA2016;316:1641-2

[14]

Siegel RL,Fuchs HE.Cancer statistics, 2021.CA Cancer J Clin2021;71:7-33

[15]

Ha J,Aguilar M.Race/ethnicity-specific disparities in cancer incidence, burden of disease, and overall survival among patients with hepatocellular carcinoma in the United States.Cancer2016;122:2512-23

[16]

Huang DQ,Loomba R.Global epidemiology of NAFLD-related HCC: trends, predictions, risk factors and prevention.Nat Rev Gastroenterol Hepatol2021;18:223-38 PMCID:PMC8016738

[17]

El-Serag HB,Feng Z,Khaderi S.Texas Hepatocellular Carcinoma ConsortiumRisk factors for cirrhosis in contemporary hepatology practices-findings from the texas hepatocellular carcinoma consortium cohort.Gastroenterology2020;159:376-7 PMCID:PMC8375364

[18]

Fischer GE,Homan CE,McMahon BJ.Chronic liver disease among alaska-native people, 2003-2004.Am J Gastroenterol2009;104:363-70

[19]

McMahon BJ,Snowball M.HBV genotype: a significant risk factor in determining which patients with chronic HBV Infection should undergo surveillance for HCC: the hepatitis B Alaska study.Hepatology2021;74:2965-73

[20]

McMahon BJ,Bulkow L.Seroprevalence of hepatitis B viral markers in 52,000 Alaska natives.Am J Epidemiol1993;138:544-9

[21]

Bradley H,Rosenthal EM,Ryerson AB.Hepatitis C virus prevalence in 50 U.S. states and D.C. by sex, birth cohort, and race: 2013-2016.Hepatol Commun2020;4:355-70 PMCID:PMC7049678

[22]

Ioannou GN,Lowy E,Berry K.Differences in hepatocellular carcinoma risk, predictors and trends over time according to etiology of cirrhosis.PLoS One2018;13:e0204412 PMCID:PMC6160079

[23]

Kim D,Perumpail BJ.Changing trends in etiology-based and ethnicity-based annual mortality rates of cirrhosis and hepatocellular carcinoma in the United States.Hepatology2019;69:1064-74 PMCID:PMC6709988

[24]

People born outside of the United States and viral hepatitis. Available from: https://www.cdc.gov/hepatitis/populations/Born-Outside-United-States.htm [Last accessed on 12 Jan 2024]

[25]

Marrero JA,Sirlin CB.Diagnosis, staging, and management of hepatocellular carcinoma: 2018 practice guidance by the American association for the study of liver diseases.Hepatology2018;68:723-50

[26]

Wolf E,Marrero JA,Singal AG.Use of hepatocellular carcinoma surveillance in patients with cirrhosis: a systematic review and meta-analysis.Hepatology2021;73:713-25 PMCID:PMC7648722

[27]

Davila JA,Richardson PA,McGlynn KA.Use of surveillance for hepatocellular carcinoma among patients with cirrhosis in the United States.Hepatology2010;52:132-41 PMCID:PMC3835698

[28]

Perumalswami PV,Bowman CA.Hepatocellular carcinoma surveillance, incidence, and tumor doubling times in patients cured of hepatitis C.Cancer Med2022;11:1995-2005 PMCID:PMC9089228

[29]

Simmons OL,Parikh ND.Primary care provider practice patterns and barriers to hepatocellular carcinoma surveillance.Clin Gastroenterol Hepatol2019;17:766-73 PMCID:PMC7212522

[30]

Hall WJ,Lee KM.Implicit racial/ethnic bias among health care professionals and its influence on health care outcomes: a systematic review.Am J Public Health2015;105:e60-76 PMCID:PMC4638275

[31]

Kim NJ,Jacob DA.Provider attitudes toward risk-based hepatocellular carcinoma surveillance in patients with cirrhosis in the United States.Clin Gastroenterol Hepatol2022;20:183-93 PMCID:PMC8657369

[32]

Barzi A,Wang S,El-Khoueiry A.Etiology and outcomes of hepatocellular carcinoma in an ethnically diverse population: the multiethnic cohort.Cancers2021;13:3476 PMCID:PMC8305188

[33]

