Income Persistence and the Risk of Hepatocellular Carcinoma in Individuals with Type 2 Diabetes

Area of Science:

• Oncology
• Epidemiology
• Health Economics

Background:

• Hepatocellular carcinoma (HCC) is a significant health concern, particularly in individuals with type 2 diabetes (T2D).
• The influence of socioeconomic factors, such as income, on HCC risk in this population remains incompletely understood.

Purpose of the Study:

• To investigate the cumulative effect of income status on the risk of developing HCC.
• To examine the duration-dependent relationship between prolonged low or high income and HCC incidence in adults with T2D.

Main Methods:

• Analysis of a nationwide cohort of 1,516,897 adults with T2D from the National Health Insurance Service (2015-2016 baseline).
• Categorization of annual income into quartiles based on health insurance premiums.
• Assessment of cumulative income status over 5 years and identification of incident HCC using ICD-10 codes.

Main Results:

• Consistent high-income status was associated with a reduced HCC risk (HR: 0.68; 95% CI: 0.65, 0.72).
• Consistent low-income status was linked to an increased HCC risk (HR: 1.34; 95% CI: 1.26, 1.43).
• A significant duration-dependent trend was observed for both low and high income, with Ptrend < .0001.

Conclusions:

• Prolonged low- or high-income status is independently associated with HCC risk in individuals with T2D.
• Income stability plays a crucial role in modulating HCC incidence within the T2D population.
• The findings highlight the importance of socioeconomic factors in diabetes care and cancer prevention strategies.