The ‘social gradient' in primary liver cancer in France: A national observational study

Social deprivation is known to increase the risk of developing primary liver cancer (PLC) and to reduce survival. However, it has been unclear if this is due to late-stage diagnoses or limited access to treatments, as earlier studies mostly considered factors like race, ethnicity, sex, and insurance status. Our study highlighted that socially deprived patients with PLC in France face reduced access to curative and palliative treatments, resulting in lower overall survival rates. A key finding was that the negative impact of social deprivation was mitigated by care centralization - when patients were diagnosed or treated in referral centers, social deprivation no longer influenced access to curative treatments or mortality outcomes. These findings support the need for centralized PLC management strategies across the country to improve care outcomes for socioeconomically disadvantaged individuals.