Estevez J,Leong J.Clinical features associated with survival outcome in African-American patients with hepatocellular carcinoma.Am J Gastroenterol2019;114:80-8

[34]

Pomenti S,Abu Sbeih H.Hepatocellular carcinoma in hispanic patients: trends and outcomes in a large United States cohort.Hepatol Commun2020;4:1708-16 PMCID:PMC7603535

[35]

Moten AS,Pitt HA.Recent improvements in racial disparity in the treatment of hepatocellular carcinoma: how times have changed.J Gastrointest Surg2021;25:2535-44

[36]

Kangas-Dick A,Hilden P.Disparities in utilization of services for racial and ethnic minorities with hepatocellular carcinoma associated with hepatitis C.Surgery2020;168:49-55

[37]

Rich NE,Odewole M.Racial and ethnic differences in presentation and outcomes of hepatocellular carcinoma.Clin Gastroenterol Hepatol2019;17:551-9.e1 PMCID:PMC6274621

[38]

McClune AC.Chronic hepatitis B and hepatocellular carcinoma.Clin Liver Dis2010;14:461-76

[39]

Rizzo A,Ricci AD.Lenvatinib plus pembrolizumab: the next frontier for the treatment of hepatocellular carcinoma?.Expert Opin Investig Drugs2022;31:371-8

[40]

Rizzo A,Brandi G.Systemic adjuvant treatment in hepatocellular carcinoma: tempted to do something rather than nothing.Future Oncol2020;16:2587-9

[41]

Santoni M,Mollica V.The impact of gender on the efficacy of immune checkpoint inhibitors in cancer patients: the MOUSEION-01 study.Crit Rev Oncol Hematol2022;170:103596

[42]

Melkonian SC,Haverkamp D.Disparities in cancer incidence and trends among american indians and alaska natives in the united states, 2010-2015.Cancer Epidemiol Biomarkers Prev2019;28:1604-11 PMCID:PMC6777852

[43]

Inadomi JM,Green BB.What multilevel interventions do we need to increase the colorectal cancer screening rate to 80%?.Clin Gastroenterol Hepatol2021;19:633-45 PMCID:PMC8288035

[44]

Samant H,Patel K.Clinical presentation of hepatocellular carcinoma in african americans vs. caucasians: a retrospective analysis.Pathophysiology2021;28:387-99 PMCID:PMC8830457

[45]

Jones PD,Muenyi V,Martin PM.Socioeconomic and survival differences among minorities with hepatocellular carcinoma in Florida.J Hepatocell Carcinoma2019;6:167-81 PMCID:PMC6863179

[46]

Poulson MR,Geary AD.The role of racial segregation in treatment and outcomes among patients with hepatocellular carcinoma.HPB2021;23:854-60 PMCID:PMC8527332

[47]

Zhou K,Gainey CS.Presentation, management, and outcomes across the rural-urban continuum for hepatocellular carcinoma.JNCI Cancer Spectr2021;5:pkaa100. PMCID:PMC7791625

[48]

Azap RA,Diaz A,Pawlik TM.Association of county-level vulnerability, patient-level race/ethnicity, and receipt of surgery for early-stage hepatocellular carcinoma.JAMA Surg2021;156:197-9 PMCID:PMC7758820

[49]

Diaz A,Paredes AZ.Accessing surgical care for pancreaticoduodenectomy: patient variation in travel distance and choice to bypass hospitals to reach higher volume centers.J Surg Oncol2019;120:1318-26

[50]

Munir MM,Woldesenbet S.Variations in travel patterns affect regionalization of complex cancer surgery in California.Ann Surg Oncol2023;30:8044-53

[51]

Smith AK,Zeymo A.Travel patterns of cancer surgery patients in a regionalized system.J Surg Res2015;199:97-105

[52]

Diaz A,Pawlik TM.Trends in the geospatial distribution of adult inpatient surgical cancer care across the United States.J Gastrointest Surg2020;24:2127-34

[53]

Diaz A,Paredes AZ,Pawlik TM.Association of neighborhood characteristics with utilization of high-volume hospitals among patients undergoing high-risk cancer surgery.Ann Surg Oncol2021;28:617-31

[54]

