S2912 Impact of Race and Socioeconomic Factors on Liver Cancer: A Nationwide Analysis

Introduction: Liver cancer is the sixth most common cancer globally and the third leading cause of cancer-related deaths, with hepatocellular carcinoma as the predominant subtype. This study examines liver cancer prevalence, length of hospital stay (LOS), total hospital charges, and comorbidities across racial groups. Methods: Patients discharged in 2019–2020 were identified from the Nationwide Inpatient Sample (NIS) database and categorized by racial identity and a primary diagnosis of liver cancer using International Classification of Diseases, Tenth Revision (ICD-10) codes. Statistical analyses assessed prevalence, LOS, total charges, and comorbidity patterns (e.g., diabetes, Hepatitis B/C, cirrhosis, CHF, chronic kidney disease [CKD], and chronic obstructive pulmonary disease [COPD]) across racial groups. Results: Among 44,665 patients (65.73% male, mean age 65.23 years), racial distribution was 58.42% White, 13.82% Black, 14.06% Hispanic, and 13.69% Other. Mortality was highest in Black (10.93%) and Other groups (9.4%) vs White (7.03%) and Hispanic (7.01%) (P < 0.001). Comorbidities varied by race. COPD and CHF were more common in White and Black patients. CKD, cirrhosis, and Hepatitis C were more prevalent in Black and Hispanic patients. Hepatitis B was more frequent in Black and Other groups. Diabetes was highest in Hispanic (40.68%) and Other groups (34.42%) (P < 0.001). Mean LOS was 6.21 days (White), 6.95 (Black), 6.46 (Hispanic), and 6.72 (Other) (P = 0.0227). Regionally, Hispanic patients were mainly hospitalized in the South (36.15%) and West (38.61%), Black in the South (53.2%), White in the South (39.09%), and Other in the West (36.14%) (P < 0.001). Black (52.1%) and Hispanic (40.07%) patients were mostly in the lowest income quartile (P < 0.001). Liver transplant rates did not differ significantly (P = 0.3049). Conclusion: Liver cancer outcomes and comorbidities vary significantly by race, reflecting disparities in access to care, socioeconomic status, and geographic trends. Black and Hispanic patients had a higher prevalence of advanced disease markers like cirrhosis and Hepatitis C, with Black patients experiencing the highest mortality. These disparities highlight the need for targeted interventions and equitable care strategies to improve liver cancer outcomes.