Abstract 4939: Social determinants disadvantage score and risk of liver cancer in the All of Us Research Program

Abstract Background: Social determinants of health (SDOH) are crucial in shaping health outcomes, yet comprehensive studies that span all key SDOH domains (economic stability, education, healthcare access and quality, neighborhood and built environment, and social and community context) to examine their associations with liver cancer risk are sparse. We developed and validated a Social Determinants Disadvantage Score (SDDS) to address this knowledge gap. Methods: We conducted a cross-sectional analysis of 117, 783 participants from the All of Us Research Program. The SDDS was systematically constructed using validated questionnaires covering five domains recognized by the World Health Organization and U.S. Department of Health and Human Services. Each domain was dichotomized into advantage (0) or disadvantage (1), with the SDDS ranging from 0 to 5. Prevalent liver cancer, especially hepatocellular carcinoma (HCC), was identified by the Electronic Health Record. We used logistic regression models to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the associations of SDDS with HCC, adjusting for age, sex, race, ethnicity, birthplace, marital status, smoking status, and alcohol intake. Results: We identified 110 HCC cases in the participants who completed the SDOH questionnaires. Disadvantage in SDOH, as assessed by higher SDDS, was associated with a higher risk of HCC. Per unit increase in SDDS, the adjusted OR (95% CI) was 1.21 (1.02, 1.43) for HCC. The OR was 5.62 (1.95, 16.22) comparing the most disadvantaged to the most advantaged SDDS group. Strongest associations were observed for disadvantage in economic stability (OR = 2.37; 95% CI = 1.22, 4.63) and education (OR = 1.87; 95% CI = 1.08, 3.24). Conclusion: The SDDS provides a comprehensive, validated tool for assessing SDOH. Our findings highlight significant associations between social disadvantage and HCC prevalence, emphasizing the need for future longitudinal studies to inform targeted interventions. Citation Format: Xinyuan (Cindy) Zhang, Longgang Zhao, David Vlahov, Yun Chen, Tamar Taddei, Xuehong Zhang. Social determinants disadvantage score and risk of liver cancer in the All of Us Research Program [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 4939.