Xu L,Spolverato G,Pawlik TM.Racial disparities in treatment and survival of patients with hepatocellular carcinoma in the United States.Hepatobiliary Surg Nutr2016;5:43-52 PMCID:PMC4739939

[55]

Nathan H,Choti MA,Pawlik TM.The volume-outcomes effect in hepato-pancreato-biliary surgery: hospital versus surgeon contributions and specificity of the relationship.J Am Coll Surg2009;208:528-38

[56]

Hyer JM,Diaz A.High social vulnerability and "textbook outcomes" after cancer operation.J Am Coll Surg2021;232:351-9

[57]

Flores YN,Yang L.Disparities in hepatocellular carcinoma incidence, stage, and survival: a large population-based study.Cancer Epidemiol Biomarkers Prev2021;30:1193-9 PMCID:PMC8172467

[58]

Singal AG,Murphy CC.Patient-reported barriers are associated with receipt of hepatocellular carcinoma surveillance in a multicenter cohort of patients with cirrhosis.Clin Gastroenterol Hepatol2021;19:987-95.e1 PMCID:PMC7779689

[59]

Singal AG.Rational HCC screening approaches for patients with NAFLD.J Hepatol2022;76:195-201 PMCID:PMC8688224

[60]

Gani F,Johnston FM,Canner JK.Comparison of clinical and financial outcomes at urban and rural hospitals among patients receiving inpatient surgical care.J Am Coll Surgeons2018;227:S140-1

[61]

Abbas A,Obeng-Gyasi S.Disparity in clinical trial participation among patients with gastrointestinal cancer.J Am Coll Surg2022;234:589-98

[62]

Alterio RE,Wang SC,Yopp A.Socioeconomic and racial/ethnic disparities in receipt of palliative care among patients with metastatic hepatocellular carcinoma.J Surg Oncol2021;124:1365-72

[63]

Scaglione S,Caines A.Association between race/ethnicity and insurance status with outcomes in patients with hepatocellular carcinoma.Dig Dis Sci2020;65:1669-78 PMCID:PMC7603399

[64]

Lee RM,Turgeon MK.Dissecting disease, race, ethnicity, and socioeconomic factors for hepatocellular carcinoma: an analysis from the United States safety net collaborative.Surg Oncol2020;35:120-5 PMCID:PMC7982991

[65]

Wang J,Lopez A,Liu B.Medicaid and uninsured hepatocellular carcinoma patients have more advanced tumor stage and are less likely to receive treatment.J Clin Gastroenterol2018;52:437-43

[66]

Adler Jaffe S,Meisner ALW,Hill DA.Relationship between insurance type at diagnosis and hepatocellular carcinoma survival.Cancer Epidemiol Biomarkers Prev2020;29:300-7 PMCID:PMC7992905

[67]

Diaz A,Paredes AZ.Utilization of high-volume hospitals for high-risk cancer surgery in california following medicaid expansion.J Gastrointest Surg2021;25:1875-84

[68]

Diaz A.Insurance status and high-volume surgical cancer: access to high-quality cancer care.Cancer2021;127:507-9

[69]

Asemota J,Babalola A.Comparison of hepatocellular carcinoma in hispanic and non-hispanic patients.Cureus2021;13:e14884 PMCID:PMC8180179

[70]

Cha AE.Demographic variation in health insurance coverage:United States, 2020.Natl Health Stat Report2022;169:1-15

[71]

Branch B. Health insurance coverage by race and hispanic origin: 2021. Available from: https://www.census.gov/content/dam/Census/library/publications/2022/acs/acsbr-012.pdf [Last accessed on 15 Jan 2024]

[72]

Chavarin D,Paredes A.High-risk cancer operations in california after medicaid expansion.J Am Coll Surgeons2020;231:S139-40

[73]

Moss HA,Kaplan SJ.The affordable care act's medicaid expansion and impact along the cancer-care continuum: a systematic review.J Natl Cancer Inst2020;112:779-91 PMCID:PMC7825479

[74]

Kim NJ,Ioannou GN,Rogal S.Rates and predictors of undergoing different hepatocellular carcinoma screening tests in patients with cirrhosis.Am J Gastroenterol2021;116:411-5

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