Hepatocellular carcinoma disparities among Latinos: A systematic literature review

Background: Liver cancer is one of the most important cancers in the United States, and hepatocellular carcinoma (HCC) is its most common form. In addition, health disparities can impact cancer-related outcomes in racial/ethnic minorities. Therefore, the aim of this study was to conduct a systematic review to analyze the hepatocellular carcinoma disparities among Latinos. Methods: A systematic review was conducted following the PRISMA guidelines. Papers were selected searching PubMed/Medline, SciELO, and LILACS databases in July 2021 using the search terms [Latin Americans] OR [Latinos] OR [Hispanics] OR [Racial Disparity] AND [Hepatocellular carcinoma]. The inclusion criteria was limited to observational studies published in the last five years that evaluated hepatocellular carcinoma disparities among Hispanics/Latinos. The language was restricted to English, Spanish or Portuguese. Results: Among the 179 papers initially identified, 44 were eligible for this review after full texts were read. Although there is a constant evolution in screening, diagnosis, and treatment strategies to improve the prognosis of HCC; racial and ethnic minorities are reported to have higher mortality related to HCC. In the United States, the age-adjusted incidence of HCC in Hispanics has surpassed those of HCC in Asians. From a public health perspective, active hepatitis C and B continue to drive most of the global burden of HCC, and there is a high prevalence of these infections in Latin America. In addition, non-alcoholic fatty liver disease (NAFLD) is one of the main risk factors for HCC in the USA, followed by alcoholic liver disease, and hepatitis C and B infections. Latin Americans have a higher prevalence of NAFLD, whereas African Americans have a lower prevalence of NAFLD. The exact contribution of genetic and environmental factors on these differences in prevalence has not been determined. While one in five HCC patients in the USA is of Hispanic ethnicity, only 38% meet the criteria for liver transplantation at the time of diagnosis. Acculturation, insurance status, and access to health care may further contribute to the observed HCC disparities among Latinos. Conclusions: The data indicates that HCC disparities in early diagnosis, treatment, and outcomes among Latinos are an important issue and need more attention. We suggest that interventions are necessary to reduce HCC disparities among Latinos in order to improve cancer-related outcomes.Citation Format: Tulio L. Correa, Mariana S.T.C. Guelli. Hepatocellular carcinoma disparities among Latinos: A systematic literature review [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-194.