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

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.