AUTHOR=Kamath Geetanjali R. , Taioli Emanuela , N. Egorova Natalia , Llovet Josep M. , Perumalswami Ponni V. , Weiss Jeffrey J. , Schwartz Myron , Ewala Stanley , Bickell Nina A. 

TITLE=Liver Cancer Disparities in New York City: A Neighborhood View of Risk and Harm Reduction Factors

JOURNAL=Frontiers in Oncology

VOLUME=8

YEAR=2018

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2018.00220

DOI=10.3389/fonc.2018.00220

ISSN=2234-943X

ABSTRACT=<sec id="ST1"><title>Introduction</title><p>Liver cancer is the fastest increasing cancer in the United States and is one of the leading causes of cancer-related death in New York City (NYC), with wide disparities among neighborhoods. The purpose of this cross-sectional study was to describe liver cancer incidence by neighborhood and examine its association with risk factors. This information can inform preventive and treatment interventions.</p></sec><sec id="ST2"><title>Materials and methods</title><p>Publicly available data were collected on adult NYC residents (<italic>n</italic> = 6,407,022). Age-adjusted data on liver and intrahepatic bile duct cancer came from the New York State Cancer Registry (<xref ref-type="bibr" rid="B1">1</xref>) (2007–2011 average annual incidence); and the NYC Vital Statistics Bureau (2015, mortality). Data on liver cancer risk factors (2012–2015) were sourced from the New York City Department of Health and Mental Hygiene: (1) Community Health Survey, (2) A1C registry, and (3) NYC Health Department Hepatitis surveillance data. They included prevalence of obesity, diabetes, diabetic control, alcohol-related hospitalizations or emergency department visits, hepatitis B and C rates, hepatitis B vaccine coverage, and injecting drug use.</p></sec><sec id="ST3"><title>Results</title><p>Liver cancer incidence in NYC was strongly associated with neighborhood poverty after adjusting for race/ethnicity (β = 0.0217, <italic>p</italic> = 0.013); and with infection risk scores (β = 0.0389, 95% CI = 0.0088–0.069, <italic>p</italic> = 0.011), particularly in the poorest neighborhoods (β = 0.1207, 95% CI = 0.0147–0.2267, <italic>p</italic> = 0.026). Some neighborhoods with high hepatitis rates do not have a proportionate number of hepatitis prevention services.</p></sec><sec id="ST4"><title>Conclusion</title><p>High liver cancer incidence is strongly associated with infection risk factors in NYC. There are gaps in hepatitis prevention services like syringe exchange and vaccination that should be addressed. The role of alcohol and metabolic risk factors on liver cancer in NYC warrants further study.</p></sec>