Neighborhood-Level Factors Contribute to Disparities in Hepatocellular Carcinoma Incidence in Texas

Texas has the highest hepatocellular carcinoma (HCC) incidence rates in the continental United States, but these rates vary by race-ethnicity. We examined racial-ethnic disparities through a geospatial analysis of the social determinants of health. Using data from the Texas Cancer Registry, we assem...

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Bibliographic Details
Published inClinical gastroenterology and hepatology Vol. 21; no. 5; pp. 1314 - 1322.e5
Main Authors Oluyomi, Abiodun O., El-Serag, Hashem B., Olayode, Adegboyega, Thrift, Aaron P.
Format Journal Article
LanguageEnglish
Published United States Elsevier Inc 01.05.2023
Subjects
Aged
Carcinoma, Hepatocellular - epidemiology
Disparities
Epidemiology
Ethnicity
Humans
Incidence
Liver Cancer
Liver Neoplasms - epidemiology
Middle Aged
Risk Factors
Social Determinants of Health
Socioeconomic Factors
Texas - epidemiology
United States
United States
Texas
RR
TCR
Risk Factors
ADI
CI
HCC
Liver Cancer
CN
Epidemiology
ACS
VIF
Social Determinants of Health
GWPR
Disparities
NBR
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Summary:Texas has the highest hepatocellular carcinoma (HCC) incidence rates in the continental United States, but these rates vary by race-ethnicity. We examined racial-ethnic disparities through a geospatial analysis of the social determinants of health. Using data from the Texas Cancer Registry, we assembled 11,547 HCC cases diagnosed between 2011 and 2015 into Texas’s census tracts geographic units. Twenty-nine neighborhood measures representing demographics and socioeconomic, and employment domains were retrieved from the U.S. Census Bureau. We performed a series of aspatial and spatially weighted regression models to identify neighborhood-level characteristics associated with HCC risk. We found positive associations between HCC and proportion of population in census tracts that are Black or African American, Hispanic, over 60 years of age, in the construction industry, and in the service occupation but an inverse association with the proportion of population employed in the agricultural industry. The magnitude of these associations varied across Texas census tracts. We found evidence that neighborhood-level factors are differentially associated with variations in HCC incidence across Texas. Our findings reinforce existing knowledge about HCC risk factors and expose others, including neighborhood-level employment status. [Display omitted]
Bibliography:Authors’ contributions
AOO, APT, and HBES conceptualized the current analysis and oversaw the overall design of the analysis and the interpretations of analysis findings. APT led the retrieval of the Texas Cancer Registry (TCR) data and AOO led the retrieval of all explanatory data used for the current analysis. AOO oversaw the assembly, processing, and analysis of all the data used for the study. AOO, AO, APT, and HBES reviewed preliminary findings from all statistical outputs, helped with interpretation of findings, and conducted a critical review of several versions of the manuscript. All authors edited drafts of the article for important intellectual content and approved the final version of this manuscript.
ISSN:1542-3565
1542-7714
DOI:10.1016/j.cgh.2022.06.031