Liver cancer screening guidelines are putting African-Americans are greater risk

NEW YORK — Early detection is key to beating liver cancer. Unfortunately, current screening guidelines are failing the African-American community, according to a study by researchers at Mount Sinai Hospital.

Study authors say most African-Americans diagnosed with liver cancer have faced a worse prognosis than other demographics over the years. To try and understand why this is happening, the team at Mount Sinai launched an investigation into patients with hepatitis C. Researchers consider this condition the number one cause of liver cancer in the U.S.

A viral Hepatitis C infection can also lead to cirrhosis, which can raise one’s risk of liver cancer considerably. Current health guidelines recommend that anyone with cirrhosis be screened for liver cancer.

What do screenings miss in Black patients?

For African-Americans, however, it appears the rate of liver damage is slower than in other racial or ethnic groups. The study finds liver cancer risk among Black patients may start earlier, perhaps even before cirrhosis appears. Study authors find that nearly one-third of Black liver cancer patients in their report would not have qualified for liver cancer screening using current cirrhosis detection methods.

Moreover, liver cancer tumors among African-American patients tend to be bigger, more invasive, more aggressive, and appear in larger numbers.

“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,” says lead study author Umut Sarpel, MD, Associate Professor of Surgery and Medical Education at the Icahn School of Medicine at Mount Sinai, in a media 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.”

The study examined a total of 1,195 patients with cancer who had a history of hepatitis C exposure. Among that sample, 390 are African-American.

The study is published in CANCER.

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John Anderer

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