S2598 Somali Patients With Chronic Hepatitis B Experience Disparities in Completion of Hepatocellular Carcinoma Surveillance

Introduction: Hepatocellular carcinoma (HCC) is a leading cause of cancer worldwide and disproportionately affects patients of Asian and African ancestry due to an increased incidence of chronic hepatitis B (CHB). Society guidelines recommend biannual screening for HCC with abdominal imaging and alpha-fetoprotein levels in select patients with CHB. Despite these recommendations, compliance with screening is estimated to be less than 30% and even lower in certain vulnerable minority populations. We aim to define compliance with HCC surveillance in Somali patients with CHB compared to Asian patients and improve compliance using a patient advocate to provide education about the importance of HCC screening and assistance with linkage of care was implemented. Methods: Somali patients aged >20, Asian men aged >40, and Asian women aged >50 with CHB seen in hepatology clinic at The Ohio State University Wexner Medical Center between January 2018 and January 2023 were identified via validated ICD-9 and International Classification of Diseases, Tenth Revision (ICD-10) codes. Variables including demographics, disease status, compliance with HCC screening before and after utilizing a patient navigator. Descriptive statistics were used to analyze and report collected data, and P-values from fishers' exact tests were used to assess differences between groups. Results: Ninety Somali patients (mean age 51, 40% man) and 94 Asian patients (mean age 58, 63% man) were included. Asian patients were more likely to utilize private health insurance as their primary payer (61% vs 8.9%, P < 0.001)) compared to Somali patients who were more likely to have Medicaid insurance (57.8% vs 4.9%, P < 0.001). Somali patients were less likely to be prescribed antiviral therapy compared to Asian patients (20% vs 54.3%). Once initiated on antiviral therapy, Asian patients showed higher compliance with therapy compared to Somali patients (82.4% vs 61.1%). Although both groups were recommended biannual HCC screening at similar rates, Somali patients had a much lower screening compliance (7.9% vs 35%, P < 0.001). Of the Somali patients who were contacted by patient advocate, there were no additional HCC surveillance testing completed. Conclusion: Compliance with HCC surveillance and medical therapy was lower in Somali patients with CHB compared to Asian patients. Further research is needed to elucidate factors contributing to this disparity to directly address the barriers impacting compliance in this vulnerable population given utilizing a patient advocate did not successfully increase compliance.