Disparities in Access to Care in the Multimodal Treatment of Primary Nonmetastatic Liver Cancers and Their Impact on Patient Outcomes.

Background: Liver cancer incidence and mortality have been shown to differ by race, ethnicity, and geography. This study aims to analyze disparities in the multimodal treatment of liver cancers in Louisiana.

Methods: Cases of nonmetastatic liver cancer in Louisiana from 2010 to 2020 were obtained from the Louisiana Tumor Registry. Generalized linear mixed models were used to model the receipt of therapy.

Results: A total of 2948 patients met inclusion criteria where 30.5% received no therapy. Multivariable models identified patients with increased odds of pursuing no treatment which include those 70 and older, no domestic partner, uninsured, high poverty, and rural residence (p < 0.05).

Conclusions: Available therapeutic modalities are underutilized in Louisiana with a considerable number of patients receiving no treatment for liver cancer. Older age, no domestic partner, uninsured, rural residence, and high poverty are risk factors for not receiving treatment. Allocating resources to these patients is an important step in reversing inequities.