Are Current Liver Cancer Screening Guidelines Failing African Americans?

Current screening guidelines may not detect liver cancer in African Americans until the prognosis is dire, according to a study published in the journal Cancer.

Researchers sought to understand the significant disparity in outcomes between Blacks with liver cancer and other groups by studying patients with hepatitis C, a known driver of liver cancer. To do so, the researchers assessed the imaging, laboratory, and pathological findings of ~1,200 patients with a history of hepatitis C exposure (n=390 Black).

According to the results, liver cancer in Black patients with hepatitis C may begin earlier in the course of liver disease, often before the onset of cirrhosis. The researchers observed that nearly one-third of Black patients would not have qualified for liver cancer screening using common cirrhosis measures. Moreover, the results showed that when diagnosed, liver cancer in Blacks tended to be more advanced and invasive.

“We know that disparities in outcome exist for Black patients with liver cancer. The reasons for this are complex and multifactorial, and this study points to two likely contributing factors,” said lead author Umut Sarpel, MD, Associate Professor of Surgery, and Medical Education at the Icahn School of Medicine at Mount Sinai via a press release.

“First, they may fall outside screening guidelines, thus delaying diagnosis. Second, the biology of their tumors may be inherently more aggressive. We suggest additional studies to see if modified guidelines can better serve this community and to determine if the tumors have a distinctive molecular signature that may allow targeted therapies to be deployed.”