Liver Cancer Has a Distinctive Profile in Black Patients: Current Screening Guidelines May Be Inadequate

Details

• Personal Author:
  Branch AD ; Sarpel U ; Shaltiel T ; Winters AC
• Description:
  There is mounting evidence that Black patients develop more advanced liver cancers with less advanced liver disease. These findings have important implications for the future of liver cancer screening. Liver cancer is often deadly, but the chances of survival can be improved by early detection, which opens the door for curative treatments, such as resection and liver transplantation. Mortality varies across sociodemographic groups for reasons that are complex and multifactorial. In the United States, Black patients are both more likely to develop hepatocellular carcinoma (HCC) and more likely to die because of it. A recent publication in the March 2021 issue of Cancer by our group at the Icahn School of Medicine at Mount Sinai adds important new evidence that HCC has a distinctive profile in Black individuals. [...] Further research is needed in four areas. First, detailed cell and molecular studies are needed to characterize HCCs in Black patients and to determine whether their tumors have distinctive mutations and/or immunologic features that could be targeted with precision interventions. Second, outcomes research is needed to define the group of patients without cirrhosis whose HCC risk is above 1.0%-1.5% (the threshold for cost-effective HCC surveillance). Such research must identify the specific exposures that elevate HCC risk in Black individuals, recognizing that genetic, environmental, sociodemographic, and lifestyle differences may all be important. Third, implementation and basic research are needed to improve strategies for preventing liver cancer, which is a largely preventable cause of death. Specifically, implementation research is needed to improve uptake of treatments for viral hepatitis and for lifestyle modifications, including smoking cession and moderation of alcohol consumption. Basic research is needed to delineate and harness liver repair pathways, allowing the safe reversal of liver damage. Overall, we must strive to understand and correct the social and economic inequities that contribute to poor health and create durable and impactful solutions. [Description provided by NIOSH]
• Subjects:
  Demography Digestive System Digestive System Diseases Liver Men Neoplasms Occupational Health Race Factors Safety Women
• Keywords:
  Cancer Demographic Characteristics Humans Liver Cancer Liver Disorders Racial Factors Screening Methods Sociological Factors
• ISSN:
  2471-254X
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Journal Article
• Place as Subject:
  California ; New York ; OSHA Region 2 ; OSHA Region 9
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  8-11
• Volume:
  6
• Issue:
  1
• NIOSHTIC Number:
  nn:20063588
• Citation:
  Hepatol Commun 2022 Jan; 6(1):8-11
• Contact Point Address:
  Andrea D. Branch, Ph.D., Division of Liver Diseases, Icahn (East) Building Room 11-26, 1425 Madison Ave., New York, NY 10029
• Email:
  Andrea.Branch@mssm.edu
• Federal Fiscal Year:
  2022
• Performing Organization:
  Icahn School of Medicine at Mount Sinai, New York
• Peer Reviewed:
  False
• Start Date:
  20170701
• Source Full Name:
  Hepatology Communications
• End Date:
  20210630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:15428556b497d123fe511138e317d71b952ac52a6f35e0696e4d63089233fbeeb42b75488b5be81aaf00bc04fcf57166de2fceddffba327eca9b0c97272d3086
• Download URL:
  https://stacks.cdc.gov/view/cdc/222170/cdc_222170_DS1.pdf
• File Type:
  [PDF - 104.00 KB ]