A study published in Cancer reported that increased U.S. liver cancer death rates have largely been observed in the less educated population, particularly in men.
Researchers performed Joinpoint analyses and Poisson regression modeling to examine liver cancer mortality trends based on education level and hepatitis C virus (HCV) infection status among individuals 25 to 74 years of age between 2000 and 2015.
Mortality rate by sex
During this time, the overall liver cancer death rate increased from 7.5 per 100,000 persons to 11.2 per 100,000 persons in men and from 2.8 per 100,000 persons to 3.8 per 100,000 persons in women.
“The rising liver cancer death rates among less educated persons largely reflect their higher rates of liver cancer risk factors, including HCV-infection, obesity, non-alcoholic fatty liver disease and alcohol use, lower HCV-screening rates, and less access to high-quality care,” lead study author Jiemin Ma, told Reuters.
— ACS Journal Cancer (@JournalCancer) April 8, 2019
Education level associated with liver cancer mortality
Patients were classified based on education level: up to 12 years (typically a high school education); 13 to 15 years (generally some education beyond high school); and at least 16 years (typically includes college education and degree).
The increased mortality was generally higher in less educated females and was confined to persons with ≤15 years of education for men. For every 100,000 men with less than a high school education, liver cancer death rates increased from 10.23 to 17.84 fatalities. Conversely, liver cancer death rates declined 3 percent in men with a college education.
The relative disparity increased until 2006 and then leveled off in women, but the increase continued from 3.49 (95% CI, 3.08‐3.97) to 7.74 (95% CI, 7.13‐8.40) in men. This increase was more pronounced for those with HCV‐related liver cancer.
“Enhanced and targeted efforts are needed to halt and reverse the undue growing burden of liver cancer in lower socioeconomic groups,” the authors concluded.