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Updated: Jan 17, 2026
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A Three-Dimensional Spheroid Model to Investigate the Tumor-Stromal Interaction in Hepatocellular Carcinoma
Published on: September 30, 2021
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Social Risk Phenotypes Are Strongly Associated With Hepatocellular Carcinoma Outcomes: A Statewide Cohort Study Using
Lauren D Nephew1,2, Allie Carter3, Nivya Varghese4
1Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Clinical and Translational Gastroenterology
|January 15, 2026
Summary
Social determinants of health (SDOH) create distinct social risk phenotypes in hepatocellular carcinoma (HCC) patients, impacting diagnosis, treatment, and survival. Identifying these phenotypes can guide targeted interventions for better HCC outcomes.
Area of Science:
- Oncology
- Public Health
- Health Disparities
Background:
- Social determinants of health (SDOH) significantly influence hepatocellular carcinoma (HCC) outcomes.
- Intersecting socioeconomic barriers create distinct social risk phenotypes among HCC patients.
- These phenotypes are associated with disparities in diagnosis, treatment, and survival.
Purpose of the Study:
- To identify and characterize social risk phenotypes in HCC patients using latent class analysis (LCA).
- To examine the association between identified social risk phenotypes and HCC diagnosis, treatment, and mortality.
- To inform the development of targeted intervention strategies for high-risk HCC patient groups.
Main Methods:
- Latent class analysis (LCA) was performed on data from 4,877 HCC patients in the Indiana State Cancer Registry (2009-2020).
- Variables included sex, race, insurance, marital status, occupation, Social Deprivation Index (SDI), and geographic distance.
- Outcomes assessed were early-stage diagnosis, receipt of curative therapy, and two-year mortality.
Main Results:
- Six distinct social risk phenotypes were identified, ranging from 'Minimal Barriers' to 'Unseen and Uninsured'.
- The 'Minimal Barriers' class exhibited the most favorable outcomes (55.4% early diagnosis, 24.4% curative therapy, 55.4% 2-year mortality).
- Other classes, particularly 'Unseen and Uninsured' (Class 6), 'Rural and Geographically Distant' (Class 4), and 'Structurally Marginalized' (Class 5), showed significantly worse outcomes, including lower diagnosis and treatment rates and higher mortality.
Conclusions:
- Social risk phenotypes, defined by intersecting SDOH, are strongly linked to HCC outcomes.
- These phenotypes highlight significant disparities in care and survival for vulnerable HCC patient populations.
- Understanding these social risk phenotypes is crucial for developing effective, risk-based intervention strategies to improve HCC care equity.
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