IDDF2023-ABS-0020 Shifting patterns of hepatocellular carcinoma mortality risk: the impact of socioeconomic status and ethnicity in NSW, australia

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Background Hepatocellular carcinoma (HCC) is a significant global public health concern with increasing mortality rates. This study aimed to examine the impact of various sociodemographic and clinical factors on HCC mortality in New South Wales (NSW), Australia. Methods We conducted a 15-year retrospective study (2001-2015) using data linkage of key health records and cancer registry databases, to identify all HCC cases and analyse HCC-related and all-cause mortality rates (IDDF2023-ABS-0020 Figure 1. Flowchart of data linkage and final study cohort). Location-based socioeconomic status (SES) was determined using the Socioeconomic Indexes for Areas (SEIFA). Multivariable Cox regression analysis was used to determine the effect of key variables on mortality. Results 5564 cases of HCC were diagnosed in NSW during the study period. A study cohort of 5454 cases was analysed after excluding cases with missing data (IDDF2023-ABS-0020 Figure 1. Flowchart of data linkage and final study cohort). More than half of the chronic liver disease cases were due to non-viral causes. During the study period, 3645 deaths occurred, of which 2592 were HCC-related. The median survival time for HCC-related deaths was 365 days, and the 5-year survival rate was 21.4% (IDDF2023-ABS-0020 Figure 2. Kaplan Meier curve for HCC-related death with 95 CI). Higher HCC-related mortality rates were observed in SEIFA quintiles 3 and 4, compared to 5 (where SEIFA 1 is most disadvantaged, and SEIFA 5 is most advantaged) (IDDF2023-ABS-0020 Figure 3. Kaplan Meier curves for factors associated with mortality caused by HCC n 2592). Furthermore, significantly increased HCC-related mortality was observed for those aged ≥65, male gender, Australian-born, hospitalized due to complications of alcohol use, having metastatic HCC at diagnosis, and not receiving surgery for HCC (IDDF2023-ABS-0020 Figure 3. Kaplan Meier curves for factors associated with mortality caused by HCC n 2592). Conclusions There is a rising prevalence of non-viral-related HCC in Australia, with higher HCC-related mortality risk among Australian-born and middle/high middle SES populations. Identifying factors contributing to these emerging disparities is crucial for developing effective prevention programs and allocating research and health resources.

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