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This study analyzed clusters with high primary liver cancer mortality and quantified how location-based determinants are associated with mortality across the contiguous U.S.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/research-report/","Research & 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ARTICLE  \nAssociation of county level poverty with mortality from primary liver cancers  \nMatthew Ledenko  | Tushar Patel   \nDivision of Gastroenterology and Hepatology, Department of Transplantation, Mayo Clinic Florida, Jacksonville, Florida, USA  \nCorrespondence  \nTushar Patel, Division of Gastroenterology and Hepatology, Department of Transplantation, Mayo Clinic Florida, 4500 San Pablo Road, Jacksonville, FL 32224, USA. [Email:](Email: patel.tushar@mayo.edu)[ patel.tushar@mayo.edu](Email: patel.tushar@mayo.edu)  \nAbstract  \nBackground: The highly variable occurrence of primary liver cancers across the United States emphasize the relevance of location-based factors. Social determinants such as income, educational attainment, housing, and other factors may contribute to regional variations in outcomes. To evaluate their impact, this study identified and analyzed clusters of high mortality from primary liver cancers and the association of location-based determinants with mortality across the contiguous United States.  \nMethods: A geospatial analysis of age-adjusted incidence and standardized mortality rates from primary liver cancers from 2000 to 2020 was performed. Local indicators of spatial association identified hot-spots, clusters of counties with significantly higher mortality. Temporal analysis of locations with persistent poverty, defined as high (>20%) poverty for at least 30 years, was performed. Social determinants were analyzed individually or globally using composite measures such as the social vulnerability index or social deprivation index. Disparities in county level social determinants between hot-spots and non-hot-spots were analyzed by univariate and multivariate logistic regression.  \nResults: There are distinct clusters of liver cancer incidence and mortality, with hotspots in east Texas and Louisiana. The percentage of people living below the poverty line or Hispanics had a significantly higher odds ratio for being in the top quintile for mortality rates in comparison to other quintiles and were highly connected with mortality rates. Current and persistent poverty were both associated with an evolution from non-hotspots to new hotspots of mortality. Hotspots were predominantly associated with locations with significant levels of socioeconomic vulnerability or deprivation.  \nConclusions: Poverty at a county level is associated with mortality from primary liver cancer and clusters of higher mortality. These findings emphasize the importance of addressing poverty and related socio-economic determinants as modifiable factors in public health policies and interventions aimed at reducing mortality from primary liver cancers.  \nThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.  \n© 2024 The Author(s). Cancer Medicine published by John Wiley & Sons Ltd.  \nCancer Medicine. 2024;13:e7463 .  \n[https://doi.org/10.1002/cam4.7463](https://doi.org/10.1002/cam4.7463)  \n[wileyonlinelibrary.com/journal/cam4](wileyonlinelibrary.com/journal/cam4)  \n1 of 13  \nKEYWORDS  \ngeospatial analyses, health disparities, hepatobiliary cancer, social determinants of health, social vulnerability  \n1 | INTRODUCTION  \nPrimary liver cancers (PLC) are a major cause of cancerrelated burden globally. There are several distinct histological types of PLC with different cells of origin, genetics and risk factors. The major types are hepatocellular carcinoma and cholangiocarcinoma. The development of these cancers involves multiple factors, often involving chronic inflammation from chronic hepatitis B or C infections, toxins, or metabolic disorders that lead to cirrhosis.  \nPublic health measures and preventative measures that target specific risk factors, such as chronic viral hepatitis, have decreased liver cancer mortality. Despite this, their incidence is pr","cbCaid7c86W60q4z","https://ap.wps.com/l/cbCaid7c86W60q4z","pdf",3176936,13,"English","# Abstract\n## Background\n## Methods\n## Results\n## Conclusions\n# Introduction","[{\"question\":\"What was the main goal of the study?\",\"answer\":\"To identify clusters (hot-spots) of high mortality from primary liver cancers and evaluate how location-based social determinants are associated with mortality across the contiguous United States.\"},{\"question\":\"How were hot-spots of liver cancer mortality identified?\",\"answer\":\"Through geospatial analysis using age-adjusted incidence and standardized mortality rates from 2000 to 2020, supported by local indicators of spatial association to find counties with significantly higher mortality.\"},{\"question\":\"Which social determinants were most strongly linked to higher mortality?\",\"answer\":\"County-level poverty and Hispanic population presence showed significantly higher odds for being in the top mortality quintile, and hot-spots were largely associated with socioeconomic vulnerability and deprivation measures.\"}]","Association of county level poverty with mortality from primary liver cancers | PDF",1790003222,33]