Research & Publications
Impact of Social Determinants of Health on Hepatocellular Carcinoma Surveillance, Treatment, and Healthcare Costs
Summary
Liver cancer, specifically hepatocellular carcinoma (HCC), is more treatable when caught early through routine surveillance, typically using imaging like ultrasound, CT, or MRI. Yet this study of over 32,000 patients with HCC found that many people are not receiving these potentially life-saving screenings.
Only 70 percent of patients received any type of surveillance in the year before their diagnosis, and fewer than one in five received curative treatment. Those who had imaging-based surveillance were more likely to receive curative therapies. The study found that race, income, education, and where a person lives all played a role in who received care. Patients who were White race and lived in neighborhoods with higher income and higher employment rates were more likely to receive imaging. Black patients and people in lower-income neighborhoods were less likely to receive curative treatment. Patients living in rural areas or neighborhoods with high unemployment, low English proficiency, or a high percentage of people living alone were more likely to face higher health care costs.
Why This Matters
Despite professional guidelines encouraging early screening, liver cancer surveillance and treatment are underused in practice and this under-utilization is more common in people with social disadvantages. This gap contributes to worse outcomes and higher healthcare costs—especially for patients from underserved communities. Increasing access to imaging-based surveillance could lead to earlier detection, better access to treatment, and more equitable care. Addressing these disparities will require coordinated efforts across patients, providers, health systems, and policy.
Read the Full Study:
