Ethnic and Racial Disparities in the Initial Presentation of Hepatocellular Carcinoma: A Single-Site Clinical Analysis at a Non-Academic Center in Los Angeles County

Summary for Medical Professionals

Title: Ethnic and Racial Disparities in the Initial Presentation of Hepatocellular Carcinoma: A Single-Site Clinical Analysis at a Non-Academic Center in Los Angeles County
Authors: Isabella Martinez BS¹², Michel Mendler MD¹, and Edward Mena MD MBA FAASLD¹
Institutions: ¹ California Liver Research Institute (Pasadena, CA); ² Rush Medical College (Chicago, IL)

HCC Poster - I. Martinez

Background

The rising incidence of hepatocellular carcinoma (HCC) in the United States parallels national increases in obesity, type 2 diabetes (T2DM), and metabolic dysfunction-associated steatotic liver disease (MASLD) and steatohepatitis (MASH).
Among U.S. ethnic groups, Hispanic/Latino (HL) populations face the highest rates of MASLD and MASH, contributing to a ~4.7 % increase in HCC since 2000 and persistently poorer survival compared to other groups

HCC Poster - I. Martinez

Objective

To evaluate racial and ethnic disparities in the initial presentation, metabolic profile, and disease severity of patients newly diagnosed with HCC at a community hepatology practice serving Los Angeles County.

Methods

A retrospective review was conducted on 187 patients newly evaluated for HCC between July 2018 – July 2023.
Diagnosis was established per AASLD imaging criteria (MRI/CT).
Data included:

Underlying etiology of liver disease (MASLD, alcohol use, HBV, HCV) and presence of cirrhosis.
Demographics and socioeconomic variables.
Clinical features (BMI, T2DM status, HCC staging within Milan/UCSF criteria).
Univariate comparisons were performed by ethnicity and race. Institutional Review Board (IRB) approval was obtained
HCC Poster - I. Martinez

Results

Hispanic/Latino patients demonstrated a higher prevalence of cirrhosis secondary to MASLD and alcohol-associated liver disease.
They also had higher BMI, greater T2DM prevalence, and a higher incidence of HCC without cirrhosis than other groups.
Asian patients most frequently had HBV-related HCC, including non-cirrhotic cases.
Compared with non-Latino groups, Hispanic/Latino patients presented with more advanced tumor stage, fewer surgical resections, and a greater need for systemic therapy.

Conclusions

This single-site, real-world study underscores that metabolic and social disparities drive earlier fibrosis and more advanced HCC at presentation among Hispanic/Latino patients.
Findings highlight the necessity for:

Targeted screening for MASLD and diabetes in high-risk populations,
Culturally informed prevention and surveillance programs, and
Broader inclusion of under-represented groups in HCC clinical research.

Presented at:European Association for the Study of the Liver (EASL) — The International Liver Congress™, Milan 2024.

Summary for General Visitors

Understanding Liver-Cancer Inequities in Los Angeles

Researchers at the California Liver Research Institute examined nearly 200 patients newly diagnosed with liver cancer (HCC) to learn how health and background influence disease severity.

Key Insights

Hispanic/Latino patients were more likely to have fatty liver disease (MASLD), diabetes, and obesity, and often developed liver cancer without prior cirrhosis.
They tended to be diagnosed later, leading to fewer surgical options and greater reliance on systemic treatments.
Asian patients most commonly had liver cancer related to hepatitis B, which can occur even without liver scarring.

Why It Matters

These findings reveal how metabolic health and social inequality contribute to liver cancer risk and outcomes. They reinforce the importance of:

Routine screening for people with fatty liver or hepatitis B,
Education and prevention campaigns within Hispanic and Asian communities, and
Equal access to specialized care and clinical research trials.