TY - JOUR
T1 - The effect of social determinants of health on utilization of surgical treatment for hepatocellular carcinoma patients
AU - Murthy, Shilpa S.
AU - Ortiz, Angel
AU - DuBois, Tesla
AU - Sorice, Kristen A.
AU - Nguyen, Minhhuyen
AU - Castellanos, Jason A.
AU - Pinheiro, Paulo
AU - Gonzalez, Evelyn T.
AU - Lynch, Shannon M.
N1 - Publisher Copyright:
© 2022 Elsevier Inc.
PY - 2023/4
Y1 - 2023/4
N2 - Background: A paucity of data exists on how social determinants of health (SDOH) influence treatment for Hepatocellular carcinoma (HCC). We investigated associations between SDOH (healthcare access, education, social/community context, economic stability, and built/neighborhood environment) and receipt of surgery. Methods: The Pennsylvania Liver Cancer Registry was linked with neighborhood SDOH from the American Community Survey. Multilevel logistic regression models with patient and neighborhood SDOH variables were developed. Results: Of 9423 HCC patients, 2393 were stage I. Only 36.3% of stage I patients received surgery. Black patients had significantly lower odds of surgery vs Whites (OR = 0.73; p < 0.01), but not after adjustments for SDOH. All 5 SDOH domains were associated with odds of surgery overall; 2 domains were associated in Stage I patients, social context (e.g., racial concentration, p = 0.03) and insurance access (p < 0.01). Conclusions: SDOH impact utilization of surgery for HCC. Findings can guide healthcare professionals to create programs for populations at risk for poor liver cancer outcomes.
AB - Background: A paucity of data exists on how social determinants of health (SDOH) influence treatment for Hepatocellular carcinoma (HCC). We investigated associations between SDOH (healthcare access, education, social/community context, economic stability, and built/neighborhood environment) and receipt of surgery. Methods: The Pennsylvania Liver Cancer Registry was linked with neighborhood SDOH from the American Community Survey. Multilevel logistic regression models with patient and neighborhood SDOH variables were developed. Results: Of 9423 HCC patients, 2393 were stage I. Only 36.3% of stage I patients received surgery. Black patients had significantly lower odds of surgery vs Whites (OR = 0.73; p < 0.01), but not after adjustments for SDOH. All 5 SDOH domains were associated with odds of surgery overall; 2 domains were associated in Stage I patients, social context (e.g., racial concentration, p = 0.03) and insurance access (p < 0.01). Conclusions: SDOH impact utilization of surgery for HCC. Findings can guide healthcare professionals to create programs for populations at risk for poor liver cancer outcomes.
KW - Carcinoma, Hepatocellular/pathology
KW - Humans
KW - Liver Neoplasms/pathology
KW - Racial Groups
KW - Social Determinants of Health
KW - White
UR - http://www.scopus.com/inward/record.url?scp=85143726165&partnerID=8YFLogxK
UR - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=purepublist2023&SrcAuth=WosAPI&KeyUT=WOS:000972614300001&DestLinkType=FullRecord&DestApp=WOS
U2 - 10.1016/j.amjsurg.2022.10.011
DO - 10.1016/j.amjsurg.2022.10.011
M3 - Article
C2 - 36344305
SN - 0002-9610
VL - 225
SP - 715
EP - 723
JO - American Journal of Surgery
JF - American Journal of Surgery
IS - 4
ER -