Hepatocellular carcinoma (HCC) is the fastest growing cause of cancer mortality in the United States. HCC is preventable, and it disproportionately affects migrants with unrecognized asymptomatic Chronic Viral Hepatitis (CVH). The long-term goal of this project is to reduce the occurrence of preventable liver cancer in migrant populations. The overall objective of this proposal is to estimate the Chronic Viral Hepatitis (CVH) and Hepatocellular Carcinoma (HCC) prevalence among migrants, to detect key identifiers associated with high- burden groups, and to describe the comorbidities and outcomes of those groups. The purpose of achieving this goal is to reduce the occurrence of preventable liver cancer in migrant populations. This study will contribute to this through the generation of the epidemiological data required for patients, practitioners, and policymakers alike to more readily identify the migrant groups that would benefit most from strategic screening and surveillance. The central hypothesis is that HCC and CVH risk and outcomes among migrants can be estimated by demographics. This will be tested by pursuing two specific aims: 1) Establish prevalence of CVH and HCC among migrant populations; and 2) Identify CVH and HCC comorbidities and outcomes within the migrant population. Under the first aim, a proven CVH and HCC disease model will be paired with migrant population statistics to establish the risk profiles for distinct migrant populations, including age group and country-of-origin. Under the second aim, an existing retrospective, population-wide health dataset will be utilized to identify common concomitant disease and outcomes among distinct migrant populations. The proposed research is innovative because it focuses on identifying key characteristics unique to specific migrant populations and establishing the associated CVH and HCC risk profiles. If achieved, the results are expected to be significant because they will contribute to resolving the current knowledge gaps in the disease burden and disparities of distinct migrant populations, allowing for risk stratifying and appropriate modifications to impact screening policy and practice.
Each year 700,000 people die from hepatocellular carcinoma and nearly all of these deaths are preventable with appropriate screening and treatment. Migrants to the United States have increased risk due to unrecognized viral hepatitis infections but have poorer access to screening and treatment, resulting in disproportionally high rates of cancer and death. This proposal seeks to reduce preventable cancer deaths in migrants by improving our understanding of who should be screened and how they should be treated, this knowledge will have a direct impact on health policy and patient care, helping people to live longer, healthier lives.
