Significant Disparities in Liver Cancer Deaths by Race, Ethnicity Persists
Differences in major risk factors and inequalities in health care access have resulted in substantial disparities in liver cancer mortality.
Death rates from liver cancer has doubled since the mid 1980s and only appears to be increasing. Furthermore, there are substantial disparities that exist by race/ethnicity.
For the study, published in the CA: A Cancer Journal for Clinicians, investigators used data from the Surveillance, Epidemiology, and End Results program and the National Center for Health Statistics.
The investigators sought to provide an overview of liver cancer incidence, mortality, and survival rates and trends, including data by race/ethnicity and state.
Although there has been substantial improvements in liver cancer survival in the past few decades, only 1 of 5 patients survive 5 years after diagnosis.
A major contributing factor to this rising trend is the higher rates of hepatitis C virus (HCV) among baby boomers, who are 5 times more likely to be exposed to HCV. Although it remains unclear why HCV rates are higher among this population, the CDC believes most baby boomers became infected between the 1970s and 90s, when the rates of infection were highest and before screenings of blood and organs became available in 1992.
Another likely contributor is the rise in obesity and type 2 diabetes, according to the authors. Other risk factors included alcohol consumption and tobacco use. Alcohol increases liver cancer risk by approximately 10% per drink per day and tobacco increases the risk by approximately 50%.
Substantial disparity in liver cancer death rates by race/ethnicity were identified in the report. Figures ranged from 5.5 per 100,000 in non-Hispanic white to 11.9 per 100,000 in American Indians/Alaska Natives.
Differences in liver cancer death rates were also observed by state, with the lowest death rates in North Dakota at 3.8 per 100,000 and the highest in the District of Columbia at 9.6 per 100,000.
The authors noted that the wide disparities by race and state were reflective of differences in the prevalence of major risk factors, and in part, inequalities in access to high-quality care.
“However, most liver cancers are potentially preventable,” the authors wrote. “Interventions to curb the rising burden of liver cancer and reduce racial/ethnic and geographic disparities should include the targeted application of existing knowledge in prevention, early detection, and treatment, including improvements in [hepatitis B virus] vaccination, screening and treatment of HCV, maintaining a healthy body weight, access to high-quality diabetes care, prevention of excessive alcohol drinking, and tobacco control.”