Determining biological and behavioral determinants of hepatocellular carcinoma incidence and outcomes

Ut Southwestern Medical Center, Dallas TX

Investigators

Linked publications, trials & patents

Abstract

Hepatocellular carcinoma (HCC) is the fastest rising cause of cancer-related death in the U.S. and a leading cause of death in patients with cirrhosis. Epidemiologic data demonstrate that certain populations, including men and older individuals, have consistently higher HCC incidence and mortality across diverse settings and time periods. Despite this well-established pattern, the underlying biologic and behavioral contributors to these differences remain unclear – particularly among patients with cirrhosis, the primary at-risk population in the U.S. This project applies a multilevel conceptual framework to identify and evaluate specific biological and behavioral factors that may influence variation in HCC incidence and outcomes. This study leverages three large multicenter cohorts of patients with cirrhosis and HCC, each with robust clinical data, patient-reported outcomes, and stored serum samples. The central hypothesis that variation in HCC risk is more strongly associated with biologic mechanisms, while variation in survival may be more closely related to behavioral and social factors, will be investigated through the following Specific Aims: 1) Estimate the association between biologic characteristics and HCC risk in >4,000 patients with cirrhosis; 2) Quantify differences in HCC survival across patient subgroups; and 3) Evaluate how biologic and behavioral factors contribute to differences in HCC survival. Findings from these project aims will be triangulated to inform future strategies aimed at improving health for patients with cirrhosis and reducing the burden of HCC. The PI is a clinical researcher and hepatologist at UT Southwestern with a long-term goal of improving liver cancer outcomes through a deeper understanding of the individual-level risk factors that drive both risk and disease progression. The proposed training plan integrates advanced methods in clinical epidemiology, behavioral science, and analysis of biologic data and is supported by a multidisciplinary team of nationally recognized mentors. This project has significant