ASPO Abstracts
Understanding Racial and Ethnic Disparities in Liver Cancer and its Precursor Liver Conditions in a Primary Care Cohort
Category: Cancer Health Disparities
Conference Year: 2020
Abstract Body:
Purpose of the Study: Over the past 15 years, liver cancer incidence and mortality have
increased and stark racial/ethnic disparities have been documented in liver cancer and its
precursor liver conditions. To address this pressing health issue, the present study utilized
electronic health record (EHR) data from a primary care cohort within a large academic health
system to assess the prevalence of liver cancer and other liver diseases by race/ethnicity.
Methods: We identified a cohort of primary care patients who had at least two outpatient visits
to a UCLA primary care provider, at least one year apart, from 2006 to 2018, and who were 18-
75 years of age at the time of the visits. Initial descriptive analyses were conducted to
characterize the cohort with regard to the number and percent of patients with each liver
disease diagnosis. Analyses were conducted in the overall sample as well as by key
demographics, including age, sex, and race/ethnicity.
Results: Our primary care cohort consists of 280,619 individuals. Of these, 27,920 (9.9%) have
at least one documented liver disease. The most common liver diagnosis was non-alcoholic
fatty liver disease (NAFLD; n= 9,648, 3.4% of cohort) followed by non-alcoholic steatohepatitis
(NASH; n= 6,715, 2.4%), hepatitis C (HCV; n= 2,949, 1.1%), cirrhosis (n= 2,634, 0.9%),
hepatitis B (HBV; n= 2,059, 0.7%), liver cancer (n= 1,590, 0.6%), and alcoholic hepatitis (n=
982, 0.3%). The highest prevalence of liver disease was observed in Latinos (14.8%) followed
by Asians (13.7%), Blacks (12.9%) and Whites (9.7%). NAFLD and NASH were the most
common conditions in each group, followed by HCV for Blacks and Whites, cirrhosis for Latinos,
and HBV for Asians. The highest prevalence of liver cancer was observed for Asians (1.1%)
followed by Blacks (.9%) and Latinos (.7%).
Conclusions: We observed distinct patterns of liver disease by race/ethnicity, which are likely
due to a combination of factors including sociodemographics, differing risk factor profiles, and
clinical care. These results will guide research focused on improving methods to predict
progression of liver disease to liver cancer, improve management and surveillance of precursor
liver conditions, and ultimately reduce racial/ethnic disparities in liver disease.
Keywords: liver cancer, racial/ethnic disparities